厦门市儿童肥胖和高血压共病现状及其多维度影响因素

张奕; 蒋家诺; 陈力; 刘婕妤; 袁雯; 郭桐君; 董彦会; 马军

doi:10.16835/j.cnki.1000-9817.2023.10.006

厦门市儿童肥胖和高血压共病现状及其多维度影响因素

doi: 10.16835/j.cnki.1000-9817.2023.10.006

北京大学公共卫生学院/北京大学儿童青少年卫生研究所, 北京 100191

基金项目:

国家自然科学基金项目 82103865

北京市自然科学基金项目 7222244

详细信息

作者简介:
张奕(1999-), 女, 江苏省人, 在读硕士, 主要研究方向为儿童青少年生长发育及其影响因素

通讯作者:
马军, E-mail: majunt@bjmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R723.14 R544.1 R179
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出版历程
- 收稿日期: 2023-06-01
- 修回日期: 2023-07-28
- 网络出版日期: 2023-10-27
- 刊出日期: 2023-10-25

Current status and multidimensional influences on the comorbidity of obesity and high blood pressure among children in Xiamen City

Institute of Child and Adolescent Health/School of Public Health, Peking University, Beijing (100191), China

摘要

摘要: 目的了解厦门市7~12岁儿童肥胖和高血压(HBP)共病现状及其多维度影响因素，为后续开展预防性举措提供参考依据。方法基于2017年厦门市青春期发育队列基线调查，采用整群随机抽样方法选取厦门市4 798名二至六年级学生作为研究对象，进行体格检查和问卷调查。采用单因素Logistic回归对肥胖合并HBP进行分析筛选潜在变量，采用多因素Logistic回归模型分析肥胖合并HBP的影响因素。结果儿童肥胖检出率为9.15%，HBP检出率为11.65%，男生中肥胖合并HBP检出率为3.00%，女生中肥胖合并HBP检出率为1.80%；BMI正常的儿童HBP检出率为8.28%，肥胖的儿童HBP检出率为26.88%。多因素Logistic回归模型表明，每周至少喝1次含糖饮料(OR=2.50)、每天吃咸菜/榨菜/腌菜(OR=4.52)、肥胖家族史(OR=3.09)与肥胖合并HBP呈正相关，女(OR=0.53)、每周至少吃1次高能量零食(OR=0.40)、身体活动充足(OR=0.58)与肥胖合并HBP呈负相关(P值均＜0.05)。结论厦门市7~12岁儿童肥胖与HBP共病负担存在性别差异，饮食和运动行为是影响肥胖合并HBP的主要维度。儿童肥胖和HBP防控应从饮食运动和行为环境等多维度出发，及早预防儿童肥胖和高血压共病状态的发生。
- 肥胖症 /
- 高血压 /
- 共病现象 /
- 回归分析 /
- 儿童
Abstract: Objective To understand the current status of obesity and high blood pressure (HBP) comorbidity and their multidimensional influencing factors in children aged 7-12 years in Xiamen, so as to provide reference basis for subsequent preventive measures. Methods Based on the baseline survey of the Xiamen pubertal development cohort in 2017, a total of 4 798 primary school students from second to sixth grade were selected in the study by cluster random sampling method. And physical examination and questionnaires were conducted. The Logistic regression was used to screen potential variables for obesity combined with HBP. A multivariate Logistic regression model was used to analyse the factors influencing obesity combined with HBP. Results About 9.15% children were found with obesity and 11.65% with HBP. The rate of obesity combined with HBP was 3.00% in boys and 1.80% in girls. The rate of HBP was 8.28% in normal-weight children and 26.88% in obese children. Multivariate Logistic regression models showed that consumption of sugary drinks at least once a week (OR=2.50), daily consumption of salted or pickled vegetables (OR=4.52), family history of obesity (OR=3.09) were positively associated with obesity combined with HBP (P < 0.05). Girls (OR=0.53), consumption of high-energy snacks at least once a week (OR=0.40) and adequate physical activity (OR=0.58) were negatively associated with comorbidity of obesity and HBP (P < 0.05). Conclusion Gender differences in comorbidity burden of obesity and HBP exist among children aged 7-12 years in Xiamen. Dietary behaviour and exercise behaviour are the main dimensions influencing the comorbidity of obesity and HBP. Prevention and control of obesity and HBP in children should be based on multiple dimensions, including diet and exercise behavioural environment, to prevent early the occurrence for comorbidity of obesity and HBP in children.
- Obesity /
- Hypertension /
- Comorbidity /
- Regression analysis /
- Child
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表 1 儿童肥胖合并HBP影响因素的单因素Logistic回归分析(n=4 798)

Table 1. Univariate Logistic analysis of factors affecting childhood comorbidity of obesity and hypertension(n=4 798)

自变量	OR值(95%CI)	P值
性别	0.51(0.35~0.76)	＜0.01
每日水果摄入	1.03(0.70~1.52)	0.89
每日蔬菜摄入	1.01(0.67~1.54)	0.95
每周喝含糖饮料次数	1.43(0.98~2.10)	0.07
每周吃高能量零食次数	0.53(0.36~0.78)	＜0.01
每周吃油炸食品次数	1.01(0.69~1.48)	0.95
是否每天吃咸菜/榨菜/腌菜	3.08(1.18~8.05)	0.02
是否每天吃早餐	0.69(0.35~1.35)	0.28
是否每天喝牛奶	0.68(0.47~0.99)	0.04
是否曾吸烟或喝酒	1.07(0.49~2.35)	0.87
是否睡眠＜9 h/d	0.95(0.64~1.41)	0.80
久坐时间/h	1.01(0.61~1.68)	0.96
每天中高强度身体活动时间/min	0.87(0.60~1.28)	0.49
是否身体活动充足	0.82(0.56~1.21)	0.32
出生体重/kg	1.17(0.72~1.89)	0.53
是否非母乳喂养	1.13(0.66~1.94)	0.65
母乳喂养月份	1.02(0.98~1.07)	0.36
是否剖宫产	1.22(0.81~1.83)	0.35
是否家中有人吸烟	0.95(0.65~1.39)	0.80
是否有HBP家族史	0.66(0.41~1.06)	0.09
是否有肥胖家族史	2.03(1.25~3.32)	0.01

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表 2 调整年龄后儿童肥胖合并HBP的多因素Logistic回归模型(n=4 798)

Table 2. Multivariate Logistic regression model for childhood comorbidity of obesity and HBP after adjusting for age(n=4 798)

自变量	OR值(95%CI)	P值
性别	0.53(0.30~0.95)	0.03
每周喝含糖饮料次数	2.50(1.44~4.33)	＜0.01
每周吃高能量零食次数	0.40(0.23~0.68)	＜0.01
是否每天吃咸菜/榨菜/腌菜	4.52(1.14~17.95)	0.03
是否每天喝牛奶	0.90(0.54~1.51)	0.70
是否身体活动充足	0.58(0.34~0.98)	0.04
久坐时间/h	0.99(0.89~1.10)	0.90
是否有肥胖家族史	3.09(1.71~5.56)	＜0.01
是否剖宫产	1.39(0.84~2.32)	0.21
是否家中有人吸烟	0.68(0.40~1.17)	0.16

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参考文献(30)

[1]	董彦会, 陈力, 刘婕妤, 等. 1985—2019年中国7~18岁儿童青少年超重与肥胖的流行趋势及预测研究[J]. 中华预防医学杂志, 2023, 57(4): 461-469. DONG Y H, CHEN L, LIU J Y, et al. Epidemiology and prediction of overweight and obesity among children and adolescents aged 7-18 years in China from 1985 to 2019[J]. Chin J Prev Med, 2023, 57(4): 461-469. (in Chinese)
[2]	陈力, 张奕, 马涛, 等. 2010—2019年中国7~17岁汉族儿童青少年正常高值血压和血压偏高的流行趋势[J]. 中华预防医学杂志, 2023, 57(4): 499-507. CHEN L, ZHANG Y, MA T, et al. Prevalence trend of high normal blood pressure and elevated blood pressure in Chinese Han children and adolescents aged 7-17 years from 2010 to 2019[J]. Chin J Prev Med, 2023, 57(4): 499-507. (in Chinese)
[3]	SONG P, ZHANG Y, YU J, et al. Global prevalence of hypertension in children: a systematic review and Meta-analysis[J]. JAMA Pediatr, 2019, 173(12): 1154-1163. doi: 10.1001/jamapediatrics.2019.3310
[4]	SERAVALLE G, GRASSI G. Obesity and hypertension[J]. Pharmacol Res, 2017, 122: 1-7. doi: 10.1016/j.phrs.2017.05.013
[5]	DONG B, MA J, WANG H J, et al. The association of overweight and obesity with blood pressure among Chinese children and adolescents[J]. Biom Environ Sci, 2013, 26(6): 437-444.
[6]	KIT B K, KUKLINA E, CARROLL M D, et al. Prevalence of and trends in dyslipidemia and blood pressure among US children and adolescents, 1999-2012[J]. JAMA Pediatr, 2015, 169(3): 272-279. doi: 10.1001/jamapediatrics.2014.3216
[7]	吴学坤, 蒋立新. 肥胖型高血压的研究进展[C]//国家心血管病中心. 中国心脏大会论文汇编. 北京: 中国循环杂志社, 2014: 341. WU X K, JIANG L X. Advances in the study of obese hypertension[C]//National Center for Cardiovascular Disease. Compendium of papers from the Chinese heart conference. Beijing: Chinese Circulation Journal Press, 2014: 341. (in Chinese)
[8]	MESSERLI F H, SUNDGAARD-RIISE K, REISIN E, et al. Disparate cardiovascular effects of obesity and arterial hypertension[J]. Am J Med, 1983, 74(5): 808-812. doi: 10.1016/0002-9343(83)91071-9
[9]	LEVY B I, SCHIFFRIN E L, MOURAD J J, et al. Impaired tissue perfusion a pathology common to hypertension, obesity, and diabetes mellitus[J]. Circulation, 2008, 118(9): 968-976. doi: 10.1161/CIRCULATIONAHA.107.763730
[10]	李婧雯, 张晓卉, 尹新华. 肥胖相关高血压的研究进展[J]. 临床与病理杂志, 2020, 40(4): 1006-1011. https://www.cnki.com.cn/Article/CJFDTOTAL-WYSB202004033.htm LI J W, ZHANG X H, YIN X H. Progress in obesity-related hypertension[J]. J Clin Pathol Res, 2020, 40(4): 1006-1011. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WYSB202004033.htm
[11]	WÜHL E. Hypertension in childhood obesity[J]. Acta Paediatr, 2019, 108(1): 37-43. doi: 10.1111/apa.14551
[12]	NOBRE L N, LESSA A D. Influence of breastfeeding in the first months of life on blood pressure levels of preschool children[J]. J Pediatr (Rio J), 2016, 92(6): 588-594. doi: 10.1016/j.jped.2016.02.011
[13]	李超, 王荣辉, 李琳, 等. 中国3~6岁儿童肥胖危险因素病例-对照研究的Meta分析[J]. 卫生研究, 2022, 51(4): 656-661. doi: 10.19813/j.cnki.weishengyanjiu.2022.04.026 LI C, WANG R H, LI L, et al. Meta-analysis of case-control studies on obesity risk factors in children aged 3-6 years in China[J]. J Hyg Res, 2022, 51(4): 656-661. (in Chinese) doi: 10.19813/j.cnki.weishengyanjiu.2022.04.026
[14]	贺刚, 王超, 李京诚, 等. 北京市学龄儿童睡眠时间与BMI的相关性研究[C]//中国体育科学学会. 第十二届全国体育科学大会论文摘要汇编. 日照: 中国体育科学学会学校体育分会, 2022: 1075-1077. HE G, WANG C, LI J C, et al. Correlation between sleep durationand BMI in school-age children in Beijing[C]//China Society of Sports Science. Compilation of abstracts of the 12th national congress of sport science. Rizhao: School Sports Branch of China Sports Science Society, 2022: 1075-1077. (in Chinese)
[15]	PFEUFFER M, SCHREZENMEIR J. Milk and the metabolic syndrome[J]. Obes Rev, 2007, 8(2): 109-118. doi: 10.1111/j.1467-789X.2006.00265.x
[16]	FALKNER B, LURBE E. Primordial prevention of high blood pressure in childhood: an opportunity not to be missed[J]. Hypertension, 2020, 75(5): 1142-1150. doi: 10.1161/HYPERTENSIONAHA.119.14059
[17]	LEYVRAZ M, CHATELAN A, DA COSTA B R, et al. Sodium intake and blood pressure in children and adolescents: a systematic review and Meta-analysis of experimental and observational studies[J]. Int J Epidemiol, 2018, 47(6): 1796-1810. doi: 10.1093/ije/dyy121
[18]	全国学生体质与健康调研组. 2014年全国学生体质与健康调研工作手册[M]. 北京, 2014. Chinese Student Physical Fitness and Health Research Group. Physical fitness and health research of Chinese school students workbook in 2014[M]. Beijing, 2014. (in Chinese)
[19]	中华人民共和国国家卫生健康委员会. 学龄儿童青少年超重与肥胖筛查[EB/OL]. (2018-03-30)[2023-08-31]. http://www.nhc.gov.cn/wjw/pqt/201803/a7962d1ac01647b9837110bfd2d69b26.shtml. National Health Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents[EB/OL]. (2018-03-30)[2023-08-31]. http://www.nhc.gov.cn/wjw/pqt/201803/a7962d1ac01647b9837110bfd2d69b26.shtml. (in Chinese)
[20]	中华人民共和国国家卫生健康委员会. 7~18岁儿童青少年血压偏高筛查界值[EB/OL]. (2018-07-04)[2023-05-04]. http://www.nhc.gov.cn/wjw/pqt/201807/6cee88c1d050493ab50a411a2978f901.shtml. National Health Commission of the PRC. Reference of screening for elevated blood pressure among children and adolescents aged 7-18 years[EB/OL]. (2018-07-04)[2023-05-04]. http://www.nhe.gov.cn/wjw/pqt/201807/6cee88c1d050493ab50a411a2978f901.shtml. (in Chinese)
[21]	LAVELLE G, NOORKOIV M, THEIS N, et al. Validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy: a cross-sectional study[J]. Physiotherapy, 2020, 107: 209-215. doi: 10.1016/j.physio.2019.08.013
[22]	陈婷, 范奕, 宋孝光, 等. 江西省儿童青少年超重肥胖流行现状及影响因素分析[J]. 中国学校卫生, 2021, 42(11): 1724-1727. doi: 10.16835/j.cnki.1000-9817.2021.11.028 CHEN T, FAN Y, SONG X G, et al. Analysis of prevalence and risk factors of overweight and obesity among children and adolescents in Jiangxi Province[J]. Chin J Sch Health, 2021, 42(11): 1724-1727. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.11.028
[23]	GUO X, ZHENG L, LI Y, et al. Differences in lifestyle behaviors, dietary habits, and familial factors among normal-weight, overweight, and obese Chinese children and adolescents[J]. Int J Behav Nutr Phys Act, 2012, 9: 120. doi: 10.1186/1479-5868-9-120
[24]	陈静仪. 广州市儿童青少年1985—2014年超重肥胖流行趋势[J]. 中国学校卫生, 2016, 37(12): 1915-1917. doi: 10.16835/j.cnki.1000-9817.2016.12.051 CHEN J Y. Prevalence of overweight and obesity among children and adolescents in Guangzhou, 1985-2014[J]. Chin J Sch Health, 2016, 37(12): 1915-1917. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2016.12.051
[25]	GUI Z H, ZHU Y N, CAI L, et al. Sugar-sweetened beverage consumption and risks of obesity and hypertension in Chinese children and adolescents: a national cross-sectional analysis[J]. Nutrients, 2017, 9(12): 1302.
[26]	MALIK A H, AKRAM Y, SHETTY S, et al. Impact of sugar-sweetened beverages on blood pressure[J]. Am J Cardiol, 2014, 113(9): 1574-1580.
[27]	SHI L, KRUPP D, REMER T. Salt, fruit and vegetable consumption and blood pressure development: a longitudinal investigation in healthy children[J]. Br J Nutr, 2014, 111(4): 662-671.
[28]	XI B, CHENG H, SHEN Y, et al. Physical activity modifies the associations between genetic variants and hypertension in the Chinese children[J]. Atherosclerosis, 2012, 225(2): 376-380.
[29]	JEBEILE H, KELLY A S, O'MALLEY G, et al. Obesity in children and adolescents: epidemiology, causes, assessment, and management[J]. Lancet Diabetes Endocrinol, 2022, 10(5): 351-365.
[30]	YU H J, LI F, HU Y F, et al. Improving the metabolic and mental health of children with obesity: a school-based nutrition education and physical activity intervention in Wuhan, China[J]. Nutrients, 2020, 12(1): 194.