Sex differences in cardiovascular health among children aged 6-8 years in Beijing City
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摘要:
目的 探索北京市6~8岁儿童心血管健康(CVH)的性别差异，为CVH相关生活方式的早期干预提供依据。 方法 基于北京儿童生长与健康队列(PROC)1 914名6~8岁儿童的体格检查、问卷调查、实验室检测数据，根据生命八要素(Life's Essential 8)评分标准计算儿童CVH评分及其分项(健康行为)和(健康因素)评分，并分为较高、中等、较低3个等级；采用χ2检验和Wilcoxon秩和检验比较性别差异。 结果 1 914名儿童中，较高、中等、较低CVH的比例分别为35.7%，63.5%，0.8%，健康行为评分比例分别为25.9%，67.5%，6.6%，性别间差异均无统计学意义(χ2值分别为2.30，0.07，P值均＞0.05)。男童和女童较高、中等、较低健康因素评分比例分别为61.1%，36.0%，2.9%和71.1%，28.4%，0.5%，差异有统计学意义(χ2=31.88，P＜0.01)。总体CVH评分为76.0(70.0，83.0)分，男童为76.0(69.0，82.0)分，女童为77.0(71.0，83.0)分。健康行为指标中，睡眠评分最好[100.0(90.0，100.0)]，体力活动评分最差[40.0(20.0，80.0)]；健康因素指标中，血糖评分最好[100.0(100.0，100.0)]，血脂评分最差[60.0(40.0，100.0)]。健康因素中体质量指数(BMI)、血脂、血糖、血压评分性别间差异均有统计学意义(Z值分别为-6.92，3.01，-6.60，-2.30，P值均＜0.05)，健康行为中膳食、体力活动、尼古丁暴露、睡眠评分性别间差异均无统计学意义(Z值分别为0.99，0.88，-0.13，0.36，P值均＞0.05)。相比于男童，较低和中等CVH组的女童健康行为评分更低，健康因素评分更高。 结论 北京市6~8岁儿童心血管健康大多处于良好及以上水平。可通过改善生活方式、监测健康因素指标，特别是男童的实验室检测指标，进而提高儿童CVH水平。 Abstract:Objective To explore sex difference in the cardiovascular health (CVH) status of 6-8 year old children in Beijing, so as to inform the early intervention of CVH-related lifestyles. Methods Based on the Beijing Children's Growth and Health Cohort (PROC), baseline physical examination, sequential questionnaire survey, and laboratory tests were conducted among 1 914 grade 1 students. Children's CVH and its subscales (health behaviors and health factors) scores were calculated according to the Life's Essential 8 (LE 8) index and categorized into high, moderate, and low CVH. CVH scores were reported as medians and interquartile ranges; sex differences were compared using the Chi-square test and Wilcoxon test. Results Among the 1 914 participants, the percentages of high, moderate, and low CVH were 35.7%, 63.5%, and 0.8%, respectively, and the percentages of high, moderate, and low health behavior scores were 25.9%, 67.5%, and 6.6%, respectively, with no statistically significant differences between sex (χ2=2.30, 0.07, P>0.05). The rates of high, moderate, and low health factor scores for boys and girls were 61.1%, 36.0%, 2.9% and 71.1%, 28.4%, 0.5%, respectively, with a statistically significant sex difference (χ2=31.88, P < 0.01). The overall CVH score was 76.0(70.0, 83.0), 76.0(69.0, 82.0) for boys, and 77.0(71.0, 83.0) for girls. Among the health behavior metrics, sleep scores were the best and physical activity scores were the worst[100.0(90.0, 100.0), 40.0(20.0, 80.0)]; among the health factor metrics, blood glucose scores were the best and lipid scores were the worst[100.0(100.0, 100.0), 60.0(40.0, 100.0)]. In respect to health factors, there were significant gender differences in body mass index, blood lipids, blood sugar, and blood pressure scores (Z=-6.92, 3.01, -6.60, -2.30, P < 0.05), but there were no significant gender differences in diet, physical activity, nicotine exposure, or sleep scores with regards to health behaviors (Z=0.99, 0.88, -0.13, 0.36, P>0.05). Compared to boys, girls in the low and moderate CVH groups had high health factor scores despite low health behavior scores. Conclusion Most 6- to 8-year-old children in Beijing were found to have relatively good CVH, and optimization of children's CVH status can be achieved by promoting healthier lifestyles and monitoring health factors, especially among boys. -
Key words:
- Cardiovascular system /
- Sex factors /
- Child /
- Health behavior
1) 利益冲突声明 所有作者声明无利益冲突。2) 关梦颖与江晓峰为共同第一作者。 -
表 1 北京市6~8岁男女童心血管健康与健康行为、健康因素等级构成比较
Table 1. Comparison of CVH and health behavior, health factors levels among boys and girls aged 6-8 years in Beijing
性别 人数 CVH等级 健康行为评分 健康因素评分 较高 中等 较低 较高 中等 较低 较高 中等 较低 男 956 327(34.2) 620(64.9) 9(0.9) 250(26.1) 644(67.4) 62(6.5) 584(61.1) 344(36.0) 28(2.9) 女 958 356(37.2) 596(62.2) 6(0.6) 246(25.7) 648(67.6) 64(6.7) 681(71.1) 272(28.4) 5(0.5) χ2值 2.30 0.07 31.88 P值 0.32 0.96 ＜0.01 注： ()内数字为构成比/%。 
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表 2 北京市6~8岁男女童生命八要素各项评分[M(Q1, Q3)]
Table 2. The LE 8 scores for boys and girls aged 6-8 in Beijing by sex[M(Q1, Q3)]
性别 人数 总CVH评分 健康行为评分 健康因素评分 膳食 体力活动 尼古丁暴露 睡眠 BMI 血脂 血糖 血压 男 956 76.0(69.0，82.0) 50.0(25.0，50.0) 40.0(20.0，90.0) 80.0(80.0，100.0) 100.0(90.0，100.0) 100.0(75.0，100.0) 60.0(40.0，100.0) 100.0(100.0，100.0) 100.0(75.0，100.0) 女 958 77.0(71.0，83.0) 50.0(25.0，50.0) 40.0(20.0，80.0) 80.0(80.0，100.0) 100.0(70.0，100.0) 100.0(100.0，100.0) 60.0(40.0，100.0) 100.0(100.0，100.0) 100.0(75.0，100.0) 合计 1 914 76.0(70.0，83.0) 50.0(25.0，50.0) 40.0(20.0，80.0) 80.0(80.0，100.0) 100.0(90.0，100.0) 100.0(75.0，100.0) 60.0(40.0，100.0) 100.0(100.0，100.0) 100.0(75.0，100.0)
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表 3 北京市不同CVH等级6~8岁儿童CVH、健康行为和健康因素评分[M(Q1，Q3)]
Table 3. Scores of CVH and health behavior, health factors of three cardiovascular health levels among children aged 6-8 years in Beijing[M(Q1, Q3)]
性别 CVH等级 人数 CVH评分 健康行为评分 健康因素评分 男 较高 327 84.0(81.0, 88.0) 80.0(73.0, 85.0) 90.0(85.0, 100.0) 中等 620 71.0(66.0, 76.0) 65.0(56.0, 71.0) 79.0(68.0, 88.0) 较低 9 48.0(45.0, 49.0) 48.0(44.0, 50.0) 43.0(40.0, 51.0) 女 较高 356 84.0(82.0, 88.0) 80.0(74.0, 85.0) 90.0(85.0, 100.0) 中等 596 73.0(68.0, 76.0) 63.0(56.0, 68.0) 81.0(73.0, 90.0) 较低 6 48.0(46.0, 49.0) 36.0(36.0, 41.0) 51.0(46.0, 60.0) 总计 较高 683 84.0(81.0, 88.0) 80.0(73.0, 85.0) 90.0(85.0, 100.0) 中等 1 216 72.0(67.0, 76.0) 63.0(56.0, 70.0) 80.0(69.0, 88.0) 较低 15 48.0(45.0, 49.0) 44.0(36.0, 50.0) 48.0(40.0, 56.0)
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