中国学龄儿童心血管健康状况评价

王西婕; 邹志勇; 董彦会; 董彬; 马军; 梁万年

doi:10.16835/j.cnki.1000-9817.2024037

中国学龄儿童心血管健康状况评价

doi: 10.16835/j.cnki.1000-9817.2024037

王西婕^{1, 2},
邹志勇³,
董彦会³,
董彬^3, ,,
马军³,
梁万年^{1, 2}

1.
清华大学万科公共卫生与健康学院，北京 100190
2.
清华大学健康中国研究院
3.
北京大学儿童青少年卫生研究所

基金项目:

国家自然科学基金项目 82204067

国家自然科学基金项目 81903344

美赞臣学优营养科研基金项目 CASNHP-MJN2023-11

清华大学万科公共卫生与健康学院博士后科研专项项目 2022BH01

详细信息

作者简介:
王西婕(1992-)，女，北京市人，博士，助理研究员，主要研究方向为肥胖相关代谢性疾病的早期预防

通讯作者:
董彬，E-mail: bindong@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: R179 G479 R331.3⁺⁶
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出版历程
- 收稿日期: 2023-09-11
- 修回日期: 2024-01-08
- 网络出版日期: 2024-02-01
- 刊出日期: 2024-01-25

Cardiovascular health status in Chinese school-aged children

WANG Xijie^{1, 2},
ZOU Zhiyong³,
DONG Yanhui³,
DONG Bin^{3
, ,},
MA Jun³,
LIANG Wannian^{1, 2}

1.
Vanke School of Public Health, Tsinghua University, Beijing (100190), China

摘要

摘要: 目的了解中国学龄儿童心血管健康状况，为促进中国学龄儿童的心血管健康提供参考依据。方法数据来源于2013年在中国7省份开展的、具有全国代表性的多中心横断面研究，其原始研究采用多阶段整群抽样方法，本研究纳入其中健康行为和健康结局指标齐全的10 326名5~19岁儿童。使用美国心脏协会“生活八要素”(LE 8)指标评价中国学龄儿童的整体心血管健康状况，健康行为指标包括膳食、体力活动、烟草暴露和睡眠健康；健康结局指标包括体质量指数(BMI)、空腹血糖、血脂和血压。结果男童平均LE 8为73.3(IQR=14.4)分，女童为73.4(IQR=13.5)分。线性回归分析结果显示，与≤9岁组相比，13~15岁组健康行为得分最低，男童β值为-7.73(95%CI=-8.35~-7.12，P < 0.01)，女童β值为-9.15(95%CI=-9.83~-8.48，P < 0.01)；≥16岁组健康结局得分最低，男童β值为-7.85(95%CI=-9.07~-6.63，P < 0.01)，女童β值为-6.11(95%CI=-7.12~-5.09，P < 0.01)。结论中国学龄儿童的心血管健康水平处于一般水平。LE 8指标不同群体间存在很大差异，需要采取有针对性的干预策略，改善学龄儿童心血管健康。
- 心血管系统 /
- 美国心脏协会 /
- 回归分析 /
- 儿童
Abstract: Objective The American Heart Association released the Life's Essential 8 (LE 8) for the overall evaluation of cardiovascular health (CVH) on individual level. The present study aimed to describe the overall CVH in Chinese school-aged children using LE 8 metrics. Methods Data of the present analysis came from a national-representative multicentered cross-sectional study conducted in 7 provinces of China in 2013. The original study used a multistage cluster sampling method. A total of 10 326 children aged 5 to 19 years with complete data of health behaviors and health outcomes were included in the study. Children's health behavior indicators included diet, physical activity, nicotine exposure and sleep health. Health outcome factors included body mass index, fast blood glucose, lipid profile and blood pressure. Results The median CVH score was 73.3 (IQR=14.4) in boys and 73.4 (IQR=13.5) in girls. Compared to children aged ≤9 years, the health behavior scores were lowest in the 13-15 age group, with boys scoring 7.73 lower (95%CI=-8.35--7.12, P < 0.01) and girls scoring 9.15 (95%CI=-9.83--8.48, P < 0.01) lower. The ≥16 age group had the lowest health outcome scores, with boys scoring 7.85 (95%CI=-9.07--6.63, P < 0.01) lower and girls scoring 6.11 (95%CI=-7.12--5.09, P < 0.01) lower. Conclusions Chinese school-aged children are generally at a moderate level of cardiovascular health. Specific LE 8 components vary substantially between groups and therefore require targeted intervention strategies.
- Cardiovascular system /
- American heart association /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 依照“生活八要素”判定中国学龄儿童心血管健康状态分类和所占比例

Figure 1. Proportion of high, moderate and low cardiovascular health status according to LE 8 and its components among Chinese school-aged children

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图 2 中国学龄儿童“生活八要素”及指标平均得分随年龄变化趋势

Figure 2. Mean scores of LE 8 and its components among Chinese school-aged children

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表 1 不同性别研究对象一般特征比较(x±s)

Table 1. Characteristics of participants by sex (x±s)

性别	人数	健康行为					健康结局
性别	人数	水果摄入/(g·d^-1)^*	蔬菜摄入/(g·d^-1)^*	肉类摄入/(g·d^-1)^*	含糖饮料摄入/(mL·d^-1)^*	体力活动/(min·d^-1)^*	BMI/(kg·m^-2)	non-HDL-C/(mg·dL^-1)^*	空腹血糖/(mg·dL^-1)	收缩压/mmHg	舒张压/mmHg
男	5 316	200.0(142.9, 400.0)	342.9(200.0, 400.0)	50.0(35.7, 100.0)	64.3(42.9, 128.6)	360.0(180.0, 660.0)	19.3±4.16	90.49(69.22, 110.21)	76.24±23.52	106.23±12.50	66.86±9.21
女	4 950	200.0(142.9, 400.0)	400.0(200.0, 400.0)	50.0(25.0, 53.6)	42.9(21.4, 85.7)	270.0(140.0, 510.0)	18.5±3.66	95.13(72.31, 114.46)	73.91±23.15	102.75±11.41	65.58±8.75
t/Z值		0.51	1.41	13.34	11.18	8.81	9.66	-3.37	5.06	14.69	7.22
P值		0.26	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
注： *采用M(P₂₅，P₇₅)描述；1 mmHg=0.133 kPa。

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表 2 各省份(直辖市)2013年学龄儿童LE 8及指标得分[M(IQR)]

Table 2. Scores of Life's Essential 8 and its components among Chinese school-aged children in 2013, by provinces[M(IQR)]

省份	男童									女童
省份	膳食	体力活动	烟草暴露	睡眠健康	BMI	non-HDL-C	空腹血糖	血压	总分	膳食	体力活动	烟草暴露	睡眠健康	BMI	non-HDL-C	空腹血糖	血压	总分
湖南	50(55)	80(60)	80(20)	30(57)	100(30)	100(40)	100(0)	100(0)	75.0(12.9)	50(55)	60(70)	80(20)	40(57)	100(0)	60(40)	100(0)	100(0)	75.0(12.5)
宁夏	50(55)	80(60)	80(20)	30(20)	100(30)	100(0)	100(0)	100(25)	73.1(12.5)	50(55)	60(60)	80(20)	30(20)	100(0)	100(0)	100(0)	100(25)	73.8(13.8)
天津	50(55)	90(60)	80(20)	30(57)	100(85)	100(40)	100(0)	100(50)	72.1(15.3)	50(55)	80(60)	80(20)	30(57)	100(70)	100(40)	100(0)	100(25)	71.3(14.0)
重庆	50(55)	90(60)	80(20)	40(57)	100(70)	100(40)	100(0)	100(0)	75.7(13.5)	50(55)	60(60)	80(20)	40(57)	100(0)	100(40)	100(0)	100(0)	73.4(12.8)
辽宁	50(55)	60(60)	80(20)	40(57)	100(85)	100(0)	100(0)	100(25)	73.1(14.0)	50(55)	40(80)	80(20)	40(57)	100(30)	100(0)	100(0)	100(25)	74.5(13.4)
上海	80(55)	80(60)	80(20)	30(57)	100(70)	100(40)	100(0)	100(25)	70.3(15.9)	50(55)	60(60)	80(20)	30(57)	100(30)	60(60)	100(0)	100(0)	72.0(13.0)
广州	80(30)	80(60)	100(20)	30(57)	100(70)	60(60)	100(0)	100(0)	73.8(14.6)	80(30)	60(60)	100(20)	30(57)	100(0)	60(60)	100(0)	100(0)	74.6(12.1)
总体	50(55)	80(60)	80(20)	30(57)	100(70)	100(40)	100(0)	100(25)	73.3(14.4)	50(55)	60(60)	80(20)	30(57)	100(0)	100(40)	100(0)	100(0)	73.4(13.5)

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表 3 不同性别年龄学龄儿童LE 8指标得分线性回归分析

Table 3. Linear regression analysis of cardiovascular health status scores in school-aged children, by age group and sex

性别	年龄/岁	健康行为		健康结局		LE 8总分
性别	年龄/岁	β值(95%CI)	P值	β值(95%CI)	P值	β值(95%CI)	P值
男童	≤9	1.00		1.00		1.00
(n=5 376)	10~12	-4.15(-4.74~-3.55)	< 0.01	-1.96(-2.87~-1.06)	< 0.01	-0.95(-1.70~-0.19)	0.01
	13~15	-7.73(-8.35~-7.12)	< 0.01	-2.09(-3.02~-1.16)	< 0.01	-1.78(-2.56~-1.00)	< 0.01
	≥16	-6.69(-7.4~-5.98)	< 0.01	-7.85(-9.07~-6.63)	< 0.01	-2.58(-3.54~-1.62)	< 0.01
女童	≤9	1.00		1.00		1.00
(n=4 950)	10~12	-5.39(-6.03~-4.75)	< 0.01	-1.28(-2.10~-0.47)	< 0.01	-0.65(-1.39~0.08)	0.08
	13~15	-9.15(-9.83~-8.48)	< 0.01	-2.25(-3.04~-1.45)	< 0.01	-3.20(-3.96~-2.44)	< 0.01
	≥16	-8.38(-9.14~-7.62)	< 0.01	-6.11(-7.12~-5.09)	< 0.01	-2.68(-3.57~-1.80)	< 0.01
注：模型调整了个体城乡居住地及出生体重。

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表 4 不同性别年龄别学龄儿童健康行为得分线性回归分析

Table 4. Linear regression analysis of cardiovascular health behavior scores in school-aged children, by age group and sex

性别	年龄/岁	膳食		体力活动		烟草暴露		睡眠健康
性别	年龄/岁	β值(95%CI)	P值	β值(95%CI)	P值	β值(95%CI)	P值	β值(95%CI)	P值
男童	≤9	1.00		1.00		1.00		1.00
(n=5 376)	10~12	-10.11(-11.47~-8.76)	< 0.01	6.73(5.51~7.95)	< 0.01	0.43(-0.03~0.90)	0.07	-5.19(-6.04~-4.34)	< 0.01
	13~15	-17.92(-19.25~-16.59)	< 0.01	5.40(4.14~6.67)	< 0.01	0.33(-0.15~0.82)	0.18	-7.29(-8.25~-6.33)	< 0.01
	≥16	-22.95(-24.63~-21.28)	< 0.01	1.20(-0.49~2.89)	0.16	-1.18(-1.85~-0.52)	< 0.01	6.19(4.99~7.39)	< 0.01
女童	≤9	1.00		1.00		1.00		1.00
(n=4 950)	10~12	-7.83(-9.36~-6.30)	< 0.01	3.60(2.29~4.91)	< 0.01	0.99(0.57~1.41)	< 0.01	-5.57(-6.44~-4.69)	< 0.01
	13~15	-16.56(-18.01~-15.10)	< 0.01	-3.05(-4.38~-1.71)	< 0.01	0.75(0.33~1.18)	< 0.01	-9.16(-10.15~-8.18)	< 0.01
	≥16	-18.73(-20.51~-16.95)	< 0.01	-12.51(-14.28~-10.75)	< 0.01	1.07(0.52~1.62)	< 0.01	-0.24(-1.38~0.89)	0.68
注：模型调整了个体城乡居住地及出生体重。

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表 5 不同性别年龄别学龄儿童健康结局得分线性回归分析

Table 5. Linear regression analysis of cardiovascular health outcome scores in school-aged children, by age group and sex

性别	年龄/岁	BMI Z评分		non-HDL-C		空腹血糖		血压
性别	年龄/岁	β值(95%CI)	P值	β值(95%CI)	P值	β值(95%CI)	P值	β值(95%CI)	P值
男童	≤9	1.00		1.00		1.00		1.00
(n=5 376)	10~12	-5.86(-7.02~-4.70)	< 0.01	1.04(-0.54~2.61)	0.21	-0.33(-0.79~0.13)	0.16	-3.35(-3.99~-2.71)	< 0.01
	13~15	-5.78(-6.99~-4.57)	< 0.01	7.37(5.74~8.99)	< 0.01	-0.54(-1.03~-0.06)	0.03	-5.92(-6.58~-5.27)	< 0.01
	≥16	-15.04(-16.68~-13.41)	< 0.01	3.18(1.04~5.33)	< 0.01	-1.42(-2.05~-0.78)	0	-11.13(-12.01~-10.24)	< 0.01
女童	≤9	1.00		1.00		1.00		1.00
(n=4 950)	10~12	-4.15(-5.19~-3.12)	< 0.01	3.71(2.03~5.39)	< 0.01	-0.47(-0.78~-0.16)	< 0.01	-3.76(-4.35~-3.17)	< 0.01
	13~15	-9.53(-10.57~-8.50)	< 0.01	5.26(3.59~6.93)	< 0.01	-0.23(-0.54~0.08)	0.14	-2.23(-2.81~-1.65)	< 0.01
	≥16	-16.7(-18.05~-15.35)	< 0.01	1.44(-0.69~3.57)	0.19	-0.72(-1.11~-0.32)	0	-1.98(-2.73~-1.23)	0.68
注：模型调整了个体城乡居住地及出生体重。

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