儿童体脂偏高与血压偏高的关联

阎玉姣; 杨慧; 程安澜; 赵敏; 席波

doi:10.16835/j.cnki.1000-9817.2024309

儿童体脂偏高与血压偏高的关联

doi: 10.16835/j.cnki.1000-9817.2024309

阎玉姣^{1, 2},
杨慧^{1, 2},
程安澜^{1, 2},
赵敏³,
席波^{1, 2, ,}

1.
山东大学齐鲁医学院公共卫生学院流行病学系/儿少卫生与妇幼保健学系，济南 250012
2.
山东大学儿童心血管研究中心
3.
山东大学齐鲁医学院公共卫生学院营养与食品卫生学系

基金项目:

国家自然科学基金项目 81673195

国家自然科学基金项目 82173538

详细信息

作者简介:
阎玉姣(1997-)，女，山东青岛人，在读硕士，主要研究方向为儿童心血管流行病学

通讯作者:
席波，E-mail：xibo2010@sdu.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 R544 R446.11⁺²
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- 被引次数: 0
出版历程
- 收稿日期: 2024-05-06
- 修回日期: 2024-07-23
- 网络出版日期: 2024-11-02
- 刊出日期: 2024-10-25

Association between high body fat mass and elevated blood pressure in children

YAN Yujiao^{1, 2},
YANG Hui^{1, 2},
CHENG Anlan^{1, 2},
ZHAO Min³,
XI Bo^{1, 2
, ,}

1.
Department of Epidemiology/Department of Maternal, Child and Adolescent Health, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan (250012), Shandong Province, China

摘要

摘要: 目的探讨儿童体脂偏高与血压偏高的关联，为儿童高血压的防治提供科学依据。方法研究对象来源于2021年在山东省淄博市桓台县开展的“桓台儿童心血管健康随访队列”的第2次随访调查数据，共纳入1 266名10~15岁儿童。将体脂肪量(FM)、体脂肪率(FMP)、脂肪质量指数(FMI)、皮下脂肪质量(SFM)、内脏脂肪质量(VFM)按研究人群年龄别、性别的P₅₀分为适中和偏高两组。采用多因素Logistic回归模型分别分析5项儿童体脂指标状态与血压偏高的关系，利用限制性立方样条模型(RCS)分别分析5项儿童体脂水平与血压偏高的剂量反应关系。结果儿童FM偏高、FMP偏高、FMI偏高、SFM偏高、VFM偏高组的血压偏高检出率均分别高于适中组(P值均 < 0.05)；调整所有潜在协变量后，与适中组相比，FM偏高(OR=4.51，95%CI=3.28~6.28)、FMP偏高(OR=4.51，95%CI=3.28~6.27)、FMI偏高(OR=4.40，95%CI=3.20~6.12)、SFM偏高(OR=4.52，95%CI=3.29~6.30)和VFM偏高(OR=4.48，95%CI=3.28~6.18)组儿童血压偏高风险较高(P值均 < 0.05)。RCS分析显示，FM、FMI、FMP和SFM水平增加与血压偏高均呈线性剂量反应关系(P_非线性值均>0.05)，VFM偏高与血压偏高呈非线性剂量反应关系(P_非线性 < 0.05)。结论体脂偏高的儿童血压偏高风险较高，且存在剂量反应关系，采取适当措施降低儿童体脂水平，有助于预防儿童血压偏高的发生。
- 体脂分布 /
- 血压 /
- 回归分析 /
- 儿童
Abstract: Objective To examine the association between high body fat mass and elevated blood pressure in children, so as to provide scientific evidence for the prevention and treatment of childhood hypertension. Methods Participants were recruited from the second follow-up survey of the Huantai Childhood Cardiovascular Health Cohort Study conducted in 2021 in Huantai County, Zibo City, Shandong Province, China. A total of 1 266 children aged 10-15 years old were included. The study categorized fat mass (FM), fat mass percentage (FMP), fat mass index (FMI), subcutaneous fat mass (SFM), and visceral fat mass (VFM), respectively, into normal and elevated groups based on age- and gender-specific median values (P₅₀) in the study population. The multivariate Logistic regression model was used to analyze the association between the status of body mass and elevated blood pressure. A restrictive cubic spline (RCS) model was used to examine the dose-response relationship between the levels of body mass and elevated blood pressure. Results The detection rates of elevated blood pressure in children with elevated FM, elevated FMP, elevated FMI, elevated SFM, and elevated VFM were all significantly higher than those in the normal group (P < 0.05). After adjusting for all potential covariates, compared to the normal group, elevated FM (OR=4.51, 95%CI=3.28-6.28), elevated FMP (OR=4.51, 95%CI=3.28-6.27), elevated FMI (OR=4.40, 95%CI=3.20-6.12), elevated SFM (OR=4.52, 95%CI=3.29-6.30), and elevated VFM (OR=4.48, 95%CI=3.28-6.18) were all positively associated with elevated blood pressure (P < 0.05). The RCS analysis demonstrated that the high levels of FM, FMP, FMI, and SFM showed linear dose-response relationships with elevated blood pressure (P_non-linear>0.05), and elevated VFM was associated with elevated blood pressure in a nonlinear dose-response relationship (P_non-linear < 0.05). Conclusions Children with elevated body fat have a higher risk of elevated blood pressure. There was a dose-response relationship between high body mass content and elevated blood pressure in children. It is essential to take appropriate measures to reduce the elevated body fat in children, in order to prevent the occurrence of high elevated blood pressure in children.
- Body fat distribution /
- Blood pressure /
- 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 儿童体脂水平增加与血压偏高的剂量反应关系

Figure 1. Dose-response relationship between increase of body fat levels and elevated blood pressure among children

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表 1 男女童不同检测指标水平比较(x±s)

Table 1. Comparison of different indicator levels between boys and girls(x±s)

性别	人数	身高/cm	体重/kg	BMI/ (kg·m^-2)	收缩压/ mmHg	舒张压/ mmHg	FM/kg	FMP/%	FMI/ (kg·m^-2)	SFM/kg	VFM/kg	睡眠时间/ (h·d^-1)	视屏时间/ (h·d^-1)^*
男	664	162.0±11.9	57.7±16.3	21.7±4.6	118.0±12.1	62.2±7.5	11.6±8.0	18.2±8.3	4.3±2.8	10.0±6.6	1.6±1.4	8.6±1.0	0.6(0.7)
女	602	157.0±8.2	52.1±13.1	20.8±4.1	112.0±10.7	62.3±7.4	13.7±7.0	24.9±6.5	5.4±2.5	12.3±6.0	1.4±1.0	8.4±1.0	0.6(0.6)
总体	1 266	160.0±10.5	55.1±15.1	21.3±4.4	115.0±11.9	62.2±7.4	12.6±7.6	21.4±8.2	4.9±2.7	11.1±6.4	1.5±1.2	8.5±1.0	0.6(0.6)
t/Z值		7.7	6.7	3.6	10.4	-0.2	-5.1	-15.8	-7.5	-6.6	2.9	3.3	20.6
P值		< 0.01	< 0.01	< 0.01	< 0.01	0.85	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.31
注：^*不符合正态分布，用中位数(四分位数间距)表示；1 mmHg=0.133 kPa。

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表 2 不同体脂水平组儿童血压偏高检出率比较

Table 2. Comparison of detection rates of elevated blood pressure in different body fat content status groups among children

组别	选项	男童			女童			合计
组别	选项	人数	血压偏高人数	χ²值	人数	血压偏高人数	χ²值	人数	血压偏高人数	χ²值
FM	适中	334	35(10.5)	66.6	303	23(7.6)	24.8	637	58(9.1)	90.3
	偏高	330	125(37.9)		299	67(22.4)		629	192(30.5)
FMP	适中	338	36(10.7)	66.6	303	23(7.6)	24.8	641	59(9.2)	89.7
	偏高	326	124(38.0)		299	67(22.4)		625	191(30.6)
FMI	适中	334	37(11.1)	60.9	302	22(7.3)	26.8	636	59(9.3)	87.1
	偏高	330	123(37.3)		300	68(22.7)		630	191(30.3)
SFM	适中	334	35(10.5)	66.6	304	23(7.6)	25.2	638	58(9.1)	90.8
	偏高	330	125(37.9)		298	67(22.5)		628	192(30.6)
VFM	适中	344	36(10.5)	71.0	328	27(8.2)	24.4	672	63(9.4)	95.8
	偏高	320	124(38.8)		274	63(23.0)		594	187(31.5)
注：()内数字为检出率/%；P值均 < 0.01。

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表 3 儿童体脂偏高与血压偏高关联性Logistic回归分析[OR值(95%CI)]

Table 3. Logistic regression analysis of associations between the elevated body fat content and elevated blood pressure among children[OR(95%CI)]

自变量	选项	男生(n=664)		女生(n=602)		总体(n=1 266)
自变量	选项	模型1	模型2	模型1	模型2	模型1	模型2
FM	适中	1.00	1.00	1.00	1.00	1.00	1.00
	偏高	5.26(3.50~8.07)	5.33(3.54~8.21)	3.63(2.21~6.16)	3.63(2.20~6.19)	4.57(3.32~6.35)	4.51(3.28~6.28)
FMP	适中	1.00	1.00	1.00	1.00	1.00	1.00
	偏高	5.21(3.48~7.96)	5.31(3.53~8.15)	3.63(2.21~6.16)	3.56(2.16~6.07)	4.54(3.31~6.31)	4.51(3.28~6.27)
FMI	适中	1.00	1.00	1.00	1.00	1.00	1.00
	偏高	4.81(3.23~7.33)	4.92(3.28~7.53)	3.85(2.33~6.58)	3.82(2.31~6.56)	4.43(3.23~6.15)	4.40(3.20~6.12)
SFM	适中	1.00	1.00	1.00	1.00	1.00	1.00
	偏高	5.26(3.50~8.07)	5.33(3.54~8.21)	3.65(2.22~6.19)	3.64(2.20~6.20)	4.58(3.33~6.37)	4.52(3.29~6.30)
VFM	适中	1.00	1.00	1.00	1.00	1.00	1.00
	偏高	5.41(3.62~8.28)	5.50(3.66~8.44)	3.49(2.16~5.79)	3.52(2.16~5.87)	4.52(3.31~6.24)	4.48(3.28~6.18)
注：模型1调整性别、年龄(性别亚组中仅调整年龄)；模型2调整性别、年龄(性别亚组中仅调整年龄)、体力活动、视屏时间、睡眠时间、蔬菜水果摄入、碳酸饮料摄入；P值均 < 0.01。

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