儿童青少年血压变化趋势及其与青春发育和营养状况的关联

郝志红; 卫飞雪; 李巧凤; 韩卫芳; 王莉

doi:10.16835/j.cnki.1000-9817.2024363

儿童青少年血压变化趋势及其与青春发育和营养状况的关联

doi: 10.16835/j.cnki.1000-9817.2024363

1.
山西省晋中市疾病预防控制中心慢性病防控部， 030600
2.
山西医科大学公共卫生学院

基金项目: 中国青少年健康新型风险因素检测与队列研究(横向合作项目)

详细信息

作者简介:
郝志红(1989-)，女，山西晋中人，硕士，主管医师，主要从事学校卫生和慢性病防控工作

通讯作者:
王莉，E-mail: 13633512201@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R153.2 R544.1 R399.3⁺⁵
计量
- 文章访问数: 170
- HTML全文浏览量: 69
- PDF下载量: 27
- 被引次数: 0
出版历程
- 收稿日期: 2024-06-18
- 修回日期: 2024-10-19
- 网络出版日期: 2025-01-07
- 刊出日期: 2024-12-25

Trend of blood pressure among children and adolescents and its correlation with pubertal development and nutritional status

1.
Department of Chronic Disease, Jinzhong Center for Disease Control and Prevention, Jinzhong (030600), Shanxi Province, China

摘要

摘要: 目的探讨儿童青少年血压变化趋势及其与青春发育和营养状况的关联，为制定血压偏高早期干预策略提供科学依据。方法 2023年9月，采用多阶段随机整群抽样方法抽取山西省晋中市57所学校20 241名7~18岁中小学生，测量身高、体重、血压。采用趋势性χ²检验分析儿童青少年正常高值血压和血压偏高检出率随青春期发育进程的变化趋势，使用Logistic回归分析血压正常高值和血压偏高与营养状况的关联性。结果晋中市儿童青少年正常高值血压检出率为17.3%，其中青春中期(23.2%)和青春后期(24.3%)>青春早期(19.5%)>青春期前(10.8%)(χ_趋势²=372.86)；儿童青少年血压偏高检出率为14.8%，其中青春后期(22.4%)>青春中期(18.9%)>青春早期(13.0%)和青春期前(12.2%)(χ_趋势²=175.43)(P值均 < 0.01)。不同性别、地区、营养状况儿童青少年的正常高值血压和血压偏高检出率均随青春期发育进程而增高(χ_趋势²=9.21~771.90，P值均 < 0.01)。超重、肥胖均是青春期发育各阶段儿童青少年正常高值血压和血压偏高的相关因素(OR=1.2~2.8，P值均 < 0.01)。结论儿童青少年正常高值血压和血压偏高在青春发育期均呈现较高的检出率，且随青春期发育进程呈现增高趋势。
- 血压 /
- 青春期发育 /
- 营养状况 /
- 回归分析 /
- 生长和发育 /
- 儿童 /
- 青少年
Abstract: Objective To explore the trend of blood pressure among children and adolescents and its correlation with pubertal development and nutritional status, so as to provide a scientific basis for developing prevention strategies targeting early stage hypertension. Methods In September 2023, a multi-stage random cluster sampling was used to select 20 241 primary and secondary school students aged 7-18 years from 57 schools in Jinzhong, whose height, weight, and blood pressure were measured. The Chi-square test for trend was used to analyze the change trend in the detection rate of elevated blood pressure and hypertension in children and adolescents with the development of adolescence puberty, and the Logistic regression was used to analyze the correlation between elevated blood pressure and hypertension and nutritional status. Results The prevalence of elevated blood pressure was 17.3% among children and adolescents. The middle and late pubertal groups had the highest prevalence (23.2% and 24.3%), followed by the early pubertal group (19.5%) and the prepuberty group (10.8%) (χ_trend²=372.86, P < 0.01). The prevalence of hypertension was 14.8%, with the highest prevalence reported in the late pubertal group (22.4%), followed by the middle pubertal group (18.9%), and the early pubertal (13.0%)/prepuberty (12.2%) groups (χ_trend²=175.43, P < 0.01). The prevalence of elevated blood pressure and hypertension increased with pubertal development, regardless of gender, region, or nutritional status (χ_trend²=9.21-771.90, P < 0.01). Overweight and obesity were influencing factors of elevated blood pressure and hypertension among children and adolescents during all stages of pubertal development (OR=1.2-2.8, P < 0.01). Conclusion The prevalence of elevated blood pressure and hypertension among children and adolescents during pubertal development is high, showing an increasing trend with pubertal development.
- Blood pressure /
- Adolescent development /
- Nutritional status /
- Regression analysis /
- Growth and development /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同组别儿童青少年青春期发育各阶段正常高值血压和血压偏高检出率比较

Table 1. Comparison of the prevalence of elevated blood pressure and hypertension among children and adolescents during pubertal development

组别	青春期阶段	人数	正常高值血压		血压偏高
组别	青春期阶段	人数	检出人数	χ_趋势²值	检出人数	χ_趋势²值
性别
男	青春期前	5 052	582(11.5)	771.90^**	609(12.1)	52.16^**
	青春早期	3 187	829(26.0)		410(12.9)
	青春中期	1 477	581(39.3)		265(17.9)
	青春后期	502	230(45.8)		107(21.3)
女	青春期前	2 884	279(9.7)	47.56^**	360(12.5)	101.60^**
	青春早期	2 999	377(12.6)		397(13.2)
	青春中期	2 804	412(14.7)		543(19.4)
	青春后期	1 336	217(16.2)		304(22.8)
地区
城区	青春期前	705	82(11.6)	29.32^**	131(18.6)	9.21^*
	青春早期	527	88(16.7)		108(20.5)
	青春中期	579	136(23.5)		131(22.6)
	青春后期	389	84(21.6)		102(26.2)
县区	青春期前	7 231	779(10.8)	349.09^**	838(11.6)	147.92^**
	青春早期	5 659	1 118(19.8)		699(12.4)
	青春中期	3 702	857(23.1)		677(18.3)
	青春后期	1 449	363(25.1)		309(21.3)
营养状况
消瘦	青春期前	461	37(8.0)	23.74^**	37(8.0)	14.29^**
	青春早期	332	29(8.7)		25(7.5)
	青春中期	185	37(20.0)		19(10.3)
	青春后期	90	19(21.1)		22(24.4)
正常	青春期前	4 394	381(8.7)	213.91^**	409(9.3)	100.43^**
	青春早期	3 767	617(16.4)		370(9.8)
	青春中期	2 695	560(20.8)		407(15.1)
	青春后期	1 175	242(20.6)		213(18.1)
超重	青春期前	1 282	160(12.5)	84.67^**	170(13.3)	58.23^**
	青春早期	969	226(23.3)		155(16.0)
	青春中期	750	200(26.7)		167(22.3)
	青春后期	356	108(30.3)		103(28.9)
肥胖	青春期前	1 799	283(15.7)	98.07^**	353(19.6)	54.61^**
	青春早期	1 118	334(29.9)		257(23.0)
	青春中期	651	196(30.1)		215(33.0)
	青春后期	217	78(35.9)		73(33.6)
注：^* P < 0.05，^** P < 0.01；()内数字为检出率/%。

下载: 导出CSV

表 2 青春期发育各阶段儿童青少年正常高值血压和血压偏高与营养状况关联性的Logistic回归分析[OR值(95%CI)]

Table 2. Association between elevated blood pressure/hypertension and nutritional status among children and adolescents during pubertal development[OR(95%CI)]

发育阶段	自变量	正常高值血压		血压偏高
发育阶段	自变量	调整前	调整后	调整前	调整后
青春期前 (n=7 936)	消瘦	0.9(0.6~1.3)	0.9(0.6~1.3)	0.9(0.6~1.2)	0.8(0.6~1.1)
	超重	1.5(1.2~1.8)^**	1.5(1.2~1.8)^**	1.5(1.2~1.8)^**	1.5(1.3~1.8)^**
	肥胖	2.0(1.7~2.3)^**	2.0(1.7~2.3)^**	2.4(2.0~2.8)^**	2.5(2.1~2.9)^**
青春早期 (n=6 186)	消瘦	0.5(0.3~0.7)^**	0.4(0.3~0.6)^**	0.7(0.5~1.1)	0.7(0.5~1.1)
	超重	1.6(1.3~1.8)^**	1.4(1.1~1.6)^**	1.7(1.4~2.1)^**	1.8(1.5~2.2)^**
	肥胖	2.2(1.9~2.5)^**	2.0(1.7~2.4)^**	2.7(2.3~3.3)^**	2.7(2.3~3.3)^**
青春中期	消瘦	1.0(0.7~1.4)	0.8(0.5~1.2)	0.6(0.4~1.0)	0.6(0.4~1.1)
(n=4 281)	超重	1.4(1.2~1.7)^**	1.2(1.1~1.5)^**	1.6(1.3~2.0)^**	1.6(1.3~2.0)^**
	肥胖	1.6(1.4~2.0)^**	1.4(1.2~1.7)^**	2.8(2.3~3.4)^**	2.8(2.3~3.5)^**
青春后期 (n=1 838)	消瘦	1.0(0.6~1.7)	1.0(0.5~1.6)	1.5(0.9~2.4)	1.5(0.9~2.4)
	超重	1.7(1.3~2.2)^**	1.5(1.1~1.9)^**	1.8(1.4~2.4)^**	1.8(1.4~2.4)^**
	肥胖	2.2(1.6~3.0)^**	1.8(1.2~2.5)^**	2.3(1.7~3.1)^**	2.3(1.7~3.2)^**
总体 (n=20 241)	消瘦	0.7(0.6~0.9)^**	0.7(0.6~0.8)^**	0.8(0.7~1.0)	0.8(0.7~0.9)^**
	超重	1.5(1.3~1.6)^**	1.4(1.3~1.5)^**	1.6(1.5~1.8)^**	1.7(1.5~1.9)^**
	肥胖	1.8(1.6~1.9)^**	1.6(1.5~1.8)^**	2.4(2.2~2.6)^**	2.5(2.3~2.8)^**
注：^** P < 0.01。

下载: 导出CSV

参考文献(20)

[1]	陶芳标, 武丽杰, 马军, 等. 儿童少年卫生学[M]. 8版. 北京: 人民卫生出版社, 2017: 188. TAO F B, WU L J, MA J, et al. Child and adolescent hygiene[M]. 8th ed. Beijing: People's Medical Publishing House, 2017: 188. (in Chinese)
[2]	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
[3]	张裕, 王非, 陈艳华, 等. 2021年湖南省中学生超重肥胖与血压的关联性研究[J]. 实用预防医学, 2023, 30(5): 549-552. ZHANG Y, WANG F, CHEN Y H, et al. Association of overweight and obesity with blood pressure among middle school students in Hunan Province, 2021[J]. Pract Prev Med, 2023, 30(5): 549-552. (in Chinese)
[4]	李盛, 杨露, 李昕蓉, 等. 2020年兰州市18岁以下中小学生超重和肥胖与血压的关系分析[J]. 疾病预防控制通报, 2023, 38(2): 25-29. LI S, YANG L, LI X R, et al. Analysis of status of overweight, obesity and relation with blood pressure in primary and middle school students under 18 years old in Lanzhou, 2020[J]. Bull Dis Control Prev, 2023, 38(2): 25-29. (in Chinese)
[5]	张昱堃, 王志强, 陈国平, 等. 安徽省中小学生血压偏高流行现状及影响因素[J]. 中国学校卫生, 2023, 44(11): 1733-1737. doi: 10.16835/j.cnki.1000-9817.2023.11.031 ZHANG Y K, WANG Z Q, CHEN G P, et al. Prevalence and influencing factors of elevated blood pressure among primary and middle school students in Anhui Province[J]. Chin J Sch Health, 2023, 44(11): 1733-1737. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2023.11.031
[6]	KOLLIAS A, DAFNI M, POULIDAKIS E, et al. Out-of-office blood pressure and target organ damage in children and adolescents: a systematic review and Meta-analysis[J]. J Hypertens, 2014, 32(12): 2315-2331. doi: 10.1097/HJH.0000000000000384
[7]	AZEGAMI T, UCHIDA K, TOKUMURA M, et al. Blood pressure tracking from childhood to adulthood[J]. Front Pediatr, 2021, 9: 785356. doi: 10.3389/fped.2021.785356
[8]	LI Y, DONG Y, ZOU Z, et al. Association between pubertal development and elevated blood pressure in children[J]. J Clin Hyp, 2021, 23(8): 1498-1505. doi: 10.1111/jch.14315
[9]	JI Y, ZHAO X, FENG Y, et al. Body mass index trajectory from childhood to puberty and high blood pressure: the China Health and Nutrition Survey[J]. BMJ Open, 2021, 11(11): e055099. doi: 10.1136/bmjopen-2021-055099
[10]	KWARTENG E A, SHANK L M, FAULKNER L M, et al. Influence of puberty on relationships between body composition and blood pressure: a cross-sectional study[J]. Pediatr Res, 2023, 94(2): 781-788. doi: 10.1038/s41390-023-02503-7
[11]	国家疾病预防控制局卫生免疫司, 北京大学儿童青少年卫生研究所. 2023全国学生常见病和健康影响因素监测与干预技术工作手册[Z]. 北京, 2023: 91. Department of Health and Immunization, National Disease Control and Prevention Administration, Institute of Child and Adolescent Health, Peking University. 2023 national technical manual of common diseases and health influencing factors for students[Z]. Beijing, 2023: 91. (in Chinese)
[12]	中华人民共和国国家卫生健康委员会. 7岁~18岁儿童青少年血压偏高筛查界值: WS/T 610—2018[S]. 北京: 中国标准出版社, 2018. National Health Commission of the PRC. Reference of screening for elevated blood pressure among children and adolescents aged 7-18 years: WS/T 610-2018[S]. Beijing: Standards Press of China, 2018. (in Chinese)
[13]	中华人民共和国国家卫生和计划生育委员会. 学龄儿童青少年营养不良筛查: WS/T 456—2014[S]. 北京: 中国标准出版社, 2014. National Health and Family Planning Commission of the PRC. Screening standard for malnutrition of school-age children and adolescents: WS/T 456-2014[S]. Beijing: Standards Press of China, 2014. (in Chinese)
[14]	中华人民共和国国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S]. 北京: 中国标准出版社, 2018. National Health and Family Planning Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018[S]. Beijing: Standards Press of China, 2018. (in Chinese)
[15]	陈一鸣, 韩梅, 史雪, 等. 青春发育期学生视力不良流行特征研究[J]. 中国预防医学杂志, 2024, 25(1): 97-101. CHEN Y M, HAN M, SHI X, et al. Epidemiological characteristics of poor eyesight in students during puberty[J]. Chin Prev Med, 2024, 25(1): 97-101. (in Chinese)
[16]	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)
[17]	WÓJCIK M, STARZYK J B, DROẐDẐ M, et al. Effects of puberty on blood pressure trajectories-underlying processes[J]. Curr Hyp Rep, 2023, 25(7): 117-125. http://www.semanticscholar.org/paper/b0ae504c857cc00835f683f430bb20377aae9798
[18]	董彦会, 宋逸, 董彬, 等. 2014年中国7~18岁学生血压状况与营养状况的关联分析: 基于中国儿童青少年血压评价标准[J]. 北京大学学报(医学版), 2018, 50(3): 422-428. DONG Y H, SONG Y, DONG B, et al. Association between the blood pressure status and nutritional status among Chinese students aged 7-18 years in 2014: based on the national blood pressure reference for Chinese children and adolescents[J]. J Peking Univ (Health Sci), 2018, 50(3): 422-428. (in Chinese)
[19]	黄婕, 曾淳子, 马婕, 等. 2016—2019年广州市农村9~12岁儿童青少年血压偏高与体质指数的关联分析[J]. 现代预防医学, 2023, 20(19): 3519-3524. HUANG J, ZENG C Z, MA J, et al. Relationship between high blood pressure and body mass index in children and adolescents aged 9 to 12 years in rural areas of Guangzhou from 2016 to 2019[J]. Mod Prev Med, 2023, 20(19): 3519-3524. (in Chinese)
[20]	赵锦平, 杨云娟, 常利涛, 等. 云南省中小学生血压分布及影响因素分析[J]. 中国健康教育, 2019, 35(9): 775-779. ZHAO J P, YANG Y J, CHANG L T, et al. Analysis of blood pressure distribution and influencing factors among primary and middle school students in Yunnan Province[J]. Chin J Health Educ, 2019, 35 (9): 775-779. (in Chinese)