北京顺义区中小学生血压和体质量指数轨迹与视力结局关联

刘斌; 史杰; 潘德静; 赵瑞兰

doi:10.16835/j.cnki.1000-9817.2025059

北京顺义区中小学生血压和体质量指数轨迹与视力结局关联

doi: 10.16835/j.cnki.1000-9817.2025059

刘斌¹,
史杰¹,
潘德静¹,
赵瑞兰^2, ,

1.
北京市顺义区中小学卫生保健所卫生科，北京 101300
2.
北京市顺义区疾病预防控制中心学校卫生科

基金项目:

首都卫生发展科研专项项目 2024-2G-7107

详细信息

作者简介:
刘斌(1986-)，男，北京市人，大学本科，主治医师，主要研究方向为学生常见病防控

通讯作者:
赵瑞兰，E-mail：zhrl_1999@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R544 R770.42⁺¹
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- 文章访问数: 72
- HTML全文浏览量: 33
- PDF下载量: 19
- 被引次数: 0
出版历程
- 收稿日期: 2024-12-12
- 修回日期: 2025-01-02
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Association of blood pressure and body mass index trajectory with visual outcomes among primary and secondary school students in Shunyi District of Beijing

1.
Division of School Health, Primary and Secondary School Healthcare Center of Shunyi District, Beijing (101300), China

摘要

摘要: 目的分析北京市顺义区7~17岁中小学生血压和体质量指数(BMI)轨迹，探讨不同类型生长轨迹与视力结局的关联，为儿童青少年常见病防控工作提供科学依据。方法对2019—2023年北京市顺义区中小学生健康体检数据(视力、血压、BMI)进行整理，运用群组轨迹模型拟合7~17岁学生BMI和血压轨迹分组，采用二分类Logistic回归分析模型分析生长轨迹与视力结局的关联。结果顺义区中小学生筛查性近视率为57.2%，中重度视力不良率为55.8%。根据潜变量增长模型，可将中小学生收缩压轨迹、舒张压轨迹和BMI轨迹均分为低增长轨迹组、中增长轨迹组和高维持轨迹组3组。Logistic回归分析显示，与低增长轨迹组相比，收缩压、舒张压、BMI中增长轨迹组和高维持轨迹组的筛查性近视发生风险均增加(OR值分别为1.14，1.11；1.07，1.19；1.06，1.08，P值均 < 0.05)；收缩压、舒张压、BMI中增长轨迹组和高维持轨迹组的中重度视力不良发生风险均增加(OR值分别为1.12，1.12；1.09，1.17；1.08，1.11，P值均 < 0.05)。结论血压和BMI中增长轨迹、高维持轨迹增加中小学生筛查性近视和中重度视力不良风险。应密切关注中小学生血压和超重肥胖轨迹变化，开展定期监测，积极预防学生多病共患的发生发展。
- 血压 /
- 人体质量指数 /
- 近视 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the trajectories of blood pressure and body mass index (BMI) among primary and secondary school students aged 7-17 in Shunyi District of Beijing, and to explore the association between different growth trajectories and visual outcomes, so as to provide a scientific basis for the prevention and control of common diseases in children and adolescents. Methods Health examination data (including vision, blood pressure and BMI) of primary and secondary school students in Shunyi District of Beijing from 2019 to 2023 were collected and analyzed. Group-based trajectory modeling was used to classify the trajectories of BMI and blood pressure (systolic and diastolic) into distinct groups among students aged 7-17 years. The relationship between these trajectories and visual outcomes was examined using binary Logistic regression analysis. Results The prevalence of screening myopia among students in Shunyi District was 57.2%, while the rate of moderate to severe visual impairment was 55.8%. Based on the latent growth model, the trajectories of systolic blood pressure, diastolic blood pressure, and BMI were divided into three groups: low-growth trajectory, moderate-growth trajectory and high-maintenance trajectory. Logistic regression analysis revealed that, compared to the low-growth trajectory group, the moderate-growth and high-maintenance trajectory groups for systolic blood pressure, diastolic blood pressure, and BMI were associated with an increased risk of screening myopia (OR=1.14, 1.11; 1.07, 1.19; 1.06, 1.08, P < 0.05). Similarly, the moderate-growth and high-maintenance trajectory groups for systolic blood pressure, diastolic blood pressure, and BMI were similarly associated with an increased risk of moderate to severe visual impairment (OR=1.12, 1.12; 1.09, 1.17; 1.08, 1.11, P < 0.05). Conclusions Moderate-growth and high-maintenance trajectories of blood pressure and BMI are associated with an increased risk of screening myopia and moderate to severe visual impairment among students. It is recommended to closely monitor changes in blood pressure and overweight/obesity trajectories in primary and secondary school students, conduct regular assessments, and actively prevent the development and progression of multimorbidity and comorbidity.
- Blood pressure /
- Body mass index /
- Myopia /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

图 1 基于GBTM模型分析的中小学生血压和BMI轨迹分组

Figure 1. Blood pressure and BMI trajectories among primary and secondary school students based on the GBTM model analysis

下载: 全尺寸图片幻灯片

图 2 中小学生长期平均血压和BMI水平与视力结局风险的非线性剂量反应关系

Figure 2. Non-linear dose-response association of curves between long-term blood pressure and BMI levels with vision outcomes risk

下载: 全尺寸图片幻灯片

表 1 不同性别学生视力检出和近视、血压偏高、肥胖共患检出情况及血压与BMI轨迹分组情况比较

Table 1. Comparison of vision screening results and comorbidity of myopia, high blood pressure and obesity results and trajectory group classifications of blood pressure and BMI among students of different genders

性别	人数	近视、血压偏高、肥胖共患	筛查性近视	中重度视力不良	长期收缩压轨迹分组
性别	人数	近视、血压偏高、肥胖共患	筛查性近视	中重度视力不良	低增长轨迹组	中增长轨迹组	高维持轨迹组
男	35 550	1 834(5.2)	19 185(54.0)	18 555(52.2)	18 014(50.7)	13 380(37.6)	4 156(11.7)
女	33 543	757(2.3)	20 353(60.7)	19 994(59.6)	20 186(60.2)	11 497(34.3)	1 860(5.5)
合计	69 093	2 591(3.8)	39 538(57.2)	38 549(55.8)	38 200(55.3)	24 877(36.0)	6 016(8.7)
χ²值		402.72	317.55	384.52		1 084.90
P值		< 0.01	< 0.01	< 0.01		< 0.01

性别	人数	长期舒张压轨迹分组			长期BMI轨迹分组
性别	人数	低增长轨迹组	中增长轨迹组	高维持轨迹组	低增长轨迹组	中增长轨迹组	高维持轨迹组
男	35 550	26 743(75.2)	7 925(22.3)	882(2.5)	18 366(51.7)	12 286(34.6)	4 898(13.8)
女	33 543	25 612(76.4)	7 163(21.4)	768(2.3)	21 309(63.5)	9 865(29.4)	2 369(7.1)
合计	69 093	52 355(75.8)	15 088(21.8)	1 650(2.4)	39 675(57.4)	22 151(32.1)	7 267(10.5)
χ²值			12.50			1 305.83
P值			< 0.01			< 0.01
注： ()内数字为检出率或构成比/%。

下载: 导出CSV

表 2 基于GBTM模型的中小学生血压和BMI轨迹与视力结局关联性二分类Logistic回归分析(n=69 093)

Table 2. Binary Logistic regression analysis of correlation of blood pressure and BMI trajectories with visual outcomes among primary and secondary school students derived from the GBTM model(n=69 093)

轨迹分组	筛查性近视		中重度视力不良
轨迹分组	OR值(95%CI)	P值	OR值(95%CI)	P值
收缩压
低增长轨迹组	1.00		1.00
中增长轨迹组	1.14(1.10~1.19)	< 0.01	1.12(1.08~1.17)	< 0.01
高维持轨迹组	1.11(1.03~1.19)	0.01	1.12(1.04~1.21)	< 0.01
舒张压
低增长轨迹组	1.00		1.00
中增长轨迹组	1.07(1.02~1.11)	< 0.01	1.09(1.05~1.14)	< 0.01
高维持轨迹组	1.19(1.05~1.36)	0.01	1.17(1.03~1.32)	0.01
BMI
低增长轨迹组	1.00		1.00
中增长轨迹组	1.06(1.02~1.10)	< 0.01	1.08(1.04~1.12)	< 0.01
高维持轨迹组	1.08(1.01~1.15)	0.02	1.11(1.04~1.18)	< 0.01

下载: 导出CSV

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