中国7~17岁儿童青少年血压偏高及其与膳食模式的关联

由文烁; 郭齐雅; 曹薇; 杨媞媞; 徐培培; 甘倩; 潘慧; 王晓宁; 杨振宇; 张倩; 赵文华; 许娟

doi:10.16835/j.cnki.1000-9817.2025191

中国7~17岁儿童青少年血压偏高及其与膳食模式的关联

doi: 10.16835/j.cnki.1000-9817.2025191

由文烁¹,
郭齐雅^{1, 2},
曹薇^{1, 2},
杨媞媞¹,
徐培培³,
甘倩¹,
潘慧¹,
王晓宁¹,
杨振宇^{1, 2, 4},
张倩^{1, 2},
赵文华¹,
许娟^1, ,

1.
中国疾病预防控制中心营养与健康所，北京 100050
2.
国家卫生健康委公共营养与健康重点实验室
3.
首都医科大学附属北京安定医院
4.
中国疾病预防控制中心母乳科学研究重点实验室

基金项目:

十三五国家科技基础资源调查专项项目 2017FY101100

详细信息

作者简介:
由文烁(2000-)，女，山东滨州人，在读硕士，主要研究方向为学生营养

通讯作者:
许娟，E-mail: xujuan@ninh.chinacdc.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R544.1 R155.1
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-26
- 修回日期: 2025-04-17
- 网络出版日期: 2025-07-04
- 刊出日期: 2025-06-25

Elevated blood pressure and its association with dietary patterns among Chinese children and adolescents aged 7-17 years

YOU Wenshuo¹,
GUO Qiya^{1, 2},
CAO Wei^{1, 2},
YANG Titi¹,
XU Peipei³,
GAN Qian¹,
PAN Hui¹,
WANG Xiaoning¹,
YANG Zhenyu^{1, 2, 4},
ZHANG Qian^{1, 2},
ZHAO Wenhua¹,
XU Juan^{1
, ,}

1.
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing (100050), China

摘要

摘要: 目的了解中国儿童青少年血压偏高状况及其与膳食模式之间的关系，为开展儿童青少年高血压的饮食干预提供参考。方法数据来源于2019—2021年“中国0~18岁儿童营养与健康系统调查与应用项目”，采用分层整群随机抽样方法，从中国东北、华北、西北、华东、华中、华南和西南七大区域的28个调查点抽取7 933名研究对象。采用多因素Logistic回归模型分析人口学特征及营养状况与儿童青少年血压偏高关联；采用探索性因子分析提取调查对象膳食模式，将膳食模式按照因子得分依从性由高到低进行三分位分组(T3、T2、T1)，并用多因素Logistic回归模型分析血压偏高与膳食模式的相关性。结果中国7~17岁儿童青少年血压偏高检出率为15.4%，不同营养状况(以消瘦为参照，正常：OR=1.57，超重：OR=2.61，肥胖：OR=3.85)、城乡(以农村为参照，城市：OR=0.86)和父亲学历(以初中及以下为参照，本科及以上：OR=0.68)的儿童青少年血压偏高检出率差异均有统计学意义(P值均 < 0.05)。4种膳食模式(主食、动物性食物、零食、蔬菜水果)T3组儿童青少年血压偏高检出率分别为15.7%，14.6%，16.8%，15.8%。多因素Logistic回归分析结果显示，调整城乡、父亲文化程度和营养状况后，零食膳食模式(主要包括糖果类、含糖饮料和膨化食品)T2(OR=1.21)、T3(OR=1.19)组与儿童青少年血压呈正向关联(P值均 < 0.05)。结论零食膳食模式是儿童青少年血压偏高的相关因素，控制儿童青少年不健康零食的摄入有助于促进血压健康。
- 儿童 /
- 青少年 /
- 高血压 /
- 膳食 /
- 回归分析
Abstract: Objective To understand the prevalence of elevated blood pressure and its association with dietary patterns in children and adolescents in China, providing evidence for developing dietary intervention of hypertension in children and adolescents. Methods Data were derived from the China Children's Nutrition and Health System Survey and Application Project(2019-2021). A stratified cluster random sampling method was used to include 7 933 participants from 28 survey sites in seven major regions of Northeast, North, Northwest, East, Central, South and Southwest China. Multivariate Logistic regression models were used to analyze associations between demographic characteristics, nutritional status and elevated blood pressure. Exploratory factor analysis identified dietary patterns, which were divided into three quartile groups (T3, T2, T1) based on factor scores (compliance for dietary pattern) from high to low, and multivariate Logistic regression model assessed the correlation between elevated blood pressure and dietary patterns. Results The prevalence of elevated blood pressure was 15.4% among Chinese children aged 7-17 years. Significant differences were observed across nutritional status (reference: underweight; normal weight: OR=1.57; overweight: OR=2.61; obesity: OR=3.85), urban/rural residence (reference: rural; urban: OR=0.86), and paternal education (reference: junior high school and below; bachelor degree or above: OR=0.68) (P < 0.05). The detection rates of high blood pressure in T3 group children and adolescents with four dietary patterns (staple food, animal based food, snacks, vegetables and fruits) were 15.7%, 14.6%, 16.8%, and 15.8%, respectively. After adjusting for residence, paternal education, and nutritional status, the "snack dietary pattern" (mainly candy, sugar-sweetened beverages, and processed snacks) showed positive associations with elevated blood pressure in T2 (OR=1.21) and T3 (OR=1.19) tertiles (P < 0.05). Conclusions The snack dietary pattern is a related factor for elevated blood pressure in children and adolescents. Restricting unhealthy snack intake may promote cardiovascular health.
- Child /
- Adolescent /
- Hypertension /
- Diet /
- Regression analysis
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 儿童青少年膳食模式探索性因子分析

Figure 1. Exploratory factor analysis of dietary patterns among children and adolescents

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表 1 不同组别7~17岁儿童青少年血压偏高检出率及Logistic逐步回归分析

Table 1. Logistic stepwise regression analysis on the prevalence of elevated blood pressure in children and adolescents aged 7-17 years with different groups

组别	选项	人数	检出人数	检出率/%	OR值(95%CI)
性别	男	3 961	603	15.2	1.00
	女	3 972	616	15.5	0.91(0.81~1.04)
年龄/岁	7~12	4 310	661	15.3	1.00
	13~17	3 623	558	15.4	0.93(0.82~1.06)
城乡	农村	3 952	669	16.9	1.00
	城市	3 981	550	13.8	0.86(0.76~0.98)^*
营养状况	消瘦	481	43	8.9	1.00
	正常	5 322	683	12.8	1.57(1.28~1.93)^**
	超重	1 144	222	19.4	2.61(2.21~3.08)^**
	肥胖	986	271	27.5	3.85(2.73~5.43)^**
睡眠时间	满足	3 536	526	14.9	1.00
	不满足	4 397	693	15.8	1.08(0.95~1.23)
每日身体活动时间/min	≥60	731	100	13.7	1.00
	＜60	7 202	1 119	15.5	0.83(0.67~1.04)
父亲学历	初中及以下	4 147	687	16.6	1.00
	高中/大专	2 471	356	14.4	0.90(0.72~1.13)
	本科及以上	1 315	176	13.4	0.68(0.53~0.86)^**
母亲学历	初中及以下	4 199	656	15.6	1.00
	高中/大专	2 492	387	15.5	0.87(0.73~1.03)
	本科及以上	1 242	176	14.2	0.87(0.68~1.11)
家庭年总收入/万元	＜10	5 478	862	15.7	1.00
	≥10	2 455	357	14.5	1.05(0.92~1.21)
注：^* P＜0.05，^** P＜0.01。

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表 2 儿童青少年4种膳食模式与食物组因子载荷

Table 2. Four dietary patterns and food group factor loadings among children and adolescents

食物组	主食	动物性食物	零食	蔬菜水果
谷类	0.66	0.16	-0.07	0.14
薯类	0.79	-0.03	0.07	0.12
豆类	0.70	0.07	0.11	0.21
蔬菜类	0.16	0.13	-0.06	0.75
菌藻类	0.16	0.09	0.35	0.42
水果类	0.14	0.03	0.12	0.80
乳类	0.06	0.37	0.20	0.34
畜肉	0.11	0.73	0.19	0.16
禽肉	0.11	0.76	0.01	-0.04
蛋类	0.00	0.36	0.26	0.16
动物血及肝脏	0.00	0.11	0.20	0.02
水产品	0.03	0.80	0.09	0.10
坚果类	0.04	0.06	0.72	0.17
烘烤食品	0.47	0.13	0.34	0.07
膨化食品	0.53	0.02	0.46	-0.16
糖果类	0.01	0.07	0.71	0.13
含糖饮料	0.15	0.15	0.61	-0.07
特征根	3.82	1.67	1.44	1.20
方差贡献率/%	22.44	9.80	8.50	7.06
累计方差贡献率/%	22.44	32.24	40.74	47.80

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表 3 儿童青少年不同膳食模式与血压偏高关联性分析[OR值(95%CI)，n=7 933]

Table 3. Association analysis of elevated blood pressure and different dietary patterns among children and adolescents [OR(95%CI), n=7 933]

膳食模式	组别	模型1	模型2	模型3
主食	T1	1.00	1.00	1.00
	T2	1.02(0.88~1.19)	1.00(0.86~1.16)	0.99(0.85~1.16)
	T3	0.98(0.84~1.14)	0.95(0.82~1.11)	0.94(0.81~1.09)
动物性食物	T1	1.00	1.00	1.00
	T2	1.03(0.89~1.20)	0.99(0.86~1.15)	1.02(0.88~1.19)
	T3	1.12(0.96~1.29)	1.02(0.87~1.19)	1.04(0.89~1.22)
零食	T1	1.00	1.00	1.00
	T2	1.19(1.03~1.39)^*	1.23(1.05~1.42)^**	1.21(1.04~1.41)^**
	T3	1.17(1.01~1.36)^*	1.21(1.04~1.41)^*	1.19(1.03~1.39)^*
蔬菜水果	T1	1.00	1.00	1.00
	T2	0.94(0.81~1.10)	0.96(0.83~1.12)	0.97(0.83~1.13)
	T3	0.92(0.79~1.07)	0.94(0.81~1.10)	0.98(0.84~1.15)
注：^* P＜0.05，^** P＜0.01；因变量血压偏高以否为参照。

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