[中国6至11岁儿童出生体重与血压升高之间的关系]

[Relationship between birth weight and elevated blood pressure among children aged 6-11 years in China].

作者信息

Zhai Yi, Li Weirong, Shen Chong, Zhao Wenhua, Shi Xiaoming

机构信息

Division of Non-Communicable Disease Control and Community Health, Chinese Center for Disease Control and Prevention, Beijing 102206, China.

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出版信息

Zhonghua Er Ke Za Zhi. 2014 Jan;52(1):11-5.

PMID:24680402

Abstract

OBJECTIVE

To analyze the relationship between birth weight and elevated blood pressure among schoolchildren aged 6-11 years in 8 provinces of China.

METHOD

A stratified random cluster sampling was used from sampling frame of eight provinces in the mainland of China. A total of 18 920 students aged 6-11 years eventually participated in this study. Height, weight, waist circumference (WC) and blood pressure of all the subjects were measured. Korotkoff I and V were recorded as systolic blood pressure (SBP) and diastolic blood pressure (DBP). Elevated blood pressure was considered for SBP and/or DBP equal to or above the reference sex-, age- and height-specific 95th percentile. Birth weight and family history of hypertension were collected by self-administered questionnaire. Analysis of variance was used to compare body measure indicators among 3 birth weight groups. Multivariate Logistic regression analysis was performed to identify the relationship between birth weight, current BMI and elevated blood pressure among children.

RESULT

The level of height, weight, WC, BMI, SBP and DBP were on the rise with the increase of the birth weight groups among boys (P < 0.05), except for WC among boys aged 6-8 years. The level of height, weight, WC, BMI and DBP showed a trend of escalation among girls (P < 0.05). But, SBP among 3 birth weight groups in girls was not significantly different (P = 0.099). After adjusting for age and family history of hypertension, compared with the normal birth weight group, the odds ratio and 95%CI of having elevated blood pressure among boys and girls in high birth weight group were 1.23 (1.06-1.43) and 0.89 (0.71-1.10), respectively; and the ORs(95%CI) were 1.06 (0.90-1.24) for boys and 0.73 (0.58-0.91) for girls after adjusting for age, family history of hypertension and current BMI of students. The relative risk of elevated blood pressure for boys and girls in low birth weight group were not significantly different as compared with normal birth weight group.

CONCLUSION

Current BMI but not birth weight was found to be a strong determinant of elevated blood pressure among children aged 6-11 years in China.

摘要

目的

分析中国8个省份6至11岁学龄儿童出生体重与血压升高之间的关系。

方法

采用分层随机整群抽样方法，抽样框架来自中国大陆8个省份。共有18920名6至11岁的学生最终参与了本研究。测量了所有受试者的身高、体重、腰围（WC）和血压。以柯氏音第I时相和第V时相分别记录收缩压（SBP）和舒张压（DBP）。当收缩压和/或舒张压等于或高于按性别、年龄和身高划分的参考值第95百分位数时，视为血压升高。通过自填问卷收集出生体重和高血压家族史。采用方差分析比较3个出生体重组之间的身体测量指标。进行多因素Logistic回归分析，以确定出生体重、当前体重指数（BMI）与儿童血压升高之间的关系。

结果

男孩中，除6至8岁男孩的腰围外，身高、体重、腰围、BMI、收缩压和舒张压水平随出生体重组的增加而升高（P<0.05）。女孩中，身高、体重、腰围、BMI和舒张压水平呈上升趋势（P<0.05）。但是，女孩3个出生体重组之间的收缩压无显著差异（P=0.099）。在调整年龄和高血压家族史后，与正常出生体重组相比，高出生体重组男孩和女孩血压升高的比值比及95%可信区间分别为1.23（1.06 - 1.43）和0.89（0.71 - 1.10）；在调整年龄、高血压家族史和学生当前BMI后，男孩和女孩的比值比（95%可信区间）分别为1.06（0.90 - 1.24）和0.73（0.58 - 0.91）。低出生体重组男孩和女孩血压升高的相对风险与正常出生体重组相比无显著差异。