儿童和青少年颈部周长与高血压的关联：一项病例对照研究。

Association of neck circumference and high blood pressure in children and adolescents: a case-control study.

作者信息

Kuciene Renata, Dulskiene Virginija, Medzioniene Jurate

机构信息

Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, Sukileliu ave. 17, LT-50009, Kaunas, Lithuania.

出版信息

BMC Pediatr. 2015 Sep 17;15:127. doi: 10.1186/s12887-015-0444-2.

DOI:10.1186/s12887-015-0444-2

PMID:26383844

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4574610/

Abstract

BACKGROUND

High blood pressure (BP) is a serious, common and growing global public health problem. The aim of this study was to evaluate the associations between high NC (neck circumference) alone and in combinations with BMI (body mass index), WC (waist circumference), and high BP among Lithuanian children and adolescents aged 12 to 15 years.

METHODS

An epidemiological case-control study was performed between May 2012 and November 2013. NC, WC, hip circumference (HC), mid-upper arm circumference (MUAC), body height, weight, and BP were measured. The participants with high BP (≥ 90th percentile) were screened on two separate occasions. Data on NC, WC, HC, MUAC, BMI, body adiposity index (BAI), waist-to-height ratio (WHtR), waist-to-hip ratio (WHR), and BP were analyzed in 1947 children and adolescents aged 12-15 years. Age- and sex-adjusted odds ratios (aORs) with 95% confidence intervals (CI) for the associations were estimated using multivariate logistic regression models.

RESULTS

The prevalence rates of prehypertension (BP ≥ 90th- < 95th percentile) and hypertension (BP ≥ 95th percentile) was 6.3 and 25.1%, respectively. The overall prevalence of high NC (if NC was in the ≥ 90th percentile), overweight/obesity (as measured by BMI), and abdominal overweight/obesity (if WC was in the ≥ 75th percentile) were 14.3, 15.8, and 13%, respectively. After adjustment for age and sex, NC in the ≥ 90th percentile was significantly associated with an increased risk of elevated BP (prehypertension: aOR = 2.99; 95% CI, 1.88-4.77; hypertension aOR = 4.05; 95% CI, 3.03-5.41, and prehypertension/hypertension aOR = 3.75; 95% CI, 2.86-4.91), compared to the participants with NC in the <90th percentile. Overweight/obesity and abdominal overweight/obesity were also significantly associated with an elevated BP. The combinations including both risk factors (high NC with overweight/obesity, and high NC with abdominal overweight/obesity) showed higher aORs than those with either risk factor alone.

CONCLUSIONS

High NC alone-but particularly in combinations with overweight/obesity and abdominal overweight/obesity-was associated with an increased risk of high BP.

摘要

背景

高血压是一个严重、常见且在全球范围内日益严重的公共卫生问题。本研究的目的是评估立陶宛12至15岁儿童和青少年中单纯高颈围（NC）以及颈围与体重指数（BMI）、腰围（WC）和高血压之间的关联。

方法

2012年5月至2013年11月进行了一项流行病学病例对照研究。测量了颈围、腰围、臀围（HC）、上臂中部周长（MUAC）、身高、体重和血压。在两个不同的场合对高血压患者（血压≥第90百分位数）进行了筛查。对1947名12至15岁儿童和青少年的颈围、腰围、臀围、上臂中部周长、体重指数、身体脂肪指数（BAI）、腰高比（WHtR）、腰臀比（WHR）和血压数据进行了分析。使用多变量逻辑回归模型估计了关联的年龄和性别调整比值比（aORs）及其95%置信区间（CI）。

结果

高血压前期（血压≥第90百分位数但<第95百分位数）和高血压（血压≥第95百分位数）的患病率分别为6.3%和25.1%。高颈围（如果颈围处于≥第90百分位数）、超重/肥胖（通过BMI测量）和腹部超重/肥胖（如果腰围处于≥第75百分位数）的总体患病率分别为14.3%、15.8%和13%。在调整年龄和性别后，与颈围处于<第90百分位数的参与者相比，颈围处于≥第90百分位数与血压升高风险增加显著相关（高血压前期：aOR = 2.99；95% CI，1.88 - 4.77；高血压：aOR = 4.05；95% CI，3.03 - 5.41，高血压前期/高血压：aOR = 3.75；95% CI，2.86 - 4.91）。超重/肥胖和腹部超重/肥胖也与血压升高显著相关。包括两种危险因素（高颈围与超重/肥胖以及高颈围与腹部超重/肥胖）的组合显示出比单独一种危险因素更高的aORs。