Liu W J, Xiong L H, Guo C S, Li B, Pallan M, Griffin T, Cheng K K, Adab P
Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.
Public Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
J Hum Hypertens. 2017 Dec;31(12):808-814. doi: 10.1038/jhh.2017.67. Epub 2017 Sep 14.
Cardiorespiratory fitness (CRF) and adiposity contribute to high blood pressure (HBP) in adults and children. However, their relative importance as risk factors is unknown. We examined the relationships between weight status, CRF and HBP among Chinese primary school children. A cross-sectional study was conducted with 4926 school children aged 5-12 years. CRF was estimated from a modified Cooper test, body mass index z-scores and weight categories were calculated from objective height and weight measurements and BP was measured using an electronic sphygmomanometer. HBP was defined as >95th percentile based on reference cutoffs for Chinese boys and girls. Generalised Linear Mixed models, adjusting for age, pubertal status and height, were developed for boys and girls to explore the independent and combined associations between fitness, weight status and HBP. Seven hundred and fifty-two (15.3%) children had HBP, with a higher prevalence in obese (40.5% and 45.9% in boys and girls, respectively) and overweight (27.6% and 30.2% in boys and girls, respectively) compared with non-overweight (9.0% and 13.8% in boys and girls, respectively) children. HBP prevalence was lower in boys with higher CRF (odds ratio (OR) for the highest vs lowest CRF quartile in boys 0.64; 95% confidence interval (CI) 0.46-0.89). This association was not seen in girls. With weight status and CRF in the same model, weight status, but not CRF, remained significantly associated with HBP (obesity in boys: OR 4.19; 95% CI 2.63-6.67; in girls: OR 2.49; 95% CI 1.19-5.19). The interaction effect for CRF and weight status was non-significant. Overweight/obesity was significantly associated with HBP among children. There was no evidence of modification of this relationship by CRF.
心肺适能（CRF）和肥胖在成人和儿童中都与高血压（HBP）有关。然而，它们作为危险因素的相对重要性尚不清楚。我们研究了中国小学生体重状况、心肺适能与高血压之间的关系。对4926名5至12岁的学童进行了一项横断面研究。通过改良的库珀测试估算心肺适能，根据客观的身高和体重测量计算体重指数z评分和体重类别，并使用电子血压计测量血压。根据中国男孩和女孩的参考临界值，高血压定义为高于第95百分位数。针对男孩和女孩建立了广义线性混合模型，对年龄、青春期状态和身高进行了调整，以探讨适能、体重状况和高血压之间的独立关联和联合关联。752名（15.3%）儿童患有高血压，与非超重儿童（男孩和女孩分别为9.0%和13.8%）相比，肥胖儿童（男孩和女孩分别为40.5%和45.9%）和超重儿童（男孩和女孩分别为27.6%和30.2%）的患病率更高。心肺适能较高的男孩中高血压患病率较低（男孩中最高与最低心肺适能四分位数的比值比（OR）为0.64；95%置信区间（CI）为0.46 - 0.89）。在女孩中未观察到这种关联。在同一模型中纳入体重状况和心肺适能后，体重状况而非心肺适能仍与高血压显著相关（男孩肥胖：OR 4.19；95% CI 2.63 - 6.67；女孩：OR 2.49；95% CI 1.19 - 5.19）。心肺适能和体重状况的交互作用不显著。超重/肥胖与儿童高血压显著相关。没有证据表明心肺适能会改变这种关系。
