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2014年中国7-18岁学生血压状况与营养状况的关联:基于中国儿童青少年血压参考标准

[Association between the blood pressure status and nutritional status among Chinese students aged 7-18 years in 2014: based on the national blood pressure reference for Chinese children and adolescents].

作者信息

Dong Y H, Song Y, Dong B, Zou Z Y, Wang Z H, Yang Z G, Wang X J, Li Y H, Ma J

机构信息

Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China.

出版信息

Beijing Da Xue Xue Bao Yi Xue Ban. 2018 Jun 18;50(3):422-428.

Abstract

OBJECTIVE

To analyze the epidemic situation of blood pressure (BP) status and its association with nutritional status among Chinese children and adolescents aged 7-18 years old in 2014, and to provide important scientific basis for the control of students' hypertension.

METHODS

All the subjects aged 7 to 18 years in both genders were sampled from 2014 Chinese national surveys on students' constitution and health. BP status was evaluated according to Chinese national gender-, age- and height-specific references, including hypertension (HTN), elevated hypertension (elevated HTN), isolated systolic HTN (SHTN), isolated diastolic HTN (DHTN) and mix HTN. Their nutritional status was evaluated using the international obesity task force (IOTF) definition, including thinness (severe thinness and moderate thinness), normal, overweight and obesity (severe obesity and moderate obesity). The Logistics method was used to analyze the association between BP status and nutritional status. The population attributable risk (PAR%) of overweight and obesity for BP status was calculated.

RESULTS

The prevalence of HTN and elevated HTN among the Chinese children and adolescents aged 7-18 years in 2014 was 14.9% and 9.2%, respectively. And the prevalence of isolated SHTN, isolated DHTN and mix HTN was 3.1%, 8.8% and 3.0%, respectively. The prevalence estimates for HTN differed the greatest for the boys, those in rural, those with high age, those in the East, and those with high BMI. The highest prevalence of HTN was detected in those with severe obesity with 44.2% and 38.8% in the boys and girls respectively, which was 2.8-fold and 3.7-fold than those with normal groups. The negative association was detected between HTN and thinness, but the positive association with overweight and obesity. The PAR% of HTN due to overweight and obesity was 16.2%, and the expected prevalence of HTN was 12.5% if controlling for overweight and obesity. Higher PAR% of isolated SHTN and mix HTN due to overweight and obesity was detected in the Chinese children and adolescents with proportions of 28.7% and 35.1%.

CONCLUSION

The prevalence of HTN among the Chinese children and adolescents aged 7-18 years was still high, whose components mainly focused on isolated DHTN. Overweight and obesity can increase the risk of HTN in children and adolescents significantly, especially for isolated SHTN and mix HTN. Controlling for overweight and obesity can decrease the risk of HTN among Chinese national children and adolescents largely, which can play an important role in preventing the occurrence of chronic disease in adults.

摘要

目的

分析2014年中国7 - 18岁儿童青少年血压状况的流行情况及其与营养状况的关联,为控制学生高血压提供重要科学依据。

方法

选取2014年中国学生体质与健康调研中所有7至18岁的男女学生作为研究对象。根据中国按性别、年龄和身高划分的全国参考标准评估血压状况,包括高血压(HTN)、高血压前期(临界高血压)、单纯收缩期高血压(SHTN)、单纯舒张期高血压(DHTN)和混合型高血压。采用国际肥胖特别工作组(IOTF)的定义评估其营养状况,包括消瘦(重度消瘦和中度消瘦)、正常、超重和肥胖(重度肥胖和中度肥胖)。运用Logistic方法分析血压状况与营养状况之间的关联。计算超重和肥胖对血压状况的人群归因危险度百分比(PAR%)。

结果

2014年中国7 - 18岁儿童青少年中高血压和高血压前期的患病率分别为14.9%和9.2%。单纯收缩期高血压、单纯舒张期高血压和混合型高血压的患病率分别为3.1%、8.8%和3.0%。男孩、农村儿童、年龄较大者、东部地区儿童以及BMI较高者的高血压患病率估计差异最大。重度肥胖者的高血压患病率最高,男孩和女孩分别为44.2%和38.8%,分别是正常组的2.8倍和3.7倍。高血压与消瘦呈负相关,但与超重和肥胖呈正相关。超重和肥胖导致的高血压PAR%为16.2%,若控制超重和肥胖,高血压的预期患病率为12.5%。在中国儿童青少年中,超重和肥胖导致的单纯收缩期高血压和混合型高血压的PAR%较高,分别为28.7%和35.1%。

结论

中国7 - 18岁儿童青少年高血压患病率仍较高,其构成主要集中在单纯舒张期高血压。超重和肥胖可显著增加儿童青少年患高血压的风险,尤其是单纯收缩期高血压和混合型高血压。控制超重和肥胖可在很大程度上降低中国儿童青少年患高血压的风险,这对预防成人慢性病的发生具有重要作用。

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