Dong Y H, Yang Z G, Yang Y D, Wang S, Wang Z H, Wang X J, Chen Y J, Zou Z Y, Ma J
School of Public Health & Institute of Child and Adolescent Health, Peking University, Beijing 100191, China.
Zhonghua Yu Fang Yi Xue Za Zhi. 2018 Aug 6;52(8):791-797. doi: 10.3760/cma.j.issn.0253-9624.2018.08.004.
This study aimed to explore the association between malnutrition and the level of blood pressure (BP) as well as elevated BP (EBP) in Han students aged 7 to 18 years in China. 170 037 subjects with normal nutritional status and malnutrition were enrolled in this study from 2014 Chinese National Surveys on Students' Constitution and Health with a multi-stage stratified cluster random sampling framework covering 31 provinces, autonomous regions and municipalities after the exclusion of 44 317 overweight and obese students. According to the standard of "Screening Standard for Malnutrition of School-age Children and Adolescents" (WS/T456-2014), the nutritional status of children were classified into two categories, normal nutritional status and malnutrition containing stunting, mild wasting and moderate severe wasting. The level of BP and prevalence of EBP were compared between students with normal nutritional status and malnutrition. The multivariate logistic regression model was used to analyze the association between malnutrition and EBP. The levels of systolic BP (SBP) and diastolic BP (DBP) in Chinese Han students aged 7-18 years who were non-overweight and non-obesity status were (103.4±12.3) and (64.7±9.5) mmHg (1 mmHg=0.133 kPa), respectively. The prevalence of EBP, systolic EBP and diastolic EBP in Chinese Han malnourished students (=21 012) were 3.1% (649), 1.5% (324) and 2.1% (445), respectively, which was significantly lower than those (=148 320) with normal nutritional status (4.5% (6 707), 2.6% (3 872) and 2.7% (3 959)), and the corresponding differences were statistically significant (0.05). The (95) between malnutrition and EBP was 0.68 (0.62-0.73), which were 0.65 (0.58-0.72) and 0.68 (0.60-0.77) for boys and girls. The (95) between EBP and stunting as well as mild wasting and moderate severe wasting were 0.69 (0.62-0.77), 0.63 (0.55-0.72) and 0.79 (0.60-1.05), respectively. The level of BP and prevalence of EBP in Chinese Han students with malnutrition were lower than those with normal nutritional status. The negative correlation existed between malnutrition and EBP in Chinese Han students aged 7 to 18 years.
本研究旨在探讨中国7至18岁汉族学生营养不良与血压水平及血压升高（EBP）之间的关联。在排除44317名超重和肥胖学生后，采用多阶段分层整群随机抽样框架，从2014年中国学生体质与健康调研中选取了170037名营养状况正常和营养不良的受试者，覆盖31个省、自治区和直辖市。根据《学龄儿童青少年营养不良筛查标准》（WS/T456 - 2014），将儿童营养状况分为两类，即营养状况正常和包含发育迟缓、轻度消瘦及中度重度消瘦的营养不良。比较了营养状况正常和营养不良学生的血压水平及EBP患病率。采用多因素logistic回归模型分析营养不良与EBP之间的关联。7至18岁非超重、非肥胖汉族学生的收缩压（SBP）和舒张压（DBP）水平分别为（103.4±12.3）和（64.7±9.5）mmHg（1mmHg = 0.133kPa）。汉族营养不良学生（n = 21012）的EBP患病率、收缩期EBP和舒张期EBP患病率分别为3.1%（649例）、1.5%（324例）和2.1%（445例），显著低于营养状况正常学生（n = 148320）（分别为4.5%（6707例）、2.6%（3872例）和2.7%（3959例）），相应差异具有统计学意义（P < 0.05）。营养不良与EBP之间的比值比（95%可信区间）为0.68（0.62 - 0.73），男孩和女孩分别为为0.65（0.58 - 0.72）和0.68（0.60 - 0.77）。EBP与发育迟缓以及轻度消瘦和中度重度消瘦之间的比值比（可信区间）分别为0.69（0.62 - 0.77）、0.63（0.55 - 0.72）和0.79（0.60 - 1.05）。汉族营养不良学生的血压水平和EBP患病率低于营养状况正常的学生。7至18岁汉族学生中，营养不良与EBP之间存在负相关。
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