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比较儿童肥胖指数在预测青年期高血压中的作用。

Comparison of child adiposity indices in prediction of hypertension in early adulthood.

机构信息

Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China.

Department of Anatomy and Medical Imaging, School of Medical Science, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.

出版信息

J Clin Hypertens (Greenwich). 2019 Dec;21(12):1858-1862. doi: 10.1111/jch.13734. Epub 2019 Nov 19.

Abstract

We aimed to compare child body mass index (BMI) in prediction of hypertension in early adulthood with 4 other adiposity indices (waist circumference [WC], waist circumference-to-height ratio [WHtR], waist-to-hip ratio [WHR], and triceps skinfold [TSF]). The cohort from the China Health and Nutrition Survey 1993-2011 consisted of 1444 adults aged 18-36 years who were examined in childhood and early adulthood. Child adiposity indices and adult blood pressure (BP) were transformed into age-, sex-, and survey year-specific Z-scores. Adult hypertension was defined as BP ≥130/80 mm Hg as per the 2017 American College of Cardiology/American Heart Association guidelines. Adult hypertension prevalence was 32.9% during a mean follow-up of 10.1 years. Childhood BMI showed stronger correlation with adult BP than WHR and TSF (P for difference <.05). Child BMI showed the better prediction of adult hypertension compared with WHtR, WHR, and TSF using area under the receiver operating characteristic curves (P for difference <.05). Per SD change in the predictor, child BMI (relative risk [95% confidence interval], 1.11 [1.04-1.18]) and WC (1.12 [1.05-1.20]) were significantly associated with adult hypertension using covariate-adjusted Poisson models with robust standard errors. Child BMI performed equally or better compared with 4 other adiposity indices in predicting adult hypertension.

摘要

我们旨在比较儿童体重指数(BMI)与其他 4 种肥胖指标(腰围[WC]、腰围与身高比[WHtR]、腰围与臀围比[WHR]和三头肌皮褶厚度[TSF])在预测青年期高血压方面的表现。本研究的队列来自中国健康与营养调查 1993-2011 年,共纳入 1444 名 18-36 岁的成年人,他们在儿童期和青年期接受了检查。儿童肥胖指标和成人血压(BP)均转换为年龄、性别和调查年份特异性 Z 分数。根据 2017 年美国心脏病学会/美国心脏协会指南,成人高血压定义为血压≥130/80mmHg。在平均 10.1 年的随访期间,成人高血压患病率为 32.9%。儿童 BMI 与成人 BP 的相关性强于 WHR 和 TSF(差异 P<.05)。与 WHtR、WHR 和 TSF 相比,儿童 BMI 对成人高血压的预测能力更好,曲线下面积更大(差异 P<.05)。使用协方差调整泊松模型(稳健标准误差),预测因子每标准差变化,儿童 BMI(相对风险[95%置信区间],1.11[1.04-1.18])和 WC(1.12[1.05-1.20])与成人高血压显著相关。与其他 4 种肥胖指标相比,儿童 BMI 在预测成人高血压方面表现相当或更好。

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