Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Pediatrics, Rush University Medical College, Chicago, IL, USA.
J Clin Hypertens (Greenwich). 2020 Jun;22(6):1009-1017. doi: 10.1111/jch.13895. Epub 2020 Jun 7.
Anthropometric indices have been used as indicators for predicting hypertension (HTN) in children and adolescents but it is not clear which anthropometric measures are a better index for identifying elevated blood pressure (EBP) risk factors in pediatric population. Body mass index (BMI), waist circumference (WC), weight-height ratio (WHR), a body shape index (ABSI) and blood pressure were measured in 14 008 children and adolescents aged 7-18 years in a national school-aged survey CASPIN V. Hypertension (HTN) was defined according to the 2017 American Academy of Pediatrics guidelines, using the 95th percentile. The predictive power of anthropometric indices for HTN risk factors was examined using receiver operating characteristic (ROC) analyses. Multivariate logistic regression analysis was used to compare areas under ROC curves (AUCs) among the four anthropometric indices. BMI, WC, WHR, and ABSI were significantly higher in adolescents than in children. EBP was more prevalent in boys (7.2%) than girls (5.5%), whereas the prevalence of HTN was higher in girls (11.3%) than boys 10.4%. Prevalence odds ratio was around 2 for BMI, WC, and WHR with AUCs scores of nearly 0.6 to predict EBP in both children and adolescents of both sexes. Thus, the ability of BMI z-score, WC, WHR or ASBI to identify Iranian children and adolescents at higher risk of EBP was week. WC, WHR or ASBI in combination with BMI did not improve predictive power to identify subjects at higher risk of EBP.
人体测量指数已被用作预测儿童和青少年高血压（HTN）的指标，但尚不清楚哪种人体测量指标是识别儿科人群中血压升高（EBP）危险因素的更好指标。在一项全国性学龄儿童调查 CASPIN V 中，对 14008 名 7-18 岁的儿童和青少年测量了体重指数（BMI）、腰围（WC）、体重-身高比（WHR）、身体形状指数（ABSI）和血压。根据 2017 年美国儿科学会指南，使用第 95 百分位将高血压（HTN）定义为 HTN。使用受试者工作特征（ROC）分析检查了人体测量指标对 HTN 危险因素的预测能力。使用多变量逻辑回归分析比较了四种人体测量指标的 ROC 曲线下面积（AUCs）。青少年的 BMI、WC、WHR 和 ABSI 明显高于儿童。男孩（7.2%）的 EBP 比女孩（5.5%）更常见，而女孩（11.3%）的 HTN 患病率高于男孩（10.4%）。BMI、WC 和 WHR 的患病率比值接近 2，AUC 评分接近 0.6，可预测男女青少年的 EBP。因此，BMI 得分、WC、WHR 或 ASBI 识别伊朗儿童和青少年 EBP 风险较高的能力较弱。WC、WHR 或 ASBI 与 BMI 结合并不能提高识别 EBP 风险较高的受试者的预测能力。
