Xijie Wang, Bin Dong, Yinghua Ma, Zhiyong Zou, Jun Ma, and Zhaogeng Yang are with the Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, PR China. Sizhe Huang is with Zhongshan Health Care Centers for Primary and Secondary School, Zhongshan, PR China. Zhiqiang Wang is with the Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, Australia.
Am J Public Health. 2020 Nov;110(11):1689-1695. doi: 10.2105/AJPH.2020.305873. Epub 2020 Sep 17.
To identify body mass index (BMI) trajectories in Chinese children and to compare the risk of incident high blood pressure (HBP) across trajectory groups. A total of 9286 children were included. The mean age at baseline was 8.9 years; age at endpoint ranged between 16 and 18 years. At least 8 measurements were obtained from each involved child. We used group-based trajectory modeling to identify BMI trajectory groups in each sex. We used blood pressure from each measurement to define HBP. We identified 4 BMI trajectories for each sex. Compared with the low trajectory group, the hazard ratios of HBP in the higher trajectory groups ranged from 1.17 (95% confidence interval [CI] = 1.11, 1.23) to 2.00 (95% CI = 1.78, 2.27) during follow-up, and HBP risk at late adolescence ranged from 1.36 (95% CI = 1.22, 1.52) to 3.63 (95% CI = 3.12, 4.21). All trend values across trajectories were less than .001. In terms of population level, overweight started 3 years earlier than HBP. Children of higher BMI trajectories had a higher risk of HBP during adolescence. The transition period from overweight to HBP onset could be critical for HBP prevention.
识别中国儿童的体重指数（BMI）轨迹，并比较不同轨迹组发生高血压（HBP）的风险。
共纳入 9286 名儿童。基线时的平均年龄为 8.9 岁；终点年龄在 16 至 18 岁之间。每个参与儿童至少获得 8 次测量值。我们使用基于群组的轨迹建模来识别每个性别中的 BMI 轨迹组。我们使用每次测量的血压来定义 HBP。我们为每个性别确定了 4 个 BMI 轨迹。与低轨迹组相比，在随访期间，高轨迹组的 HBP 发生风险比（HR）范围为 1.17（95%置信区间[CI] = 1.11, 1.23）至 2.00（95% CI = 1.78, 2.27），青少年晚期的 HBP 风险范围为 1.36（95% CI = 1.22, 1.52）至 3.63（95% CI = 3.12, 4.21）。所有轨迹的趋势值均小于 0.001。从人群水平来看，超重比 HBP 早出现 3 年。较高 BMI 轨迹的儿童在青春期发生 HBP 的风险更高。从超重到 HBP 发病的过渡时期可能对 HBP 的预防至关重要。
