Yang L, Ma C W, Zhao M, Xi B
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University/Children Cardiovascular Research Center of Shandong University, Ji'nan 250012, China.
Department of Toxicology and Nutrition, School of Public Health, Cheeloo College of Medicine, Shandong University, Ji'nan 250012, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2020 Sep 10;41(9):1445-1449. doi: 10.3760/cma.j.cn112338-20200225-00173.
To analyze the trends in blood pressure (BP) values and the elevated BP based on the measurements at three occasions in different days and its relationship with obesity in children and provide scientific evidence for the identification and prevention of hypertension in children. A public primary school in Huantai county of Zibo, Shandong province, was selected as the investigation field by using a convenient cluster sampling method. The baseline survey of "Children's Cardiovascular Health Cohort" was carried out from November 2017 to January 2018. All the students with willingness and informed consent in this school were included in the survey, and the valid sample size was 1 505 children (aged 6-11 years). Children with elevated BP at the measurement of the first occasion should had a second measurement 2 weeks later, and a third measurement was given 2 weeks later if BP was still high at the measurement of the second occasion. Hypertension was confirmed if elevated BP was detected in the measurements at all the three occasions in different days. Multivariate linear regression model was used to assess the trend in BP values in children in the measurements at three occasions in different days, Cochran-Armitage trend analysis was used to evaluate the trend of elevated BP, and logistic regression model was used to analyze the relationship of elevated BP with obesity at three occasions in different days. In this study, with the increase of follow-up visits, the BP levels continued to rise (trend <0.05). The elevated BP rates at three occasions were 15.5%, 4.0% and 1.9%, respectively, showing a significantly downward trend (trend <0.05). Compared with both normal weight and normal waist circumference, the association between obesity types (general obesity only, abdominal obesity only, and mixed obesity) and elevated BP at three occasions increased (the first occasion: =3.62, 95: 2.65-4.96; the second occasion: =9.50, 95: 4.95-18.22; and the third occasion: =8.94, 95: 3.48-22.96; all <0.05). Stratified analysis by gender showed similar results. The elevated BP rates based on the measurements at three occasions in different days in children aged 6-11 years showed a significant decrease trend. The association between different types of obesity (especially mixed obesity) and elevated BP in children became stronger gradually with the progress of the follow up.
分析不同日期三次测量的儿童血压(BP)值及血压升高的趋势及其与肥胖的关系,为儿童高血压的识别和预防提供科学依据。采用方便整群抽样方法,选取山东省淄博市桓台县一所公立小学作为调查现场。2017年11月至2018年1月开展“儿童心血管健康队列”基线调查。该校所有自愿且知情同意的学生纳入调查,有效样本量为1505名儿童(6 - 11岁)。首次测量血压升高的儿童应在2周后进行第二次测量,若第二次测量血压仍高,则在2周后进行第三次测量。若在不同日期的三次测量中均检测到血压升高,则确诊为高血压。采用多变量线性回归模型评估不同日期三次测量中儿童血压值的趋势,采用 Cochr an - Armitage趋势分析评估血压升高的趋势,采用逻辑回归模型分析不同日期三次测量中血压升高与肥胖的关系。本研究中,随着随访次数增加,血压水平持续上升(趋势<0.05)。三次测量时血压升高率分别为15.5%、4.0%和1.9%,呈显著下降趋势(趋势<0.05)。与正常体重和正常腰围相比,肥胖类型(仅全身肥胖、仅腹型肥胖和混合肥胖)与三次测量时血压升高的关联增加(首次测量:=3.62,95%:2.65 - 4.96;第二次测量:=9.50,95%:4.95 - 18.22;第三次测量:=8.94,95%:3.48 - 22.96;均<0.05)。按性别分层分析显示结果相似。6 - 11岁儿童不同日期三次测量的血压升高率呈显著下降趋势。随着随访进展,儿童不同类型肥胖(尤其是混合肥胖)与血压升高的关联逐渐增强。