Clinical Epidemiology and Biostatistics Department, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Pediatrics in Chongqing, China International Science and Technology Cooperation Center of Child Development and Critical Disorders, Chongqing, China.
Hematology and Oncology Department, Children's Hospital of Chongqing Medical University, Chongqing, China.
J Clin Hypertens (Greenwich). 2022 Aug;24(8):1015-1025. doi: 10.1111/jch.14544. Epub 2022 Jul 21.
Childhood hypertension has become a global public health issue due to its increasing prevalence and association with cerebral-cardiovascular disease in adults. In this study, we developed a predictive model for childhood hypertension based on environmental and genetic factors to identify at-risk individuals. Eighty children diagnosed with childhood hypertension and 84 children in the control group matched by sex and age from an established cohort were included in a nested case-control study. We constructed a multiple logistic regression model to analyze the factors associated with hypertension and applied the 10-fold cross-validation method to verify the prediction stability of the model. Childhood hypertension was found positively correlated with triglyceride level ≥150 mg/dL; low-density lipoprotein cholesterol level ≥110 mg/dL; body mass index Z score; waist-to-height ratio Z score; and red blood cell count (all P < .01) and negatively correlated with the relative expression level of retinol acyltransferase; relative expression level of vitamin D receptor; and dietary intake of fiber, vitamin C and copper (all P < .05) in this study. BMI Z score, triglyceride ≥150 mg/dL, RBC count, VDR/β-actin and LRAT/β-actin ratios were used to construct the predictive model. The area under the receiver operating characteristic curve was 94.45% (95% CI = 89.35%∼98.65%, P < .001). The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were all above 80% in both the training and validation sets. In conclusion, this model can predict the risk of childhood hypertension and could provide a theoretical basis for early prevention and intervention to improve the cardiovascular health of children.
儿童高血压已成为一个全球性的公共卫生问题，因为它的发病率不断增加，并与成年人的脑心血管疾病有关。在这项研究中，我们基于环境和遗传因素开发了一个预测儿童高血压的模型，以识别高危个体。从一个已建立的队列中，我们纳入了 80 名被诊断为儿童高血压的儿童和 84 名性别和年龄匹配的对照组儿童进行巢式病例对照研究。我们构建了一个多因素逻辑回归模型来分析与高血压相关的因素，并应用 10 折交叉验证方法来验证模型的预测稳定性。我们发现，儿童高血压与甘油三酯水平≥150mg/dL、低密度脂蛋白胆固醇水平≥110mg/dL、体重指数 Z 评分、腰围身高比 Z 评分和红细胞计数呈正相关（均 P<0.01），与视黄醇酰基转移酶的相对表达水平、维生素 D 受体的相对表达水平以及纤维、维生素 C 和铜的饮食摄入量呈负相关（均 P<0.05）。在该研究中，我们使用 BMI Z 评分、甘油三酯≥150mg/dL、红细胞计数、VDR/β-actin 和 LRAT/β-actin 比值构建了预测模型。受试者工作特征曲线下面积为 94.45%（95%置信区间为 89.35%~98.65%，P<0.001）。在训练集和验证集中，该模型的准确性、敏感度、特异度、阳性预测值和阴性预测值均高于 80%。总之，该模型可以预测儿童高血压的风险，并为早期预防和干预提供理论依据，以改善儿童的心血管健康。
