Gu Huan, Hao Long, Li Mingxi, Li Ji
Department of Integrative Cardiology, China-Japan Friendship Hospital, Beijing, China.
Department of Pediatrics, Beijing Fangshan District Liangxiang Hospital, Beijing, China.
Front Pediatr. 2023 Jun 30;11:1188417. doi: 10.3389/fped.2023.1188417. eCollection 2023.
To assess the individual effects of overweight/obesity and tobacco exposure, and their combined effects on hypertension in children.
This cross-sectional study included 6,339 children aged 6-17 years from National Health and Nutrition Examination Surveys 1999-2018. Participants' height, weight and blood pressure (BP) were measured by trained technicians. Hypertension was defined as: mean systolic BP (SBP) and/or diastolic BP (DBP) ≥ 90th percentile for sex, age, and height (for children aged 1-13 years), and SBP ≥120 mmHg and/or a DBP ≥80 mmHg (for adolescents aged 13-17 years); or self-reported having been diagnosed with hypertension or taking antihypertensive medication. Gender- and age-specific body mass index (BMI) cut-points were used to define overweight/obesity: "overweight" was defined as a BMI > 1 standard deviation (SD); "obesity" was defined as BMI > 2SD; and "thinness" was defined as BMI < -2SD. Tobacco exposure was defined as having serum cotinine levels >0.05 µg/L or reporting the presence of at least one smoker in the household. Weighted univariate and multivariate logistic regression models were used to assess overweight/obesity and tobacco exposure with the odds of hypertension, and the combined effects of overweight/ obesity and tobacco exposure on hypertension, followed by strata-specific analyses. Odds ratios (OR) with 95% confidence intervals (CI) were calculated.
The prevalence of overweight/obesity and tobacco exposure was significantly higher in the hypertension group than in the non-hypertension group. Overweight/obesity ( = 1.67, 95%CI: 1.26-2.21/ = 2.38, 95%CI: 1.67-3.39) and tobacco exposure ( = 1.58, 95%CI: 1.16-2.14) were associated with a higher odd of hypertension in children, respectively. Additionally, we also observed the combined effect between overweight ( = 3.05, 95%CI: 1.96-4.75)/obesity ( = 3.68, 95%CI: 2.24-6.03) and tobacco exposure were related to hypertension odds in children, with a significant effect in different populations.
There may exist joint effect of overweight/obesity and tobacco exposure on the odds of hypertension in American children. These findings offer an insight that early weight control and reduction of tobacco exposure may be important to reduce odds of hypertension in children.
评估超重/肥胖和烟草暴露对儿童高血压的个体影响及其联合效应。
这项横断面研究纳入了1999 - 2018年国家健康与营养检查调查中的6339名6 - 17岁儿童。由经过培训的技术人员测量参与者的身高、体重和血压（BP）。高血压定义为：按性别、年龄和身高计算的平均收缩压（SBP）和/或舒张压（DBP）≥第90百分位数（适用于1 - 13岁儿童），以及SBP≥120 mmHg和/或DBP≥80 mmHg（适用于13 - 17岁青少年）；或自我报告已被诊断患有高血压或正在服用抗高血压药物。采用性别和年龄特异性的体重指数（BMI）切点来定义超重/肥胖：“超重”定义为BMI＞1个标准差（SD）；“肥胖”定义为BMI＞2SD；“消瘦”定义为BMI＜ - 2SD。烟草暴露定义为血清可替宁水平＞0.05 μg/L或报告家中至少有一名吸烟者。采用加权单因素和多因素逻辑回归模型评估超重/肥胖和烟草暴露与高血压发生几率的关系，以及超重/肥胖和烟草暴露对高血压的联合效应，随后进行分层分析。计算比值比（OR）及95%置信区间（CI）。
高血压组中超重/肥胖和烟草暴露的患病率显著高于非高血压组。超重/肥胖（OR = 1.67，95%CI：1.26 - 2.21/OR = 2.38，95%CI：1.67 - 3.39）和烟草暴露（OR = 1.58，95%CI：1.16 - 2.14）分别与儿童高血压发生几率较高相关。此外，我们还观察到超重（OR = 3.05，95%CI：1.96 - 4.75）/肥胖（OR = 3.68，95%CI：2.24 - 6.03）与烟草暴露的联合效应与儿童高血压发生几率相关，在不同人群中有显著影响。
超重/肥胖和烟草暴露对美国儿童高血压发生几率可能存在联合效应。这些发现表明，早期控制体重和减少烟草暴露对于降低儿童高血压发生几率可能很重要。
