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儿童和青少年肥胖指数作为高血压风险预测指标的系统评价

Systematic Evaluation of Adiposity Indices as Predictors of Hypertension Risk in Children and Adolescents.

作者信息

Zhu Bowen, Zhan Shumin, Shi Hui, Wang Xingyun, Yue Jingwen, Gao Jianfang, Wang Tongshuai, Wang Rui, Guo Xirong, Fu Junfen

机构信息

Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou, 310051, China.

Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No.1111, XianXia Road, Shanghai 200336, China.

出版信息

medRxiv. 2024 Nov 28:2024.11.26.24318031. doi: 10.1101/2024.11.26.24318031.

Abstract

OBJECTIVE

To systemically examine the concomitant impact of adiposity indices on hypertension in children and adolescents.

METHODS

A community-based cohort study by China Health and Nutrition Survey (2009-2011) included 262 children and adolescents aged 7-17. Anthropometric and lipid profiles were analyzed for hypertension risk using logistic and cross-lagged models.

RESULTS

Of the 227 participants (mean age, 16.5 [2.3] years), 147 (53.9%) were boys. Over a two-year period, 26.4% developed hypertension, 5.3% had elevated systolic blood pressure (SBP), and 25.6% had elevated diastolic blood pressure (DBP). After adjusting for covariates, higher body mass index (BMI), waist circumference (WC), hip circumference (HC), triceps skinfold thickness (TST), and body roundness index (BRI) were associated with increased hypertension risk. Incorporating these measures into a BP-based model improved the AUC for hypertension prediction from 0.551 (95% CI: 0.463, 0.640) to 0.670 (95% CI: 0.592, 0.748). A longitudinal relationship were observed between these adiposity indices and hypertension symptoms.

CONCLUSIONS

The study suggests anthropometry parameters are superior to blood lipid indicators in predicting the occurrence of hypertension in children. Abdominal obesity, as indicated by WC, HC, and BRI, accounts for a significant portion of the risk for hypertension, particularly in children aged 7 to 12 years.

摘要

目的

系统研究肥胖指数对儿童和青少年高血压的综合影响。

方法

中国健康与营养调查(2009 - 2011年)开展的一项基于社区的队列研究纳入了262名7至17岁的儿童和青少年。使用逻辑回归模型和交叉滞后模型分析人体测量指标和血脂谱以评估高血压风险。

结果

在227名参与者(平均年龄16.5[2.3]岁)中,147名(53.9%)为男孩。在两年期间,26.4%的人患高血压,5.3%的人收缩压(SBP)升高,25.6%的人舒张压(DBP)升高。在调整协变量后,较高的体重指数(BMI)、腰围(WC)、臀围(HC)、肱三头肌皮褶厚度(TST)和体圆度指数(BRI)与高血压风险增加相关。将这些指标纳入基于血压的模型后,高血压预测的曲线下面积(AUC)从0.551(95%CI:0.463,0.640)提高到0.670(95%CI:0.592,0.748)。观察到这些肥胖指数与高血压症状之间存在纵向关系。

结论

该研究表明,在预测儿童高血压的发生方面,人体测量参数优于血脂指标。腰围、臀围和体圆度指数所表明的腹型肥胖在高血压风险中占很大比例,尤其是在7至12岁的儿童中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a93/11623758/9bcf21dd4110/nihpp-2024.11.26.24318031v1-f0001.jpg

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