Rona R J, Qureshi S, Chinn S
Division of Public Health Sciences, UMDS, St Thomas's Hospital, London.
J Epidemiol Community Health. 1996 Oct;50(5):512-18. doi: 10.1136/jech.50.5.512.
To assess which factors are associated with total cholesterol concentration and blood pressure in 9 year olds, and to examine the extent to which a report of a heart attack in a close relative identifies children with a high total cholesterol value or high systolic blood pressure.
This was a cross sectional study.
The analysis was based on 22 study areas from a representative English sample, 14 areas from a representative Scottish sample, and 20 areas from an inner city sample.
There were 1987 children aged 8 or 9 whose blood pressure was measured and 1662 children whose total cholesterol was assessed.
Blood pressure was measured using the Dinamap 1846 automated sphygmomanometer and cholesterol using the Lipotrend C. Multiple regression analysis was used to examine the independent associations with each of the outcome variables. Either weight for height or sum of skinfolds measured in four sites was highly associated with the outcome measures in the study (p < 0.001). Fatter or overweight children had higher blood pressure and higher cholesterol concentrations. Child's height was also associated with the outcome measures in most of the analyses, but was positively related to blood pressure and negatively associated with cholesterol value. There was an association between diastolic blood pressure and area of residence as represented by the regional health authority (RHA), but the association was not the same as the association reported between coronary heart disease, standardised mortality ratio, and RHA. Children with low birth weight and those with shorter gestation had higher systolic blood pressure (p < 0.05 and p < 0.01 respectively), but not diastolic blood pressure. A report of a premature heart attack in a parent or a grandparent was not associated with higher cholesterol or blood pressure.
Reducing obesity in children, together with the avoidance of smoking, may be an appropriate action to prevent coronary heart disease in adulthood. A report of heart disease in a close relative is an ineffective means of identifying children at greater risk of high cholesterol or blood pressure without other measurements from relatives.
评估哪些因素与9岁儿童的总胆固醇浓度和血压相关，并探究近亲有心脏病发作报告在多大程度上能识别出总胆固醇值高或收缩压高的儿童。
这是一项横断面研究。
分析基于来自具有代表性的英格兰样本中的22个研究区域、来自具有代表性的苏格兰样本中的14个区域以及来自市中心样本中的20个区域。
共有1987名8或9岁儿童测量了血压，1662名儿童评估了总胆固醇。
使用Dinamap 1846自动血压计测量血压，使用Lipotrend C测量胆固醇。采用多元回归分析来检验与每个结果变量的独立关联。身高体重比或四个部位测量的皮褶厚度总和与研究中的结果指标高度相关（p < 0.001）。较胖或超重的儿童血压和胆固醇浓度更高。在大多数分析中，儿童身高也与结果指标相关，但与血压呈正相关，与胆固醇值呈负相关。以地区卫生当局（RHA）表示的居住地与舒张压之间存在关联，但该关联与冠心病、标准化死亡率和RHA之间报告的关联不同。低出生体重和妊娠期较短的儿童收缩压较高（分别为p < 0.05和p < 0.01），但舒张压不高。父母或祖父母有过早心脏病发作的报告与较高的胆固醇或血压无关。
减少儿童肥胖，同时避免吸烟，可能是预防成年期冠心病的合适措施。近亲有心脏病报告，在没有对亲属进行其他测量的情况下，是识别胆固醇高或血压高风险更高儿童的无效方法。
