苏州市儿童青少年青春发动时相与血压偏高的关联

doi:10.11852/zgetbjzz2024-0478

摘要/Abstract

摘要： 目的探讨儿童青少年青春发动时相与血压水平及血压偏高的关联性研究,为高血压防控提供科学依据。方法 2022年10—11月采用多阶段分层整群随机抽样方法选取苏州市4所小学和4所初中共1 992名9~16岁儿童青少年为研究对象。现场采集身高、体重和血压等基本信息,使用问卷收集学生饮食习惯、视屏情况、学习情况、运动情况,通过青春期发育量表(PDS)将青春发动时相分为提前组(>P₇₅)、适时组(P₂₅~P₇₅)、延迟组(<P₂₅)。采用线性回归分析不同青春发动时相和血压水平的关联,采用Logistic回归方法分析不同青春发动时相和血压偏高风险的关联。结果本次研究包括男生999名(50.2%),女生993名(49.8%)。男、女生年龄分别为(12.76±1.76)岁、(12.31±1.77)岁,男、女生收缩压(SBP)分别(114.40±12.70)、(110.34±11.74)mmHg,差异有统计学意义(t＝7.412,P＜0.001),舒张压(DBP)分别为(65.05±7.36)、(65.44±7.41)mmHg,差异无统计学意义(P＞0.05)。男、女生血压偏高检出率分别为26.3%、16.3%(χ²＝29.744,P＜0.001)。调整相关协变量后,线性回归分析显示,男生青春发动时相延迟与收缩压Z评分呈负相关(β =-0.340,95%CI:-0.340~-0.140,P＜0.05),女生结果无统计学意义(P＞0.05);男、女生青春发动时相提前和延迟与舒张压Z评分的相关性均无统计学意义(P＞0.05)。Logistic回归分析显示,男生青春发动时相延迟与血压偏高风险呈负相关(OR=0.545,95%CI:0.314~0.944),女生无统计学意义(P＞0.05)。结论儿童青少年青春发动时相与血压水平和血压偏高风险的关联在不同性别中存在差异,应尽早采取干预措施改善青春期发育状况,尤其是在男生中更应引起重视。

关键词: 血压, 儿童, 青少年, 青春发动时相, 青春期发育量表

Abstract: Objective To investigate the association of the timing of pubertal onset with blood pressure levels and hypertension risk in children and adolescents,in order to provide scientific evidence for hypertension prevention and control. Methods A multi-stage stratified cluster random sampling method was used to select 1 992 children and adolescents aged 9 - 16 years from four primary schools and four junior high schools in Suzhou between October and November 2022.Basic information including height,weight,and blood pressure was collected on-site.Questionnaires were used to gather data on students' dietary habits,screen time,academic performance,and physical activity.The Pubertal Development Scale (PDS) was employed to categorize pubertal timing into early group(>P₇₅),timely group(P₂₅ -P₇₅),and delayed groups(<P₂₅).Linear regression analysis was conducted to examine the association between different pubertal timing and blood pressure levels.Logistic regression analysis was performed to assess the relationship between pubertal timing and the risk of elevated blood pressure. Results A total of 999 males (50.2%) and 993 females (49.8%) were enrolled in this study.The average age of males and females was (12.76±1.76) years and (12.31±1.77) years,respectively,and thesystolic blood pressure (SBP) of males and females were (114.40±12.70) and (110.34±11.74) mmHg (χ²=7.412,P<0.001),respectively,and diastolic blood pressure(DBP) was (65.05±7.36) and (65.44±7.41) mmHg (P>0.05).The detection rates of high blood pressure in male and female students were 26.3% and 16.3%,respectively (χ²=29.744, P<0.001).After adjusting for the relevant covariates,linear regression analysis revealed a negative correlation between delayed pubertal timing and SBP Z-score in boys(β=-0.340,95%CI:-0.340 - -0.140), while the results of the girls were not statistically significant (P>0.05),and the early and delayed puberty initiation groups and the DBP Z-score were not statistically significant (P>0.05).No significant correlations were observed between early or delayed pubertal timing and DBP Z-score in either gender (P>0.05).Logistic regression analysis indicated a negative association between delayed pubertal timing and the risk of elevated blood pressure in boys (OR=0.545,95%CI:0.314 - 0.944),whereas no statistical significance was found in girls (P>0.05). Conclusions The association of pubertal timing with blood pressure levels and hypertension risk varies by gender in children and adolescents.Early intervention measures should be taken to improve pubertal development,particularly in boys.

Key words: blood pressure, children, adolescents, pubertal timing, Pubertal Developmental Scale

中图分类号:

R179

王希, 吕慧玲, 胡佳乐, 韩迪, 丁子尧, 沈蕙, 胡佳. 苏州市儿童青少年青春发动时相与血压偏高的关联[J]. 中国儿童保健杂志, 2024, 32(11): 1173-1178.

WANG Xi, LYU Huiling, HU Jiale, HAN Di, DING Ziyao, SHEN Hui, HU Jia. Association between the pubertal timing and high blood pressure in children and adolescents in Suzhou City[J]. Chinese Journal of Child Health Care, 2024, 32(11): 1173-1178.

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