目的 分析蒙自市儿童青少年超重和肥胖与血压偏高之间的关系,为卫生相关部门制定有效的干预措施提供参考。方法 于2020年10月—2021年9月采用分层随机整群抽样方法,共抽取14所学校中30个班级的中小学生开展研究,对其进行问卷调查并测量身高、体重及血压。超重和肥胖与血压偏高之间的关系采用Logistic回归分析。结果 研究共纳入7～17岁儿童青少年4 015人。超重、肥胖及血压偏高检出率分别为12.53%、10.01%及12.38%。体重正常组、超重组和肥胖组血压偏高检出率分别为9.96%、19.48%及25.62%。超重组和肥胖组血压偏高风险是体重正常组的2.190倍(95%CI:1.696～2.926,P＜0.001)和3.243倍(95%CI:2.501～4.204,P＜0.001)。对1 604名9～17岁儿童青少年的饮食、运动等行为进行分析,非寄宿生(15.09%)、食用新鲜水果≥1次/d(13.49%)学生的肥胖率更高(χ2=18.012、7.225,P＜0.05);不饮用含糖饮料(16.88%)、每周进行60min以上中高强度运动≤2d(14.47%)的学生血压偏高率更高(χ2=9.403、14.921,P＜0.01)。结论 高血压的患病风险随超重肥胖发生风险的增加而增高,且与多种因素密切相关。因此,对儿童青少年进行有效的体重控制与行为生活方式干预十分必要。
Abstract
Objective To analyze the association of overweight and obesity with elevated blood pressure(BP) among children and adolescents in Mengzi City, in order to provide reference for making effective interventions. Methods A total of 30 classes of students in 14 schools were selected into this study by a stratified random cluster sampling method from October 2020 to September 2021. The paticipants completed a questionnaire survey, and had their height, weight and BP measured. Logistic regression analysis was used to evaluate the association of overweight and obesity with elevated BP. Results A total of 4 015 children and adolescents aged 7 - 17 years were involved in the study. The detection rate of overweight, obesity and elevated BP was 12.53%, 10.01% and 12.38%, respectively. The detection rate of elevated BP was 9.96%, 19.48% and 25.62% in normal weight, overweight and obese groups, respectively. The risk of elevated BP in the overweight and obese groups was 2.190 times(95%CI: 1.696 - 2.926, P<0.001) and 3.243 times(95%CI: 2.501 - 4.204, P<0.001) as high as that in normal weight groups. The dietary and exercise behaviors of 1 604 adolescents were analyzed, it was found that the detection rate of obesity was significntly higher in non-boarding students(15.09%) and those who consumed fresh fruits at least once a day(13.49%)(χ2=18.012, 7.225, P<0.05), the detection rate of elevated BP was significantly higher in among those who did not consume sugary beverages(16.88%), and performed moderate-to-high intensity physical exercise of 60 minutes or more ≤ 2 days per week(16.88%)(χ2=9.403, 14.921,P<0.01). Conclusions The risk of developing hypertension increases with the high prevalence of overweight and obesity and is strongly associated with multiple factors. Therefore, it is essential to conduct effective weight control and behavioral lifestyle interventions among children and adolescents.
关键词
儿童青少年 /
超重 /
肥胖 /
血压偏高
Key words
children and adolescents /
overweight /
obesity /
elevated blood pressure
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参考文献
[1] NCD Risk Factor Collaboration(NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults[J]. Lancet, 2017, 390(10113): 2627-2642.
[2] 马军,宋逸,陈天娇,等.2020年中国儿童健康状况分析报告[M].社会科学文献出版社,2021:25-52.
Ma J, Song Y, Chen TJ, et al. Analysis report on the health status of Chinese children in 2020[M]. Soc Sci Acad Press, 2021: 25-52. (in Chinese)
[3] Wühl E. Hypertension in childhood obesity[J]. Acta Paediatr, 2019, 108(1): 37-43.
[4] Samson R,Ayinapudi K,Jemtel THL,et al. Obesity, hypertension, and bariatric surgery[J]. Curr Hypertens Rep, 2020, 22(7): 46-56.
[5] Kartiosuo N,Ramakrishnan R,Lemeshow S,et al. Predicting overweight and obesity in young adulthood from childhood body-mass index: Comparison of cutoffs derived from longitudinal and cross-sectional data[J]. Lancet Child Adolesc Health, 2019, 3(11): 795-802.
[6] 严明明,罗淑颖,张耀东.郑州市城区7～15岁儿童青少年中心性肥胖流行现况[J].中国儿童保健杂志,2022,30(9):1000-1004.
Yan MM, Luo SY, Zhang YD. Prevalence of abdominal obesity among children and adolescents aged 7 to 15 years in Zhengzhou[J]. Chin J Child Health Care,2022,30(9): 1000-1004.(in Chinese)
[7] Hardy ST,Urbina EM. Blood pressure in childhood and adolescence[J]. Am J Hypertens, 2021, 34(3): 242-249.
[8] Candelino M,Tagi VM,Chiarelli F. Cardiovascular risk in children: A burden for future generations[J]. Ital J Pediatr, 2022, 48(1):57-65.
[9] 国家卫生健康委员会.学生健康检查技术规范[S].北京:中国国家标准化管理委员会,2011.
National Health Commission of the People's Republic of China. TechnicaI standard for physical examination for students[S]. Beijing:Standardization Administration, 2011.(in Chinese)
[10] 中华人民共和国国家卫生和计划生育委员会.WS/T 586-2018学龄儿童青少年超重与肥胖筛查[S].北京:中国标准出版社,2018.
National Health and Family Planning Commission of the People's Republic of China. WS/T 586-2018 screening for overweight and obesity in school-age children and adolescents[S]. Beijing:China Standard Press,2018.(in Chinese)
[11] 中华人民共和国国家卫生健康委员会.WS/T 610-2018 7岁～18岁儿童青少年血压偏高筛查界值[S].北京:中国标准出版社, 2018.
National Health Commission of the People's Republic of China. WS/T 610-2018 reference of screening for elevated blood pressure among children and adolescents aged 7-18 years[S]. Beijing: China Standard Press, 2018.(in Chinese)
[12] 李国波.福建省学龄前儿童超重肥胖流行现状及其与环状RNA的关联研究[D].福州:福建医科大学,2022.
Li GB. The prevalence of overweight and obesity in preschoolers in Fujian Province and its association with CircRNAs[D].Fuzhou:Fujian Med Univ, 2022.(in Chinese)
[13] 李盛,杨露,李昕蓉,等.2020年兰州市18岁以下中小学生超重和肥胖与血压的关系分析[J].疾病预防控制通报,2023,38(2):25-29.
Li S, Yang L, Li XR, et al. Analysis of status of overweight, obesity and relation with blood pressure in primary and middle school students under 18 years old in Lanzhou, 2020[J]. Bull Dis Control Prev,2023, 38(2): 25-29.(in Chinese)
[14] 陈永刚,高青,朴泰弘,等.辽宁省本溪市青少年血压偏高现况及其影响因素分析[J].中国儿童保健杂志,2021,29(7):779-782.
Chen YG, Gao Q, Piao TH, et al. Prevalence of high blood pressure and its influencing factors among adolescents in Benxi, Liaoning Province[J]. Chin J Child Health Care, 2021, 29(7): 779-782.(in Chinese)
[15] 宝红升,孙元芳,唐丽燕,等.浙江省儿童青少年超重肥胖影响因素分析[J].中国儿童保健杂志,2023,31(3):341-345.
Bao HS, Sun YF, Tang LY, et al. Influencing factors of overweight and obesity among children and adolescents in Zhejiang Province[J]. Chin J Child Health Care, 2023, 31(3): 341-345.(in Chinese)
[16] Yang YJ,Dai J,Min JQ, et al. Prevalence trends of hypertension and influence factors among children and adolescents aged 7-17 years in China, 2011—2015: A serial cross-sectional study[J]. Front Public Health, 2022, 10: 8872-8885.
[17] Wang LL, Song LL,Liu BQ, et al. Trends and status of the prevalence of elevated blood pressure in children and adolescents in China: A systematic review and meta-analysis[J]. Curr Hypertens Rep, 2019, 21(11): 88-99.
[18] Liu K, Li C, Gong HB, et al. Prevalence and risk factors for hypertension in adolescents aged 12 to 17 years: A school-based study in China[J]. Hypertension, 2021,78(5):1577-1585.
[19] Agustina R,Meilianawati, Fenny, et al. Psychosocial, eating behavior, and lifestyle factors influencing overweight and obesity in adolescents[J]. Food Nutr Bull, 2021, 42(Suppl 1):72-91.
[20] Jebeile H,Kelly AS,O'Malley G, et al. Obesity in children and adolescents: Epidemiology, causes, assessment, and management[J]. Lancet Diabetes Endocrinol, 2022, 10(5): 351-365.
[21] Farhangi MA,Nikniaz L,Khodarahmi M. Sugar-sweetened beverages increases the risk of hypertension among children and adolescence: A systematic review and dose-response meta-analysis[J]. J Transl Med,2020, 18(1): 344-361.
[22] Gui ZH,Zhu YN,Cai L, et al. Sugar-sweetened beverage consumption and risks of obesity and hypertension in Chinese children and adolescents: A national cross-sectional analysis[J]. Nutrients, 2017, 9(12): 1302-1315.
[23] Wang C, Sun J, Hui Z, et al. Consumption frequencies of beverages and the hypertension risk in adults: A cohort study in China[J]. BMJ open, 2023, 13(4): e072474.
[24] Duan R, Kou C, Jie J, et al. Prevalence and correlates of overweight and obesity among adolescents in northeastern China: A cross-sectional study[J]. BMJ open, 2020, 10(7): e036820.
[25] You J, Choo J. Adolescent overweight and obesity: Links to socioeconomic status and fruit and vegetable intakes[J].Int J Environ Res Public Health, 2016, 13(3):307-317.
[26] German C, Makarem N, Fanning J, et al. Sleep, sedentary behavior, physical activity, and cardiovascular health:MESA[J].Med Sci Sports Exerc,2021, 53(4):724-731.
基金
兰州枣林云创商贸有限公司特定人群膳食结构、食品安全与保健食品开发研究项目(071100229)
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