目的 分析学龄儿童青少年体成分不同指标与血压偏高的关联,为成年期高血压的早期预防提供依据。方法 2023年9—11月,采用分层整群随机抽样方法在苏州市的12所学校中选取3 444名7~17岁学龄儿童青少年,测量其身高、体重、腰围、血压及体成分。以血压是否偏高为因变量,采用logistic回归分析、限制性立方样条模型(RCS)分析体成分不同指标与血压偏高的关系。结果 苏州市7~17岁儿童青少年血压偏高检出率为11.61%(400/3 444)。全身体脂率(PBF)为(23.25±8.82)%,体脂质量指数(FMI)为(4.81±2.73)kg/m2,肌肉质量指数(MMI)为(13.84±2.06)kg/m2,体质量指数(BMI)为(19.55±4.18)kg/m2,血压偏高组均高于血压正常组(P<0.05);全身肌肉率(PBM)为(72.06±8.36)%,血压偏高组低于血压正常组(P<0.05)。RCS分析显示,PBF和PBM水平增加与血压偏高存在非线性关系(P非线性<0.05),FMI、MMI和BMI与血压偏高呈现线性关系(P非线性>0.05)。logistic回归分析女生中FMI、MMI和PBF与血压偏高的关联性强于男生(P<0.05)。以BMI、PBF均正常为参照组,BMI正常、PBF超重肥胖组(OR=3.467)和BMI、PBF均超重肥胖组(OR=4.177)血压偏高的风险增加(P<0.05),而BMI超重肥胖、PBF正常组血压偏高的风险未增加(P=0.266)。结论 体脂率与血压偏高呈现正向关联,肌肉率对血压偏高可能具有保护作用。应加强体成分监测,增强体育锻炼,增加肌肉率,预防儿童青少年血压偏高发生。
Abstract
Objective To analyze the association between different body composition indicators and elevated blood pressure among school-age children and adolescents, in order to provide evidence for early prevention of hypertension in adulthood. Methods From September to November 2023, a stratified cluster random sampling method was used to select 3 444 school-age children and adolescents aged 7 - 17 from 12 schools in Suzhou.Measurements included height, weight, waist circumference, blood pressure, and body composition.Elevated blood pressure was used as the dependent variable.Logistic regression and restricted cubic spline (RCS) models were applied to analyze the relationship between different body composition indicators and elevated blood pressure. Results The detection rate of elevated blood pressure among children and adolescents aged 7 - 17 in Suzhou was 11.61% (400/3 444).The whole-body percentage body fat (PBF) was (23.25±8.82)%, fat mass index (FMI) was (4.81±2.73) kg/m2, muscle mass index (MMI) was (13.84±2.06) kg/m2, and body mass index (BMI) was (19.55±4.18) kg/m2.All these indices were higher in the elevated blood pressure group compared to the normal blood pressure group (P<0.05).The whole-body percentage of muscle mass (PBM) was (72.06±8.36)%, which was lower in the elevated blood pressure group (P<0.05).RCS analysis revealed a nonlinear association of increasing PBF and PBM levels with elevated blood pressure (P for nonlinearity<0.05), while FMI, MMI, and BMI showed a linear relationship with elevated blood pressure (Pfor nonlinearity>0.05).Logistic regression analysis indicated that the associations of FMI, MMI, and PBF with elevated blood pressure were stronger in girls than in boys (P<0.05).Using the group with normal BMI and normal PBF as the reference, the group with normal BMI and overweight/obesity based on PBF (OR =3.467) and the group with overweight/obesity based on both BMI and PBF (OR=4.177) had an increased risk of elevated blood pressure (P<0.05), while no increased risk was observed in the group with overweight/obesity based on BMI and normal PBF (P=0.266). Conclusions Higher body fat percentage is positively associated with elevated blood pressure, while muscle mass percentage may have a protective effect.It is recommended to strengthen body composition monitoring, promote physical exercise, increase muscle mass percentage, and prevent elevated blood pressure in children and adolescents.
关键词
体成分 /
血压 /
体脂率 /
儿童
Key words
body composition /
blood pressure /
percent body fat /
children
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参考文献
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基金
国家自然科学基金青年项目(82204070);苏州市科技计划项目(SKY2022067);苏州市医学重点学科(SZXK202523)
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