Objective To examine the waist circumference (WC)'s predict role to elevate blood pressure (BP) among children and adolescents aged 7~17 years old who have normal body mass index (BMI),and provide scientific evidence for prevention and intervention of elevated BP in children and adolescents.
Methods Data were combined from the China Health and Nutrition Survey,which was conducted during the period of 1993-2011.A total of 9 038 children and adolescents aged 7~17 years old who had normal BMI were included in the final data analysis.Data were on gender,age,WC,systolic blood pressure (SBP),diastolic blood pressure (DBP),and the prevalence of elevated BP.After adjusted for sex and age,the multiple liner regression model was used to analyze the trend in mean BP with increase of WC levels.Logistic regression model was conducted to examine the trend in elevated BP prevalence and the risk of elevated BP with increase of WC levels.
Results Both the mean value of BP and prevalence of elevated BP showed rising trends with the increase of WC levels among children and adolescents with normal BMI (SBP/DBP ranged from 96.0/63.1 mmHg to 102.4/ 68.0 mmHg; prevalence of elevated BP ranged from 6.9% to 21.8%,all
P<0.001),independently of age and sex.When WC<P
25 as the referent group,the risk for elevated BP were1.39,1.70,2.21 and 3.10,for groups of WC≥P
25 and WC<P
50,WC≥P
50 and WC<P
75,WC≥P
75 and WC<P
90,and WC≥P
90,respectively,independently of age and sex(
P<0.01).
Conclusions WC can be used as an important predictor of elevated BP in children and adolescents.BMI should be in combined with WC in order to more effectively prevent risk of elevated BP in children and adolescents.
Key words
body mass index /
waist circumference /
elevated blood pressure /
children /
adolescents
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Xi B,Liang Y,Mi J.Hypertension trends in Chinese children in the national surveys,1993 to 2009[J].Int J Cardiol,2013,165(3):577-579.
[2] 米杰.中国儿童青少年高血压及盐摄入水平现状[EB/OL].2015.http://www.365yixue.com/m/shownews.aspid=109316.
[3] Kollias A,Dafni M,Poulidakis E,et al.Out-of-office blood pressure and target organ damage in children and adolescents:a systematic review and meta-analysis[J].J Hypertens,2014,32(12):2315-2331.
[4] Cai L,Wu Y,Wilson RF,et al.Effect of childhood obesity prevention programs on blood pressure:a systematic review and meta-analysis[J].Circulation,2014,129(18):1832-1939.
[5] Falaschetti E,Hingorani AD,Jones A,et al.Adiposity and cardiovascular risk factors in a large contemporary population of pre-pubertal children[J].Eur Heart J,2010,31(24):3063-3072.
[6] Chorin E,Hassidim A,Hartal M,et al.Trends in adolescents obesity and the association between BMI and blood pressure:A cross-sectional study in 714 922 healthy teenagers[J].Am J Hypertens,2015,28(9):1157-1163.
[7] Wang J,Zhu Y,Jing J,et al.Relationship of BMI to the incidence of hypertension:a 4 years' cohort study among children in Guangzhou,2007-2011[J].BMC Public Health,2015,15:782.
[8] Freedman DS,Wang J,Maynard LM,et al.Relation of BMI to fat and fat-free mass among children and adolescents[J].Int J Obes (Lond),2005,29(1):1-8.
[9] Huxley R,Mendis S,Zheleznyakov E,et al.Body mass index,waist circumference and waist:hip ratio as predictors of cardiovascular risk a review of the literature[J].Eur J Clin Nutr,2010,64(1):16-22.
[10] Sahakyan KR,Somers VK,Rodriguez-Escudero JP,et al.Normal-weight central obesity:implications for total and cardiovascular mortality[J].Ann Intern Med,2015,163(11):827-835.
[11] Mokha JS,Srinivasan SR,Dasmahapatra P,et al.Utility of waist-to-height ratio in assessing the status of central obesity and related cardiometabolic risk profile among normal weight and overweight/obese children:the Bogalusa Heart Study[J].BMC Pediatr,2010,10:73.
[12] Zhang YX,Zhao JS,Chu ZH.Children and adolescents with low body mass index but large waist circumference remain high risk of elevated blood pressure[J].Int J Cardiol,2016,215:23-25.
[13] Popkin BM,Du S,Zhai F,et al.Cohort Profile:The China Health and Nutrition Survey monitoring and understanding socio-economic and health change in China,1989-2011[J].Int J Epidemiol,2010,39(6):1435-1440.
[14] 李辉,宗心南,季成叶,等.中国2~18岁儿童青少年超重和肥胖筛查体重指数界值点的研究[J].中华流行病学杂志,2010,31(6):616-620.
[15] 季成叶,宋银子,马冠生,等.中国学龄儿童青少年腰围的地区分布和人群特征[J].中华流行病学杂志,2010,31(6):603-608.
[16] 米杰,王天有,孟玲慧,等.中国儿童青少年血压参照标准的研究制定[J].中国循证儿科杂志,2010,5(1):4-14.
[17] Kovacs VA,Gabor A,Fajcsak Z,et al.Role of waist circumference in predicting the risk of high blood pressure in children[J].Int J Pediatr Obes,2010,5(2):143-150.
[18] 张世伟,马军,张衡,等.儿童青少年体质量指数和腰围与血压的关系[J].中国学校卫生,2008,29(5):437-439.
PDF(550 KB)
