新疆7~17岁儿童青少年超重肥胖和血压关系的关联研究

Association of overweight and obesity with blood pressure in children and adolescents aged 7 - 17 years in Xinjiang

目的掌握新疆儿童青少年超重肥胖及血压偏高的现状,探讨超重肥胖与血压偏高的关系,为制定相应的防控措施和策略提供科学依据。方法采用分层整群随机抽样的方法,对2019年新疆14个地(州、市)的城区6所学校及郊区5所学校开展调查身体测量及问卷调查,儿童青少年超重肥胖、血压偏高分别按照《学龄儿童青少年超重与肥胖筛查》(WS/T586-2018)、《7~18岁儿童青少年血压偏高筛查界值》(WS/T610-2018)进行判定。计数资料的组间比较采用χ^(2)检验,利用多因素Poisson回归计算超重肥胖率比(PRR)及其95%CI。结果本研究共调查7~17岁儿童青少年41005人,其中超重率为15.8%,肥胖率为12.2%,男生超重率和肥胖率均高于女生(17.4%vs.14.3%,15.1%vs.9.4%,χ^(2)=133.23、744.99,P<0.01);汉族的超重率和肥胖率均高于其他民族(18.5%vs.14.2%,17.8%vs.8.7%,χ^(2)=75.61、301.76,P<0.01);城市超重率和肥胖率均高于农村(16.3%vs.15.1%,13.3%vs.10.3%,χ^(2)=10.56、80.40,P<0.01),且肥胖率随年龄的增加而降低(χ^(2)_(趋势)=707.65,P_(趋势)<0.01)。血压偏高检出率为13.2%,汉族血压偏高检出率高于其他民族(14.9%vs.12.2%,χ^(2)=61.08,P<0.01);农村血压偏高检出率高于城市(14.6%vs.12.4%,χ^(2)=37.07,P<0.01),且血压偏高的检出率随着年龄的增加而增加(χ^(2)_(趋势)=2.05,P<0.01)。BMI正常组的血压偏高患病率10.9%,超重组和肥胖组的血压偏高患病率分别为15.9%和23.3%。在调整年龄、民族和城乡等因素后,超重组血压偏高的患病率是正常组的1.50倍(95%CI:1.45~1.55)、肥胖组血压偏高的患病率是正常组的2.24倍(95%CI:2.09~2.40)。结论重视男生超重肥胖的预防,尤其是年龄较小儿童,无论城市还是农村学生,都应是血压防控的重点人群,要尽早在肥胖儿童中开展体重的综合干预与管理,从而控制血压,减少影响心血管代谢的危险因素,降低未来心血管疾病的发生风险。

Objective To understand the prevalent status of overweight,obesity,and hypertension among children and adolescents in Xinjiang,and to investigate the associations between these conditions,so as to provide scientific basis for formulating targeted prevention and control strategies.Methods By means of stratified cluster random sampling,body measurement and questionnaire survey were carried out in 6 schools from urban areas and 5 schools from suburban areas in 14 prefectures and cities of Xinjiang in 2019.Overweight,obesity and high blood pressure in children and adolescents were determined according to Screening for Overweight and Obesity in School-age Children and Adolescents(WS/T 586-2018)and Screening Cut-off Value for High Blood Pressure in Children and Adolescents aged 7-18(WS/T 610-2018).Analysis of variance(ANOVA)was employed for comparing measurement data,while the chi-square test was used for group comparisons of categorical data.Multivariate Poisson regression was utilized to calculate the overweight/obesity ratio(PRR)alongside its 95%confidence interval(95%CI).Results A total of 41005 children and adolescents aged 7-17 years were investigated.The prevalence of overweight and obesity was 15.8%and 12.2%,respectively.Males exhibited higher rates of overweight(17.4%)and obesity(15.1%)compared to females(14.3%and 9.4%,χ^(2)=133.23,744.99,P<0.01).Han ethnicity children and adolescents had higher rates of overweight(18.5%)and obesity(17.8%)than other ethnic groups(14.2%and 8.7%,χ^(2)=75.61,301.76,P<0.01).Urban areas reported higher rates of overweight(16.3%)and obesity(13.3%)than rural areas(15.1%and 10.3%,χ^(2)=10.56,80.40,P<0.01),with obesity rates decreasing with age(χ^(2)_(trend)=707.65,P_(trend)<0.01).The detection rate of hypertension was 13.2%,with Han ethnicity children and adolescents showing a higher rate(14.9%)than other ethnic groups(12.2%,χ^(2)=61.08,P<0.01).The detection rate of high blood pressure was higher in rural areas(14.6%)than that in urban areas(12.4%,χ^(2)=37.07,P<0.01),and it increased with age(χ^(2)_(trend)=2.05,P_(trend)<0.01).The prevalence of hypertension was 10.9%in the normal BMI group,15.9%in the overweight group,and 23.3%in the obese group.Adjusting for age,ethnicity,and urban/rural residence,the prevalence of hypertension in the overweight group was 1.50 times higher than in the normal group(95%CI:1.45-1.55),and in the obese group,it was 2.24 times higher than that in the normal group(95%CI:2.09-2.40).Conclusions The study highlights the need for comprehensive interventions and management should be highlighted to address overweight and obesity in boys,particularly younger children,regardless of whether they reside in urban or rural areas.Control of blood pressure should be a priority,and early intervention is crucial to mitigate metabolic risk factors for cardiovascular health and reduce the risk of future cardiovascular diseases.