肥胖指标在青少年高血压病预测中的价值

Obesity parameters as predictive factors of hypertension in adolescents

目的评价体重指数（BMI）、腰围／身高比值（WHtR）、腰围（WC）及腰臀比（WHR）在预测青少年高血压病中的价值。方法通过分层整群随机抽样，共抽取12—18岁青少年3953例（男1947例，女2006例）。据血压水平分为正常对照组（3724例）和高血压组（229例）。测量身高、体重、腰围、收缩压（SBP）、舒张压（DBP）水平。结果高血压组BMI、WC、WHtR、WHR、SBP及DBP均明显高于正常对照组，差异有统计学意义（P〈0．05）。校正年龄、性别后，4个指标（BMI、WHtR、WC及WHR）均与SBP和DBP呈正相关，BMI与SBP和DBP的偏相关分析r’最大（r’分别为0．3228和0．2358）（P〈0．05）。4个指标预测高血压的受试者工作特性曲线下面积以BMI最大，分别为男性0．715（95％C10．659～0．771）和女性0．702（95％C10．646～0．757）。以SBP和DBP为因变量，以性别、年龄、BMI、腰围、WHtR和WHR为自变量，行多元线性回归，BMI均第一个被引入方程。结论BMI是预测青少年高血压病的有效指标。

Objective To investigate the relation of obesity parameters,including body mass index （BMI） ,waist-to-height ratio （WHR） ,waist circumference,and waist-to-hip ratio （WHR） ,with hypertension in adolescents. Methods A cross-section study was conducted among 3953 adolescents aged 12 to 18 years old, who were assigned to the normal blood pressure group （3724） or hypertension group （229）. Measurements were height, weight, waist circumference, systolic blood pressure （ SBP）, and diastolic blood pressure （DBP）. Results The data showed that mean BMI, WHR, waist circumference, WHR, SBP, and DBP in the hypertension group was significantly higher than those in the normal blood pressure group （ all P 〈 0. 05 ）. In partial correlation analysis, BMI, WHR, waist circumference, and WHR were positively correlated with both SBP and DBP after gender or age were adjusted （r＇ = 0. 3228 and 0. 2358, both P 〈 0. 05）. For areas under the receiver operating curve （ROC）, the BMI was observed to strongly predict hypertension in male （0. 715; 95 % CI 0. 659-0. 771 ） and female （0. 702; 95 % CI 0. 646-0. 757 ）. BMI was also entered into the multiple linear regression model. Conclusion BMI could be an effective predictive factor of hypertension in adolescents.