长春市儿童和青少年原发性高血压与肥胖相关性分析

Relationship between primary hypertension and obesity in children and adolescents of Changchun City

目的：总结长春市3～18岁儿童和青少年超重肥胖和原发性高血压的发生率，分析原发性高血压与超重肥胖的相关性，为儿童和青少年超重、肥胖、高血压的防治提供科学依据。方法2012-07至2012-09，采用整群随机抽样对长春市4860名3～18岁儿童和青少年进行高血压、肥胖流行特点的横断面调查。对资料进行统计学分析。结果（1）3～18岁儿童和青少年高血压发生率8．9％。超重肥胖总发生率20．9％，肥胖的高峰期出现于9～11岁。（2）超重组高血压发生率13．17％，肥胖组高血压发生率32．85％，显著高于体重正常组高血压发生率（5．3％），BMI值增加对收缩压升高产生的影响高于对舒张压升高产生的影响。（3）BMI、腰围、腰围身高比（waist to height ratio，WHtR）与收缩压和舒张压均呈正相关，腰围和BMI与血压的相关性优于WHtR，没有明显性别差异。（4）有家族史者超重肥胖发生率为56．3％，无家族史者超重肥胖发生率为18．7％，差异有统计学意义（P＜0．05）。（5）高血压更易出现糖、脂代谢紊乱，多元Logistic回归分析显示BMI、腰围、血脂水平是影响血压的主要因素， BMI对收缩压的影响显著，腰围对舒张压的影响差异有统计学意义（P＜0．05）。结论 BMI能够敏感预测儿童及青少年高血压，目前我国儿童和青少年超重肥胖发生率明显升高，此类人群中高血压发病的危险性显著增强。

Objective To determine the relationship between primary hypertension and obesity in 3-18-years-old children and adolescents of Changchun City so as to provide scientific basis for early prevention of hypertension.Methods Children aged from 3 to 18 years were sampled by random-cluster.Height, weight, waist circumference and blood pressure were measured.Questionnaire survey, t-test, and Chi-squared test were conducted.Pearson correlation analysis and multivariate Logistic regression analysis of the data were used.Results （1）The prevalence of hypertension was 8.9%.The prevalence of overweight and obesity was 20.9%.The peak of obesi-ty was found at the age of 9 to 11 years.（ 2 ） The incidencies of hypertension in overweight and obesity groups were 13.17% and 32.85%,respectively significantly higher than in the normal weight group（5.3%）.The influence of BMI on systolic blood pressure was greater than its influence on diastolic blood pressure.（3）BMI, waist circumference, waist height ratio （WHtR） were positively correlated with systolic blood pressure and diastolic blood pressure.The correlation between waist circumference and BMI with blood pressure was greater than WHtR;there was no significant gender differences.（4） The incidence of overweight and obesity was 56.3%in adolescents with overweight family history, and it was 18.7%in adolescents without overweight history （P〈0.05）.（5）Children with high blood pressure were more likely to be inflicted with hyperglycemia and lipid metabolism disorder.BMI, waist circumference and serum lipids were the main factors influencing the blood pressure.BMI significantly influenced systolic blood pressure whereas waist circumference sig-nificantly influenced diastolic blood pressure（P〈0.05）.Conclusions Hypertension in children and adolescents can be predicted sensi-tively by BMI.At present, incidence of overweight and obesity has increased significantly in China.The intervention against overweight, obesity and hypertension among children and adolescents should be concerned with by local government, schools and parents.