小学生肥胖及代谢异常对血压影响的病例对照研究

Effects of obesity and metabolic abnormalities on pupils' blood pressure in a District of Shanghai

目的分析上海市某区小学生肥胖及代谢异常对儿童血压的影响,为探讨引起小学生血压升高发病的代谢相关因素提供参考依据。方法采用整群随机抽样方法,在上海市松江区抽取6所非寄宿制的公立小学,在选中的小学中,用抽签随机法从二～五年级中随机抽取2个班级,共计840名学生,以其中血压偏高学生为病例组（56人）,以同学校、同性别、身高相差5 cm以内、年龄相差6个月以内为条件在血压正常的学生中按1∶4匹配对照组（224人）。对2组学生进行基本情况问卷调查、体格检查和血生化检测。结果病例组的体质量指数（BMI）、腰围、三酰甘油（TG）和空腹血糖（FPG）[（18.17±3.89）kg/m^2,（60.09±4.12）cm,（1.04±0.56）mmol/L,（4.66±0.59）mmol/L]高于对照组[（17.26±2.75）kg/m^2,（56.19±2.46）cm,（0.79±0.22）mmol/L,（4.47±0.47）mmol/L],差异均有统计学意义（t值分别为3.16,6.71,2.97,4.33,P值均〈0.05）。调整年龄、性别、BMI后,两组腰围、TG、FG的差异仍具有统计学意义。Logistic回归分析结果表明,BMI增加与儿童血压偏高的发生呈正相关（OR=2.836,P〈0.05）;腹部肥胖、高三酰甘油和高血糖均与儿童血压偏高的发生有一定关系（OR值分别为4.357,3.049,6.000,P值均〈0.05）。结论小学生血压偏高的发生与肥胖呈正相关,代谢异常与小学生高血压的关系需进一步研究。

Objective To analyze the influence of obesity and metabolic abnormalities on pupils＂ blood pressure in a district of Shanghai, and to investigate the metabolic-related factors affecting elevation of blood pressure. Methods With cluster random sampling method, six non-boarding public elementary schools were selected from Songjiang District, in which 2 classes were randomly chosen from grades 2-5 （840 samples as a whole ）. After a blood pressure measurement, students with higher blood pressure are classified into case group （ 56 samples）. The control group matches 4 normal blood pressure students for each case （ 224 samples as a whole ）. Demographic information, physical examination and blood biochemical testing were conducted for both groups. Results BMI, waist circumference, TG and FG in the case group were statistically higher than control group, （ 18.17 ± 3.89） vs （17.26 ±2.75） kg/m^2, （60.09± 4.12） vs （56.19 ±2.46） cm, （1.04±0.56） vs （0.79 ± 0.22） mmol/Land （4.66 ± 0.59） vs （4.47 ± 0.47）mmol / L, respectively. It showed the same trend after adjusted for age, sex, BMI. Logistic regression analysis showed that BMI was positively correlated with the increase in high blood pressure in children（ OR = 2.135 ）. Abdominal obesity, high triglycerides and high blood sugar were all associated with high blood pressure in children （OR = 4.357, 3.049 and 6.000, respectively ）. Conclusion The incidence of elevation of blood pressure in children is positively correlated with obesity, more researches are needed to clarify the relationship between metabolic abnormalities and elevation of blood pressure of children.