广州市中小学生2014年肥胖类型与血压水平的关系

Association between different types of obesity and blood pressure of primary and middle school students in Guangzhou,2014

目的分析2014年广州市中小学生超重肥胖、单纯腹型肥胖、复合型肥胖与血压之间的关联性,旨在为高血压的预防和干预提供依据。方法选择广州市11个区的15所小学和15所中学的13 004名7~18岁在校学生为研究对象,采用协方差分析以及多因素Logistic回归模型,分析儿童青少年肥胖类型与血压水平[收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)]及血压偏高率之间的关系。结果协方差分析显示,男生和女生中不同肥胖类型学生间SBP和DBP平均水平差异均有统计学意义(P值均<0.01)。在男生中,超重肥胖、复合型肥胖的SBP、DBP水平均高于正常体重学生(P值均<0.01);女生中,血压水平在不同类型肥胖的变化趋势大体为复合型肥胖>腹型肥胖>超重肥胖>正常体重。Logistic回归分析显示,男生和女生的复合型肥胖与血压偏高风险的关联性最强(男生:OR=4.40,95%CI=3.61~5.36;女生:OR=5.25,95%CI=4.16~6.64)。在男生中,超重肥胖者的血压偏高风险亦高于正常体重者(OR=2.68,95%CI=1.31~5.49),但腹型肥胖者与血压偏高之间未见统计学关联。女生中,腹型肥胖和超重肥胖与血压偏高的关联均无统计学意义。结论肥胖是引起儿童青少年血压升高的重要危险因素。其中复合型肥胖学生中引起血压升高的风险最高,其次是超重肥胖或腹型肥胖。

Objective To analyze the association among general obesity, abdominal obesity, combined obesity and blood pressure among primary and middle school students in Guangzhou in 2014, and to provide a reference for the prevention and control strategies of hypertension. Methods A total of 13 004 students aged 7-18 years seleted from 15 primary schools and 15 middle schools in 11 districts of Guangzhou were recruited in this study. Covariance analysis and Logistic regression model were used to analyze the association between obesity types and blood pressure（ systolic blood pressure, SBP and diastolic blood pressure,DBP）.Results Covariance analysis showed that SBP and DBP were significantly different among students with distinct obesity types by gender（ P〈0.01）. In boys, the SBP and DBP of general obesity group or combined obesity group were higher than those of normal weight group（ P〈0.01）. In girls, the changing trend of blood pressure in different obesity types was as follows： combined obesity abdominal obesity general obesity normal weight. Logistic regression analysis showed that combined obesity was strongly associated with elevated blood pressure both for boys and girls（ boys： OR = 4.40, 95%CI = 3.61-5.36; girls： OR = 5.25, 95%CI = 4.16-6.64）. Boys with general obesity also showed a higher risk of elevated blood pressure（ OR = 2.68, 95%CI = 1.31-5.49） than boys of normal weight, but the association of abdominal obesity with risk of high blood pressure was not statistically significant. In girls,there were no significant associations among general obesity, abdominal obesity and elevated blood pressure. Conclusion Obesity is an important risk factor for elevated blood pressure in children. Students with combined obesity have the highest risk of elevated blood pressure, followed by those with general obesity or abdominal obesity.