超重肥胖对高血压学龄儿童左心室肥厚的影响

The effects of overweight and obesity on left ventricular hypertrophy among hypertensive school-aged children

目的分析超重肥胖对高血压学龄儿童左心室肥厚的影响,为制定学龄儿童心脏结构损害的早期筛查及干预策略提供科学依据。方法数据来源于2012-2014年在济南城区开展的一项横断面研究。本研究选取327例6~17岁高血压中小学生进行左心室肥厚检测,控制性别、年龄和血压,采用协方差分析探讨体质量指数(BMI)和左心室质量指数(LVMI)的关系。采用趋势χ^2检验探讨随BMI分组的变化,左心室肥厚检出率变化趋势,控制潜在协变量,采用Logistic回归模型分析超重、肥胖对左心室肥厚的影响。结果随BMI分组的变化,LVMI(26.8±1.8,34.7±1.5,40.1±0.9)g/m2.7与左心室肥厚检出率(8.0%,22.4%,41.4%)均呈增加趋势,差异均有统计学意义(F/χ^2值分别为22.68,24.28,P值均<0.05)。超重和肥胖学龄儿童的左心室肥厚风险均增加,与正常体重组相比,OR值和95%CI分别为3.83(1.16~12.61)和9.18(3.10~27.19)。结论超重和肥胖可能增加学龄儿童左心室肥厚的风险。预防和控制肥胖可能有利于降低学龄儿童的心脏结构异常风险。

Objective To examine the influences of overweight and obesity on left ventricular hypertrophy(LVH) in school-aged children, and to provide the scientific reference for early screening and making interventional measures for the damage of their heart structure. Methods Based on a cross-sectional survey conducted in Jinan between 2012 and 2014, a total of 327 students aged 6-17 who had hypertension were selected. Covariance analysis and trend chi-square test were used to analyze the trend of left ventricular mass index(LVMI) and abnormal LVH rate across different categories of body mass index(BMI) after adjusted for age, gender and blood pressure(BP). Logistic regression analysis was used to evaluate the effects of overweight and obesity on LVH. Results After adjusting for age, gender and BP, covariance analysis indicated that with the increase of BMI, the levels of LVMI [(26.8±1.8, 34.7±1.5, 40.1±0.9)g/m^2.7] and prevalence of LVH(80.%, 22.4%, 41.4%) showed upward trends(F/χ^2=22.68, 24.28, P<0.05). Compared with normal weight school-aged children, the risk of LVH increased for overweight and obese school-aged children, and the odds ratios(95% confidence intervals) were 3.83(1.16-12.61) and 9.18(3.10-27.19), respectively. Conclusion Overweight and obesity significantly increase the risk of LVH in school-aged children. Effective prevention and treatment of overweight and obesity may reduce the risk of abnormal cardiac structure in school-aged children.