上海莘庄社区儿童及青少年超重、肥胖的发生率及血压相关因素分析

Prevalence of overweight and obesity and analysis of blood pressure related factors among children and adolescents in Xinzhuang community,Shanghai

目的:了解上海莘庄社区儿童青少年超重肥胖的流行情况以及血压的影响因素,为儿童青少年高血压的防治提供参考依据。方法:结合上海莘庄中小学生常规健康体检,邀请年龄为7~17岁的在校学生参加研究,测量其身高、体重、腰围、臀围,并使用欧姆龙HBP1100电子血压计,于坐位测量3次肱动脉血压,取平均值分析。使用问卷收集受检者的基本情况及疾病史、出生史、用药情况、母亲孕产史、父母吸烟史及父母高血压、糖尿病病史及家族史等。结果:在全部14 715名学生中(男生7 703人、女生7 012人),超重、肥胖和高腰围的检出率分别为17.3%、13.9%和18.0%。受检学生的肱动脉收缩压、舒张压均与其年龄、身高、体质量指数(body mass index,BMI)、腰围、父亲或母亲患高血压、母亲妊娠期高血压史显著正相关(r=0.03~0.37,P≤0.01)。父母均有高血压的学生,其血压(120/77 mmHg)高于父母一方有高血压(118/75 mmHg)及父母血压均正常(116/74 mmHg)的学生(趋势P≤0.001);而肥胖组学生的血压(122/76 mmHg)显著高于超重组(119/75 mmHg)及BMI正常组(115/74 mmHg);高腰围组学生的血压(121/76 mmHg)高于正常腰围高值组(118/75 mmHg)及正常腰围组(115/74 mmHg),且校正年龄等因素后的P均<0.001。此外,学生出生体重与收缩压呈显著独立负相关。结论:上海莘庄社区儿童及青少年超重、肥胖的发生率为17.3%及13.9%,除年龄及父母患高血压情况等不可逆因素外,儿童及青少年的血压与其BMI及腰围大小有关,提示肥胖是上海地区儿童及青少年高血压的主要危险因素。

Objective: To investigate the prevalence of overweight and obesity and blood pressure related factors among children and adolescents in Xinzhuang community, Shanghai, for providing reference information for the prevention and treatment of hypertension in children and adolescents. Methods: Students aged 7-17 yearsin primary and secondary schools in Xinzhuang district, Shanghai, were invited to participate in the study. Body height, weight, waist and hip circumference were measured. Omron HBP1100 electronic sphygmomanometer was used to measure brachial blood pressure for three times at sitting position. Questionnaires were used to collect basic information, including disease history, birth history, use of medications, maternal pregnancy and delivery history, parents’ smoking habits and history of hypertension and diabetes, and family history, etc. Results: ①Among all the 14 715 students(male 7703, female 7 012), the prevalences of overweight, obesity and high waist circumference were 17.3%, 13.9% and 18.0%, respectively. ② Both the brachial systolic and diastolic blood pressure were positively associated with age, body height, BMI, waist circumference,father or mother hypertension history and mother pregnancy hypertension history(r= 0.03-0.37, P≤0.01). Students whose both parents had hypertension had a higher blood pressure(120/77 mmHg) than those with single parent having hyperten-sion(118/75 mmHg) and those having both normotensive parents(116/74 mmHg, P for trend ≤0.001). ③ Obese students had higher blood pressure(122/76 mmHg) than those overweight(119/75 mmHg) and those with normal weight(115/74 mmHg). Similar trend was observed between students with high(121/76 mmHg), high-normal(118/75 mmHg) and normal(115/74 mmHg) waist circumference. P values were all <0.001 after adjustment for age and other factors. Conclusions:In addition to factors could not be revised such as age and parent’s hypertension, blood pressure of children and adoles-cents is related to obesity indices such as BMI and waist circumference, indicating that obesity control should be the key for the prevention and control of hypertension in children and adolescents.