身高增长与超重肥胖联合作用对儿童血压的影响

Combined effect of height growth and overweight/obesity on blood pressure in children

目的分析不同身高增长幅度与超重肥胖联合作用对儿童新发血压偏高的影响,为探索防控儿童血压偏高的策略提供科学依据。方法基于厦门市青春期发育队列研究,采用整群抽样方法,选取2017年基线和2019年随访时身高、体重和血压数据完整的1313名小学生作为研究对象。采用多因素Logistic回归模型分析不同身高增长幅度与超重肥胖的联合作用对儿童血压偏高的影响。结果1313名小学生基线时(2017年)血压偏高检出率为25.2%;随访2年后,未发生血压偏高的人群中有19.7%的儿童新发了血压偏高,男生血压偏高新发率为23.4%,女生为16.6%。多因素Logistic回归模型分析显示,在调整年龄、性别、高血压家族史、睡眠时间、水果、蔬菜、含糖饮料及肉制品摄入情况后,总体及男生身高增长高水平超重肥胖组血压偏高新发的风险高于身高增长低水平非超重肥胖组(总体:RR=2.41,95%CI=1.44~4.04;男生:RR=2.69,95%CI=1.45~5.02);女生身高增长低水平联合超重肥胖组血压偏高检出率也显著增加(RR=4.47,95%CI=1.45~13.75)。结论身高增长幅度较高和超重肥胖是儿童血压偏高发病的影响因素,尤其是在男生中。在青春期身高突增前对儿童进行肥胖的预防和干预可能有益于降低儿童期高血压的发生。

Objective To investigate the association between the combined effect of height growth and overweight/obesity with elevated blood pressure in Chinese children.Methods Based on a cohort study of puberty development in Xiamen,a cluster sampling method was used to select 1313 children whose complete height,weight and blood pressure levels at baseline were obtained in 2017 and during a follow-up in 2019.The incidence of elevated blood pressure was compared between four different subgroups,and multivariate Logistic regression was performed to analyze the combined effect in boys and girls.Results Among 1313 children,the prevalence of elevated blood pressure at baseline was 25.2%.After 2 years of follow-up,the incidence of elevated blood pressure was 19.7% and 23.4% in boys,and 16.6% in girls.After adjusting for factors including age,sex,family history of hypertension,sleep time,intake of fruits,vegetables,sugar-sweetened beverages,and meat products,multivariate Logistic regression analyses showed that children in the high height growth and overweight/obesity group were more likely to exhibit a higher incidence of elevated blood pressure(overall:RR=2.41,95%CI=1.44-4.04;boys:RR=2.69,95%CI=1.45-5.02).Among girls,the risk of elevated blood pressure in the low height growth and overweight/obesity group also increased significantly(RR=4.47,95%CI=1.45-13.75).Conclusion A large magnitude of height growth and being overweight/obesity were associated with elevated blood pressure in children,especially boys.Therefore,interventions that are targeted toward obesity prevention in children before pubertal growth spurts in height may be beneficial to reduce childhood high blood pressure.