青春期少年1607例臂-踝脉搏波速度分析

Analysis of brachial-ankle pulse wave velocity in 1607 adolescents

目的探讨臂-踝脉搏波速度(BaPWV)在青春期少年人群中的分布特点。方法采用横断面调查研究。2020年6月至2021年5月选自北京市海淀区5所中学的12~17岁青春期少年1607例。其中男782例,女825例。测量其血压、体质量、身高后,计算体质量指数(BMI),采用动脉硬化检测仪测量BaPWV。多组计量资料差异性比较采用单因素方差分析,其中2组间的差异性比较采用LSD法。2组计量资料的差异性比较采用两独立样本t检验,相关性分析采用Pearson相关分析。结果12~17岁青春期少年的BaPWV中位数水平随着年龄的增长呈现逐渐增加的趋势,由12岁BaPWV中位数982.50 cm/s,呈逐渐上升趋势,至17岁时达到最高值1113.50 cm/s,12~17岁青少年的BaPWV与年龄呈正相关(r=0.936,P=0.006)。在区分了性别的人群研究中,12岁男性和女性的BaPWV中位数分别为962.25 cm/s和997.50 cm/s,均随年龄递增呈逐渐上升趋势,至17岁时男性和女性的BaPWV中位数分别达到1122.50 cm/s和1096.00 cm/s,男性和女性的BaPWV均与年龄呈正相关(r=0.903,P=0.014;r=0.945,P=0.004)。男性BaPWV与收缩压、舒张压、年龄、体质量、身高、BMI均呈正相关(r=0.308,P<0.001;r=0.289,P<0.001;r=0.478,P<0.001;r=0.190,P<0.001;r=0.315,P<0.001;r=0.109,P=0.002)。女性BaPWV也与收缩压、舒张压、年龄、体质量、身高、BMI均呈正相关(r=0.340,P<0.001;r=0.285,P<0.001;r=0.379,P<0.001;r=0.115,P=0.001;r=0.170,P=0.001;r=0.097,P=0.014)。整体人群中肥胖组与正常组之间的BaPWV比较差异有统计学意义(t=-3.428,P=0.001)。在性别方面的比较显示:12~13岁组的男女之间BaPWV比较差异无统计学意义(t=0.123,P=0.902),但在14~15岁组和16~17岁组中,男女之间BaPWV比较差异均有统计学意义(t=2.315,P=0.021;t=2.152,P=0.032),均表现为女性平均BaPWV水平低于同组男性。结论12~17岁青春期少年的BaPWV水平随着年龄的增长呈现逐渐增高趋势。收缩压、舒张压、体质量、BMI、年龄、身高均与BaPWV呈正相关。肥胖可增加其血管僵硬度。不同性别的青春期发育对血管僵硬度有不同影响。

Objective To explore the distribution characteristics of brachial-ankle pulse wave velocity(BaPWV)in adolescents.Methods Cross sectional survey research.A total of 1607 adolescents aged 12-17 years from 5 middle schools in the Haidian District,Beijing from June 2020 to May 2021 were enrolled for measuring their blood pressure,weight,height and the body mass index(BMI),including 782 males and 825 females.BaPWV was measured using an arteriosclerosis detector.They were divided by the age,sex and obesity.Differences of measurement data among multiple groups were compared by one-way ANOVA,followed by the LSD test,and those between groups were compared by the two-sample t-test.The correlation between BaPWV and other indexes was assessed by the Pearson correlation analysis.Results The median level of BaPWV in adolescents aged 12-17 years increased with age,which was 982.50 cm/s in adolescents aged 12 years,and maximum 1113.50 cm/s those aged 17 years.BaPWV in adolescents aged 12-17 years was positively correlated with age(r=0.936,P=0.006).Subgrouped by the sex,the median BaPWV of male and female adolescents aged 12 years was 962.25 cm/s and 997.50 cm/s,respectively,which reached 1122.50 cm/s and 1096.00 cm/s in those aged 17 years,respectively.BaPWV of male and female adolescents was positively correlated with the age(r=0.903,P=0.014;r=0.945,P=0.004).In male adolescents,BaPWV was positively correlated the systolic and diastolic blood pressure,age,weight,height,BMI(r=0.308,P<0.001;r=0.289,P<0.001;r=0.478,P<0.001;r=0.190,P<0.001;r=0.315,P<0.001;r=0.109,P=0.002).In female adolescents,BaPWV also was positively correlated the systolic and diastolic blood pressure,age,weight,height,BMI(r=0.340,P<0.001;r=0.285,P<0.001;r=0.379,P<0.001;r=0.115,P=0.001;r=0.170,P=0.001;r=0.097,P=0.014).In the overall population,BaPWV was statistically significant between the obese and normal groups(t=-3.428,P=0.001).No significant difference in BaPWV between male and female adolescents aged 12-13 years was identified(t=0.123,P=0.902),but it was significantly lower in female adolescents aged 14-15 years and 16-17 years than those of age-matched males(t=2.315,P=0.021;t=2.152,P=0.032).Conclusions The median BaPWV level in adolescents aged 12-17 years,increases with the age.Systolic blood pressure,diastolic blood pressure,body weight,BMI,age and height are positively correlated with BaPWV in adolescents.Obesity can increase the stiffness of blood vessels,which is influenced by the sex.