儿童血压发育轨迹及其与超重肥胖的关系

Childhood blood pressure trajectory and its association with overweight and obesity

目的 分析儿童血压发育的轨迹及其与超重肥胖的关系,为儿童血压偏高的防控提供科学依据。方法 利用“自贡基于学校的心血管代谢风险队列研究”,纳入1 177名接受5次血压测量的儿童,使用中国儿童血压参照标准判断儿童的血压状态。基于群组的轨迹模型探索儿童血压的发育轨迹,采用Logistic模型分析儿童血压发育轨迹与超重肥胖出现次数的关系。结果 儿童5次测量血压偏高的流行率分别为1.9%,6.6%,7.0%,12.5%和11.2%。儿童血压的发育轨迹分为血压偏高的低风险组和血压偏高风险持续升高组。血压偏高的低风险组,其血压偏高的风险随着年龄的增长而较为平稳。血压偏高风险持续升高组,其血压偏高的风险随着年龄的增长而明显增加。Logistic回归分析显示,研究期间出现超重肥胖次数越多的儿童,其血压偏高风险升高(OR=1.34,95%CI=1.17~1.53,P<0.01)。结论 儿童血压的发育轨迹不同,超重肥胖儿童的血压偏高风险随着年龄的增长而明显增加。需关注超重肥胖儿童的血压发育轨迹,预防其出现血压偏高。

Objective To analyze the childhood blood pressure(BP) trajectory and its relationship with overweight and obesity,to provide evidence regarding prevention and control of childhood elevated BP.Methods A total of 1 177 children who participated in five surveys of Zigong school-based cardiometabolic risks survey.Elevated BP was defined by using National BP reference for Chinese children.Group-based trajectory model was used to identify distinct BP trajectories.Logistic models were conducted to investigate the association of number of overweight/obesity across surveys with BP trajectory.Results In the five consecutive waves,the corresponding prevalence of elevated BP was 1.9%,6.6%,7.0%,12.5% and 11.2%.Childhood BP trajectory were classified into constant low and high increasing risk of elevated BP groups.The risk of elevated BP increased at a steady rate with age in constant low risk of elevated BP groups,while the risk of elevated BP increased dramatically with age in high increasing risk of elevated BP groups.Logistic regression analysis showed that those with increasing number of occurrence of overweight/obesity tended to be classified into high increasing risk of elevated BP group(OR=1.34,95%CI=1.17-1.53,P<0.01).Conclusion Blood pressure trajectory during childhood varies.The risk of elevated BP increased dramatically with age in overweight and obese children.Attention should be paid to the BP trajectory of overweight and obese children to prevent elevated BP.