儿童青少年不同体质量指数与血压水平关联的队列研究

Cohort study on different BMI and blood pressure levels in children and adolescents

目的 分析中小学生基线体质量指数(BMI)水平及BMI变化与随访8年后(又称“终期”)血压水平及血压偏高发生风险的关联,为开展儿童青少年血压防控工作提供依据。方法 基于队列研究设计,采用2014-2022年连续8年山东省龙口市9 748名中小学生年度健康体检随访数据。采用χ^(2)检验比较组间差异,采用广义线性模型和Logistic回归模型分析基线BMI水平及BMI变化对终期血压水平及血压偏高的影响。结果 在基线非超重肥胖人群中,血压偏高率为9.1%,在基线超重肥胖人群中,血压偏高率为12.0%。在基线不同BMI状态下,男生血压偏高发生率均高于女生。与BMI-Z分≤-1组相比,随着BMI-Z分的增加,收缩压水平和血压偏高的发生风险逐渐增加;以BMI变化持续低为对照,持续高和增高组均呈现出终期血压偏高的发生风险增加(OR值分别为4.00,2.21,P值均<0.01),且男生终期血压增高的发生风险更大。结论 基线具有较高BMI水平以及BMI变化增加的儿童青少年血压偏高发生风险更高。应及时监测血压,采取综合有效措施控制儿童青少年儿童期血压偏高的发生。

Objective To analyze the relationship between the baseline BMI level and body mass index(BMI)changes of primary and middle school students and the blood pressure level and the risk of elevated blood pressure after 8 years of follow-up(also known as the end-stage),so as to provide a basis for the prevention and control of blood pressure in children and adolescents.Methods The physical examination data of 9748 primary and secondary school students were selected from a cohort study design in Longkou City,Shandong Province for 8 years from 2014 to 2022,and analyzed the association of baseline BMI level and BMI changes with end-stage blood pressure level and the risk of elevated blood pressure.Chi-square test was used to compare differences between groups,and the generalized linear model and Logistic regression model were used to analyze the effect of baseline BMI level and BMI changes on blood pressure level and elevated blood pressure after 8-year follow-up.Results Among non-overweight and obesity group at baseline,the prevalence of high blood pressure was 9.1%.Among the overweight and obesity group,the prevalence of high blood pressure was 12.0%.Under different BMI status at baseline,the incidence of high blood pressure in boys was higher than that in girls.Compared with the BMI-Z value≤-1 group,with the increase of BMI-Z value,the systolic blood pressure level and the risk of high blood pressure gradually increased;with the BMI change continuously low as the control,sustained high and increased groups showed an increased risk of end-stage high blood pressure(OR=4.00,2.21,P<0.01),and boys had a greater risk of elevated blood pressure.Conclusion Children and adolescents with higher baseline BMI level and increased BMI changes are at a higher risk of elevated blood pressure.Therefore,secondary school students should monitor the occurrence and development of blood pressure level in real time,and take comprehensive and effective measures to control the occurrence of elevated blood pressure level in childhood.