厦门市儿童肥胖和高血压共病现状及其多维度影响因素

Current status and multidimensional influences on the comorbidity of obesity and high blood pressure among children in Xiamen City

目的 了解厦门市7~12岁儿童肥胖和高血压(HBP)共病现状及其多维度影响因素,为后续开展预防性举措提供参考依据。方法 基于2017年厦门市青春期发育队列基线调查,采用整群随机抽样方法选取厦门市4 798名二至六年级学生作为研究对象,进行体格检查和问卷调查。采用单因素Logistic回归对肥胖合并HBP进行分析筛选潜在变量,采用多因素Logistic回归模型分析肥胖合并HBP的影响因素。结果 儿童肥胖检出率为9.15%,HBP检出率为11.65%,男生中肥胖合并HBP检出率为3.00%,女生中肥胖合并HBP检出率为1.80%;BMI正常的儿童HBP检出率为8.28%,肥胖的儿童HBP检出率为26.88%。多因素Logistic回归模型表明,每周至少喝1次含糖饮料(OR=2.50)、每天吃咸菜/榨菜/腌菜(OR=4.52)、肥胖家族史(OR=3.09)与肥胖合并HBP呈正相关,女(OR=0.53)、每周至少吃1次高能量零食(OR=0.40)、身体活动充足(OR=0.58)与肥胖合并HBP呈负相关(P值均<0.05)。结论 厦门市7~12岁儿童肥胖与HBP共病负担存在性别差异,饮食和运动行为是影响肥胖合并HBP的主要维度。儿童肥胖和HBP防控应从饮食运动和行为环境等多维度出发,及早预防儿童肥胖和高血压共病状态的发生。

Objective To understand the current status of obesity and high blood pressure(HBP)comorbidity and their multidimensional influencing factors in children aged 7-12 years in Xiamen,so as to provide reference basis for subsequent preventive measures.Methods Based on the baseline survey of the Xiamen pubertal development cohort in 2017,a total of 4798 primary school students from second to sixth grade were selected in the study by cluster random sampling method.And physical examination and questionnaires were conducted.The Logistic regression was used to screen potential variables for obesity combined with HBP.A multivariate Logistic regression model was used to analyse the factors influencing obesity combined with HBP.Results About 9.15%children were found with obesity and 11.65%with HBP.The rate of obesity combined with HBP was 3.00%in boys and 1.80%in girls.The rate of HBP was 8.28%in normal-weight children and 26.88%in obese children.Multivariate Logistic regression models showed that consumption of sugary drinks at least once a week(OR=2.50),daily consumption of salted or pickled vegetables(OR=4.52),family history of obesity(OR=3.09)were positively associated with obesity combined with HBP(P<0.05).Girls(OR=0.53),consumption of high-energy snacks at least once a week(OR=0.40)and adequate physical activity(OR=0.58)were negatively associated with comorbidity of obesity and HBP(P<0.05).Conclusion Gender differences in comorbidity burden of obesity and HBP exist among children aged 7-12 years in Xiamen.Dietary behaviour and exercise behaviour are the main dimensions influencing the comorbidity of obesity and HBP.Prevention and control of obesity and HBP in children should be based on multiple dimensions,including diet and exercise behavioural environment,to prevent early the occurrence for comorbidity of obesity and HBP in children.