北京市6~8岁儿童心血管健康的性别差异

Sex differences in cardiovascular health among children aged 6-8 years in Beijing City

目的探索北京市6~8岁儿童心血管健康(CVH)的性别差异,为CVH相关生活方式的早期干预提供依据。方法基于北京儿童生长与健康队列(PROC)1914名6~8岁儿童的体格检查、问卷调查、实验室检测数据,根据生命八要素(Life’s Essential 8)评分标准计算儿童CVH评分及其分项(健康行为)和(健康因素)评分,并分为较高、中等、较低3个等级;采用χ^(2)检验和Wilcoxon秩和检验比较性别差异。结果1914名儿童中,较高、中等、较低CVH的比例分别为35.7%,63.5%,0.8%,健康行为评分比例分别为25.9%,67.5%,6.6%,性别间差异均无统计学意义(χ^(2)值分别为2.30,0.07,P值均>0.05)。男童和女童较高、中等、较低健康因素评分比例分别为61.1%,36.0%,2.9%和71.1%,28.4%,0.5%,差异有统计学意义(χ^(2)=31.88,P<0.01)。总体CVH评分为76.0(70.0,83.0)分,男童为76.0(69.0,82.0)分,女童为77.0(71.0,83.0)分。健康行为指标中,睡眠评分最好[100.0(90.0,100.0)],体力活动评分最差[40.0(20.0,80.0)];健康因素指标中,血糖评分最好[100.0(100.0,100.0)],血脂评分最差[60.0(40.0,100.0)]。健康因素中体质量指数(BMI)、血脂、血糖、血压评分性别间差异均有统计学意义(Z值分别为-6.92,3.01,-6.60,-2.30,P值均<0.05),健康行为中膳食、体力活动、尼古丁暴露、睡眠评分性别间差异均无统计学意义(Z值分别为0.99,0.88,-0.13,0.36,P值均>0.05)。相比于男童,较低和中等CVH组的女童健康行为评分更低,健康因素评分更高。结论北京市6~8岁儿童心血管健康大多处于良好及以上水平。可通过改善生活方式、监测健康因素指标,特别是男童的实验室检测指标,进而提高儿童CVH水平。

Objective To explore sex difference in the cardiovascular health(CVH)status of 6-8 year old children in Beijing,so as to inform the early intervention of CVHrelated lifestyles.Methods Based on the Beijing Children's Growth and Health Cohort(PROC),baseline physical examination,sequential questionnaire survey,and laboratory tests were conducted among 1914 grade 1 students.Children's CVH and its subscales(health behaviors and health factors)scores were calculated according to the Life's Essential 8(LE 8)index and categorized into high,moderate,and low CVH.CVH scores were reported as medians and interquartile ranges;sex differences were compared using the Chisquare test and Wilcoxon test.Results Among the 1914 participants,the percentages of high,moderate,and low CVH were 35.7%,63.5%,and 0.8%,respectively,and the percentages of high,moderate,and low health behavior scores were 25.9%,67.5%,and 6.6%,respectively,with no statistically significant differences between sex(χ^(2)=2.30,0.07,P>0.05).The rates of high,moderate,and low health factor scores for boys and girls were 61.1%,36.0%,2.9%and 71.1%,28.4%,0.5%,respectively,with a statistically significant sex difference(χ^(2)=31.88,P<0.01).The overall CVH score was 76.0(70.0,83.0),76.0(69.0,82.0)for boys,and 77.0(71.0,83.0)for girls.Among the health behavior metrics,sleep scores were the best and physical activity scores were the worst[100.0(90.0,100.0),40.0(20.0,80.0)];among the health factor metrics,blood glucose scores were the best and lipid scores were the worst[100.0(100.0,100.0),60.0(40.0,100.0)].In respect to health factors,there were significant gender differences in body mass index,blood lipids,blood sugar,and blood pressure scores(Z=-6.92,3.01,-6.60,-2.30,P<0.05),but there were no significant gender differences in diet,physical activity,nicotine exposure,or sleep scores with regards to health behaviors(Z=0.99,0.88,-0.13,0.36,P>0.05).Compared to boys,girls in the low and moderate CVH groups had high health factor scores despite low health behavior scores.Conclusion Most 6to 8yearold children in Beijing were found to have relatively good CVH,and optimization of children's CVH status can be achieved by promoting healthier lifestyles and monitoring health factors,especially among boys.