儿童体脂偏高与血压偏高的关联

Association between high body fat mass and elevated blood pressure in children

目的 探讨儿童体脂偏高与血压偏高的关联,为儿童高血压的防治提供科学依据。方法 研究对象来源于2021年在山东省淄博市桓台县开展的“桓台儿童心血管健康随访队列”的第2次随访调查数据,共纳入1 266名10~15岁儿童。将体脂肪量(FM)、体脂肪率(FMP)、脂肪质量指数(FMI)、皮下脂肪质量(SFM)、内脏脂肪质量(VFM)按研究人群年龄别、性别的P_(50)分为适中和偏高两组。采用多因素Logistic回归模型分别分析5项儿童体脂指标状态与血压偏高的关系,利用限制性立方样条模型(RCS)分别分析5项儿童体脂水平与血压偏高的剂量反应关系。结果 儿童FM偏高、FMP偏高、FMI偏高、SFM偏高、VFM偏高组的血压偏高检出率均分别高于适中组(P值均<0.05);调整所有潜在协变量后,与适中组相比,FM偏高(OR=4.51,95%CI=3.28~6.28)、FMP偏高(OR=4.51,95%CI=3.28~6.27)、FMI偏高(OR=4.40,95%CI=3.20~6.12)、SFM偏高(OR=4.52,95%CI=3.29~6.30)和VFM偏高(OR=4.48,95%CI=3.28~6.18)组儿童血压偏高风险较高(P值均<0.05)。RCS分析显示,FM、FMI、FMP和SFM水平增加与血压偏高均呈线性剂量反应关系(P_(非线性值均)>0.05),VFM偏高与血压偏高呈非线性剂量反应关系(P_(非线性)<0.05)。结论 体脂偏高的儿童血压偏高风险较高,且存在剂量反应关系,采取适当措施降低儿童体脂水平,有助于预防儿童血压偏高的发生。

Objective To examine the association between high body fat mass and elevated blood pressure in children,so as to provide scientific evidence for the prevention and treatment of childhood hypertension.Methods Participants were recruited from the second follow-up survey of the Huantai Childhood Cardiovascular Health Cohort Study conducted in 2021 in Huantai County,Zibo City,Shandong Province,China.A total of 1266 children aged 10-15 years old were included.The study categorized fat mass(FM),fat mass percentage(FMP),fat mass index(FMI),subcutaneous fat mass(SFM),and visceral fat mass(VFM),respectively,into normal and elevated groups based on age-and gender-specific median values(P_(50))in the study population.The multivariate Logistic regression model was used to analyze the association between the status of body mass and elevated blood pressure.A restrictive cubic spline(RCS)model was used to examine the dose-response relationship between the levels of body mass and elevated blood pressure.Results The detection rates of elevated blood pressure in children with elevated FM,elevated FMP,elevated FMI,elevated SFM,and elevated VFM were all significantly higher than those in the normal group(P<0.05).After adjusting for all potential covariates,compared to the normal group,elevated FM(OR=4.51,95%CI=3.28-6.28),elevated FMP(OR=4.51,95%CI=3.28-6.27),elevated FMI(OR=4.40,95%CI=3.20-6.12),elevated SFM(OR=4.52,95%CI=3.29-6.30),and elevated VFM(OR=4.48,95%CI=3.28-6.18)were all positively associated with elevated blood pressure(P<0.05).The RCS analysis demonstrated that the high levels of FM,FMP,FMI,and SFM showed linear dose-response relationships with elevated blood pressure(P_(non-linear)>0.05),and elevated VFM was associated with elevated blood pressure in a nonlinear dose-response relationship(P_(non-linear)<0.05).Conclusions Children with elevated body fat have a higher risk of elevated blood pressure.There was a dose-response relationship between high body mass content and elevated blood pressure in children.It is essential to take appropriate measures to reduce the elevated body fat in children,in order to prevent the occurrence of high elevated blood pressure in children.