Pediatric hypertension(HTN)has become the focus of interest recently due to its increasing prevalence.This is mainly related to the increase in childhood obesity,although the current evidence suggests that other lifes...Pediatric hypertension(HTN)has become the focus of interest recently due to its increasing prevalence.This is mainly related to the increase in childhood obesity,although the current evidence suggests that other lifestyle factors,apart from obesity,contribute to high blood pressure(BP)in childhood.Traditionally,office BP measurements by the physician have been the cornerstone for the assessment of HTN in children.However,since the white coat and masked HTN phenomena are not rare in childhood,out-of-office BP measurements have significantly improved the accurate diagnosis of HTN and decision making.Ambulatory BP monitoring is regarded as indispensable for the evaluation of pediatric HTN,providing details not only for the staging for HTN,but also for the study of other ambulatory BP patterns.It should be pointed out that HTN in children and adolescents is associated with target-organ damage which is significant in terms of cardiovascular risk.The current knowledge,outlined in the present review,is expected to help in early and accurate diagnosis as well as in the management of HTN in children and adolescents.展开更多
Background The age of onset of hypertension(HTN)is decreasing,and obesity is a significant risk factor.The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pres...Background The age of onset of hypertension(HTN)is decreasing,and obesity is a significant risk factor.The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pressure are insufficiently studied.This study aimed to evaluate the prevalence of HTN in Chinese and American children and adolescents and to assess the relationship between various body composition indices and HTN.Methods Seven thousand,five hundred and seventy-three Chinese and 6239 American children and adolescents aged 8–18 years from the 2013–2015 China Child and Adolescent Cardiovascular Health study and the 2011–2018 National Health and Nutrition Examination Surveys were analyzed.Blood pressure and body composition(fat and muscle)were measured by trained staff.The crude prevalence and age-standardized prevalence rate(ASPR)of primary HTN and its subtypes[isolated systolic hypertension(ISH)and isolated diastolic hypertension(IDH)]were calculated based on 2017 American Academy of Pediatrics guidelines.Multivariable-adjusted linear regression coefficients and odds ratios(ORs)were calculated to assess the associations of body composition indicators with HTN,ISH and IDH.Results The ASPR of HTN was 18.5%in China(CN)and 4.6%in the United States(US),whereas the obesity prevalence was 7.4%and 18.6%,and the population attributable risk of HTN caused by overweight and obesity was higher in the US than in CN.Increased fat mass,muscle mass and body fat percentage mass were associated with a higher risk of HTN in both countries.The percent of muscle body mass had a protective effect on HTN and ISH in both countries[HTN(CN:OR=0.83,95%CI=0.78–0.88;US:OR=0.72,95%CI=0.64–0.81);ISH(CN:OR=0.87,95%CI=0.80–0.94;US:OR=0.71,95%CI=0.62–0.81)],and the protective effect was more common among children and adolescents with high levels of physical activity.Conclusions The burden of HTN in Chinese children and adolescents was substantial and much greater than that in the US,and the contribution of obesity to HTN was higher in the US than in CN.Augmenting the proportion of muscle mass in body composition has a protective effect against HTN in both populations.Optimizing body composition positively influences blood pressure in children and adolescents,particularly those with high-level physical activity.展开更多
BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM T...BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.展开更多
为考察国际基于自我决定理论的儿童青少年体育活动研究的发展脉络和最新进展,运用科学计量学中的关键词共现、关键词聚类和可视化技术等方法对2000—2022年Web of Science核心合集数据库相关研究文献进行分析。结果发现:中国在亚洲国家...为考察国际基于自我决定理论的儿童青少年体育活动研究的发展脉络和最新进展,运用科学计量学中的关键词共现、关键词聚类和可视化技术等方法对2000—2022年Web of Science核心合集数据库相关研究文献进行分析。结果发现:中国在亚洲国家中产出领先;历年研究呈现从宏观到微观、从单一到多重、从横断到纵横结合、从解决到预防、从验证到应用、从开拓到回顾的发展趋势,最新研究体现出重视结构化问卷、研究设计联系实际情境和纳入各种心理学变量的特点;已有研究存在针对特殊群体、干预的作用路径、系统化干预项目设计方法等方面的局限。对我国相关研究的启示:对热度仍持续的主题继续优化研究设计;对基本达到饱和的主题结合实际推进本土研究;利用多重变量关系路径、多元干预模型、跨情境研究、横向与纵向相结合等开展实证研究;编制、修订中国版的相关问卷。展开更多
绿色暴露是人与绿色空间积极互动的重要结果,为解决儿童与青少年健康问题提供新的契机。运用CiteSpace知识图谱分析软件对322篇Web of Science核心合集收录的相关文献进行文献计量分析,梳理绿色暴露对儿童和青少年健康影响研究的整体发...绿色暴露是人与绿色空间积极互动的重要结果,为解决儿童与青少年健康问题提供新的契机。运用CiteSpace知识图谱分析软件对322篇Web of Science核心合集收录的相关文献进行文献计量分析,梳理绿色暴露对儿童和青少年健康影响研究的整体发展脉络。结果显示:(1)在纵向时间维度上,相关研究历经明显的阶段性特征,多数文献源于景观规划与环境资源类刊物;(2)高频发表的作者组团引导该领域的主要研究方向,文献支持机构主要来自欧美国家的众多高校;(3)在横向关键词维度上,通过共现、突现与时间线分析得出主要关键词,并从实践设计、儿童与青少年成长特点与社会属性出发,分析研究前沿内容;(4)基于研究方法与视角对相关文献进行差异性分析,总结重要的测度指标与发展层次。针对现有研究不足,为未来绿色暴露对儿童与青少年健康研究方向提供参考。展开更多
目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年...目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年分年龄、性别、身高百分位血压标准来评价血压状况,包括儿童血压偏高前期、血压偏高、单纯性收缩压偏高、单纯性舒张压偏高和混合性血压偏高。按照国际儿童青少年体质量指数(body mass index,BMI)标准评价儿童青少年营养状况,包括消瘦(重度消瘦和轻度消瘦)、正常BMI、超重和肥胖(重度肥胖和轻度肥胖)。利用多因素Logistics回归模型分析血压偏高与营养状况之间的关联性,并计算人群归因危险度评估超重肥胖控制对于预防儿童血压偏高的公共卫生学意义。结果:2014年中国7~18岁儿童青少年血压偏高和血压偏高前期的检出率分别为14.9%和9.2%,儿童青少年血压偏高者中收缩压偏高、舒张压偏高和混合性血压偏高检出率分别为3.1%、8.8%和3.0%。血压偏高状况整体呈现为男生高于女生,乡村高于城市,随年龄逐渐增高,随地区(东部、中部和西部)逐渐降低,随BMI的增加而增加的趋势。重度肥胖组的血压偏高检出率最高,男女生分别为44.2%和38.8%,分别是正常组(15.8%和10.6%)的2.8倍和3.7倍。血压偏高与消瘦(重度消瘦和轻度消瘦)呈负相关,与超重肥胖呈正相关。血压偏高归因于超重肥胖的危险度为16.2%,控制超重肥胖后,血压偏高的期望检出率为12.5%,且对单纯性收缩压偏高和混合性血压偏高影响较大,归因危险度分别为28.7%和35.1%。结论:我国儿童青少年血压偏高检出率较高,且以单纯性舒张压偏高为主。超重肥胖可显著增加血压偏高的风险,尤其是对单纯性收缩压偏高和混合性血压偏高影响较大,通过控制超重肥胖可显著降低全国儿童高血压的发生风险,从而对预防成年期慢性病的发生具有重要意义。展开更多
体育社会化在促进体育素质教育和个体健康成长方面具有重要意义。该文采用科学知识图谱方法,并利用CiteSpace软件,对Web of Science和中国知网数据库中近30年来的体育社会化核心文献进行了对比分析,分别从热点主题和发展趋势等方面分析...体育社会化在促进体育素质教育和个体健康成长方面具有重要意义。该文采用科学知识图谱方法,并利用CiteSpace软件,对Web of Science和中国知网数据库中近30年来的体育社会化核心文献进行了对比分析,分别从热点主题和发展趋势等方面分析中外体育社会化领域的研究现状及其差异,并为我国体育社会化研究提供了参考和启示。研究结果指出:在热点主题方面,国内研究集中于青少年、学校体育和体育教学,而国外更关注儿童、健康、青少年和行为研究;从研究方法角度看,国内研究倾向于宏观视角且方法单一,缺少实证研究,相比之下,国外在理论和方法上更为丰富,实证研究较多;在发展趋势上,国内研究主要围绕“竞技体育—学校体育—大学生—青少年—社会体育—体育产业”发展,而国外则集中于“家庭与儿童社会化—性别社会化—学校与青少年社会化—运动员社会化—职业社会化”。这些发现对于我国未来的体育社会化研究具有重要的借鉴价值,特别是在儿童青少年社会化、职业社会化和特殊群体社会化等细分领域。展开更多
为了解近10年(2006~2016)来美国18岁及以下的儿童青少年创伤后应激障碍(PTSD)治疗研究的热点和重点,利用Bicomb 2.0软件和IBM SPSS Statistics 20.0软件,对ISI Web of Science数据库中查询到的363篇论文进行了知识图谱的可视化分析。结...为了解近10年(2006~2016)来美国18岁及以下的儿童青少年创伤后应激障碍(PTSD)治疗研究的热点和重点,利用Bicomb 2.0软件和IBM SPSS Statistics 20.0软件,对ISI Web of Science数据库中查询到的363篇论文进行了知识图谱的可视化分析。结果表明,近10年来美国儿童青少年PTSD治疗研究可分为两个大的研究领域。领域一为儿童青少年PTSD的精神科和神经生物学相关的治疗,包括了两个小的研究热点:(1)儿童青少年PTSD精神科药物治疗相关的研究;(2)儿童青少年PTSD眼动脱敏再加工治疗等神经生物学机制的疗法。领域二为儿童青少年PTSD的心理学治疗,包括了两个小的研究热点:(1)家庭暴力导致的儿童青少年PTSD心理学治疗研究;(2)儿童青少年PTSD的认知行为治疗研究。其中关于儿童青少年PTSD的认知行为治疗研究是研究的热点和重点领域,但关于儿童青少年PTSD治疗效果的长期纵向研究还较为缺乏,未来研究者应加强对儿童青少年PTSD治疗效果的追踪研究,并开展心理治疗与药物治疗相结合的疗效研究。展开更多
文摘Pediatric hypertension(HTN)has become the focus of interest recently due to its increasing prevalence.This is mainly related to the increase in childhood obesity,although the current evidence suggests that other lifestyle factors,apart from obesity,contribute to high blood pressure(BP)in childhood.Traditionally,office BP measurements by the physician have been the cornerstone for the assessment of HTN in children.However,since the white coat and masked HTN phenomena are not rare in childhood,out-of-office BP measurements have significantly improved the accurate diagnosis of HTN and decision making.Ambulatory BP monitoring is regarded as indispensable for the evaluation of pediatric HTN,providing details not only for the staging for HTN,but also for the study of other ambulatory BP patterns.It should be pointed out that HTN in children and adolescents is associated with target-organ damage which is significant in terms of cardiovascular risk.The current knowledge,outlined in the present review,is expected to help in early and accurate diagnosis as well as in the management of HTN in children and adolescents.
基金the National Natural Science Foundation of China(grant numbers:81973110 and 82204062).
文摘Background The age of onset of hypertension(HTN)is decreasing,and obesity is a significant risk factor.The prevalence and racial disparities in pediatric HTN and the association between body composition and blood pressure are insufficiently studied.This study aimed to evaluate the prevalence of HTN in Chinese and American children and adolescents and to assess the relationship between various body composition indices and HTN.Methods Seven thousand,five hundred and seventy-three Chinese and 6239 American children and adolescents aged 8–18 years from the 2013–2015 China Child and Adolescent Cardiovascular Health study and the 2011–2018 National Health and Nutrition Examination Surveys were analyzed.Blood pressure and body composition(fat and muscle)were measured by trained staff.The crude prevalence and age-standardized prevalence rate(ASPR)of primary HTN and its subtypes[isolated systolic hypertension(ISH)and isolated diastolic hypertension(IDH)]were calculated based on 2017 American Academy of Pediatrics guidelines.Multivariable-adjusted linear regression coefficients and odds ratios(ORs)were calculated to assess the associations of body composition indicators with HTN,ISH and IDH.Results The ASPR of HTN was 18.5%in China(CN)and 4.6%in the United States(US),whereas the obesity prevalence was 7.4%and 18.6%,and the population attributable risk of HTN caused by overweight and obesity was higher in the US than in CN.Increased fat mass,muscle mass and body fat percentage mass were associated with a higher risk of HTN in both countries.The percent of muscle body mass had a protective effect on HTN and ISH in both countries[HTN(CN:OR=0.83,95%CI=0.78–0.88;US:OR=0.72,95%CI=0.64–0.81);ISH(CN:OR=0.87,95%CI=0.80–0.94;US:OR=0.71,95%CI=0.62–0.81)],and the protective effect was more common among children and adolescents with high levels of physical activity.Conclusions The burden of HTN in Chinese children and adolescents was substantial and much greater than that in the US,and the contribution of obesity to HTN was higher in the US than in CN.Augmenting the proportion of muscle mass in body composition has a protective effect against HTN in both populations.Optimizing body composition positively influences blood pressure in children and adolescents,particularly those with high-level physical activity.
基金The study was reviewed and approved by the Institutional Review Board at Rabin Medical Center,approval No.0075-17-RMC.
文摘BACKGROUND Type 1 diabetes(T1D)contributes to altered lipid profiles and increases the risk of cardiovascular disease(CVD).Youth with T1D may have additional CVD risk factors within the first decade of diagnosis.AIM To examine risk factors for dyslipidemia in young subjects with T1D.METHODS Longitudinal and cross-sectional retrospective study of 170 young subjects with T1D(86 males;baseline mean age 12.2±5.6 years and hemoglobin A1c 8.4%±1.4%)were followed in a single tertiary diabetes center for a median duration of 15 years.Predictors for outcomes of lipid profiles at last visit(total cholesterol[TC],triglycerides[TGs],low-density lipoprotein-cholesterol[LDL-c],and highdensity lipoprotein-cholesterol[HDL-c])were analyzed by stepwise linear regression models.RESULTS At baseline,79.5%of the patients had at least one additional CVD risk factor(borderline dyslipidemia/dyslipidemia[37.5%],pre-hypertension/hypertension[27.6%],and overweight/obesity[16.5%])and 41.6%had multiple(≥2)CVD risk factors.A positive family history of at least one CVD risk factor in a first-degree relative was reported in 54.1%of the cohort.Predictors of elevated TC:family history of CVD(β[SE]=23.1[8.3],P=0.006);of elevated LDL-c:baseline diastolic blood pressure(DBP)(β[SE]=11.4[4.7],P=0.003)and family history of CVD(β[SE]=20.7[6.8],P=0.017);of elevated TGs:baseline DBP(β[SE]=23.8[9.1],P=0.010)and family history of CVD(β[SE]=31.0[13.1],P=0.020);and of low HDL-c levels:baseline DBP(β[SE]=4.8[2.1],P=0.022]).CONCLUSION Our findings suggest that elevated lipid profiles are associated with DBP and a positive family history of CVD.It is of utmost importance to prevent and control modifiable risk factors such as these,as early as childhood,given that inadequate glycemic control and elevation in blood pressure intensify the risk of dyslipidemia.
文摘为考察国际基于自我决定理论的儿童青少年体育活动研究的发展脉络和最新进展,运用科学计量学中的关键词共现、关键词聚类和可视化技术等方法对2000—2022年Web of Science核心合集数据库相关研究文献进行分析。结果发现:中国在亚洲国家中产出领先;历年研究呈现从宏观到微观、从单一到多重、从横断到纵横结合、从解决到预防、从验证到应用、从开拓到回顾的发展趋势,最新研究体现出重视结构化问卷、研究设计联系实际情境和纳入各种心理学变量的特点;已有研究存在针对特殊群体、干预的作用路径、系统化干预项目设计方法等方面的局限。对我国相关研究的启示:对热度仍持续的主题继续优化研究设计;对基本达到饱和的主题结合实际推进本土研究;利用多重变量关系路径、多元干预模型、跨情境研究、横向与纵向相结合等开展实证研究;编制、修订中国版的相关问卷。
文摘绿色暴露是人与绿色空间积极互动的重要结果,为解决儿童与青少年健康问题提供新的契机。运用CiteSpace知识图谱分析软件对322篇Web of Science核心合集收录的相关文献进行文献计量分析,梳理绿色暴露对儿童和青少年健康影响研究的整体发展脉络。结果显示:(1)在纵向时间维度上,相关研究历经明显的阶段性特征,多数文献源于景观规划与环境资源类刊物;(2)高频发表的作者组团引导该领域的主要研究方向,文献支持机构主要来自欧美国家的众多高校;(3)在横向关键词维度上,通过共现、突现与时间线分析得出主要关键词,并从实践设计、儿童与青少年成长特点与社会属性出发,分析研究前沿内容;(4)基于研究方法与视角对相关文献进行差异性分析,总结重要的测度指标与发展层次。针对现有研究不足,为未来绿色暴露对儿童与青少年健康研究方向提供参考。
文摘目的:分析2014年中国7~18岁儿童青少年学生血压状况的流行病学现状及其与营养状况之间的关联性,为制定儿童血压防控措施提供依据。方法:利用2014年"中国学生体质与健康调研"结果中7~18岁的儿童青少年数据,依据我国儿童青少年分年龄、性别、身高百分位血压标准来评价血压状况,包括儿童血压偏高前期、血压偏高、单纯性收缩压偏高、单纯性舒张压偏高和混合性血压偏高。按照国际儿童青少年体质量指数(body mass index,BMI)标准评价儿童青少年营养状况,包括消瘦(重度消瘦和轻度消瘦)、正常BMI、超重和肥胖(重度肥胖和轻度肥胖)。利用多因素Logistics回归模型分析血压偏高与营养状况之间的关联性,并计算人群归因危险度评估超重肥胖控制对于预防儿童血压偏高的公共卫生学意义。结果:2014年中国7~18岁儿童青少年血压偏高和血压偏高前期的检出率分别为14.9%和9.2%,儿童青少年血压偏高者中收缩压偏高、舒张压偏高和混合性血压偏高检出率分别为3.1%、8.8%和3.0%。血压偏高状况整体呈现为男生高于女生,乡村高于城市,随年龄逐渐增高,随地区(东部、中部和西部)逐渐降低,随BMI的增加而增加的趋势。重度肥胖组的血压偏高检出率最高,男女生分别为44.2%和38.8%,分别是正常组(15.8%和10.6%)的2.8倍和3.7倍。血压偏高与消瘦(重度消瘦和轻度消瘦)呈负相关,与超重肥胖呈正相关。血压偏高归因于超重肥胖的危险度为16.2%,控制超重肥胖后,血压偏高的期望检出率为12.5%,且对单纯性收缩压偏高和混合性血压偏高影响较大,归因危险度分别为28.7%和35.1%。结论:我国儿童青少年血压偏高检出率较高,且以单纯性舒张压偏高为主。超重肥胖可显著增加血压偏高的风险,尤其是对单纯性收缩压偏高和混合性血压偏高影响较大,通过控制超重肥胖可显著降低全国儿童高血压的发生风险,从而对预防成年期慢性病的发生具有重要意义。
文摘体育社会化在促进体育素质教育和个体健康成长方面具有重要意义。该文采用科学知识图谱方法,并利用CiteSpace软件,对Web of Science和中国知网数据库中近30年来的体育社会化核心文献进行了对比分析,分别从热点主题和发展趋势等方面分析中外体育社会化领域的研究现状及其差异,并为我国体育社会化研究提供了参考和启示。研究结果指出:在热点主题方面,国内研究集中于青少年、学校体育和体育教学,而国外更关注儿童、健康、青少年和行为研究;从研究方法角度看,国内研究倾向于宏观视角且方法单一,缺少实证研究,相比之下,国外在理论和方法上更为丰富,实证研究较多;在发展趋势上,国内研究主要围绕“竞技体育—学校体育—大学生—青少年—社会体育—体育产业”发展,而国外则集中于“家庭与儿童社会化—性别社会化—学校与青少年社会化—运动员社会化—职业社会化”。这些发现对于我国未来的体育社会化研究具有重要的借鉴价值,特别是在儿童青少年社会化、职业社会化和特殊群体社会化等细分领域。
文摘为了解近10年(2006~2016)来美国18岁及以下的儿童青少年创伤后应激障碍(PTSD)治疗研究的热点和重点,利用Bicomb 2.0软件和IBM SPSS Statistics 20.0软件,对ISI Web of Science数据库中查询到的363篇论文进行了知识图谱的可视化分析。结果表明,近10年来美国儿童青少年PTSD治疗研究可分为两个大的研究领域。领域一为儿童青少年PTSD的精神科和神经生物学相关的治疗,包括了两个小的研究热点:(1)儿童青少年PTSD精神科药物治疗相关的研究;(2)儿童青少年PTSD眼动脱敏再加工治疗等神经生物学机制的疗法。领域二为儿童青少年PTSD的心理学治疗,包括了两个小的研究热点:(1)家庭暴力导致的儿童青少年PTSD心理学治疗研究;(2)儿童青少年PTSD的认知行为治疗研究。其中关于儿童青少年PTSD的认知行为治疗研究是研究的热点和重点领域,但关于儿童青少年PTSD治疗效果的长期纵向研究还较为缺乏,未来研究者应加强对儿童青少年PTSD治疗效果的追踪研究,并开展心理治疗与药物治疗相结合的疗效研究。
