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目的分析上海市某区小学生肥胖及代谢异常对儿童血压的影响,为探讨引起小学生血压升高发病的代谢相关因素提供参考依据。方法采用整群随机抽样方法,在上海市松江区抽取6所非寄宿制的公立小学,在选中的小学中,用抽签随机法从二~五年级中随机抽取2个班级,共计840名学生,以其中血压偏高学生为病例组(56人),以同学校、同性别、身高相差5 cm以内、年龄相差6个月以内为条件在血压正常的学生中按1∶4匹配对照组(224人)。对2组学生进行基本情况问卷调查、体格检查和血生化检测。结果病例组的体质量指数(BMI)、腰围、三酰甘油(TG)和空腹血糖(FPG)[(18.17±3.89)kg/m2,(60.09±4.12)cm,(1.04±0.56)mmol/L,(4.66±0.59)mmol/L]高于对照组[(17.26±2.75)kg/m2,(56.19±2.46)cm,(0.79±0.22)mmol/L,(4.47±0.47)mmol/L],差异均有统计学意义(t值分别为3.16,6.71,2.97,4.33,P值均<0.05)。调整年龄、性别、BMI后,两组腰围、TG、FG的差异仍具有统计学意义。Logistic回归分析结果表明,BMI增加与儿童血压偏高的发生呈正相关(OR=2.836,P<0.05);腹部肥胖、高三酰甘油和高血糖均与儿童血压偏高的发生有一定关系(OR值分别为4.357,3.049,6.000,P值均<0.05)。结论小学生血压偏高的发生与肥胖呈正相关,代谢异常与小学生高血压的关系需进一步研究。
Objective To analyze the influence of obesity and metabolic abnormalities on blood pressure in primary school students in a district of Shanghai, and to provide a reference for exploring the metabolic factors that cause the rise of blood pressure in primary school students. Methods A cluster random sampling method was used to select 6 non-boarding public elementary schools in Songjiang District of Shanghai. Among the selected primary schools, randomly selected 2 classes from the second to fifth grade by random lottery method, a total of 840 students, Among them, the students with high blood pressure were selected as the case group (56 students), the same students, same sex, within 5 cm of height, within 6 months of age, people). The two groups of students for the basic situation questionnaire, physical examination and blood biochemical tests. Results Body mass index (BMI), waist circumference, triglyceride (TG), and fasting plasma glucose (FPG) were significantly higher in patients than those in control group (18.17 ± 3.89 vs 60.09 ± 4.12 and 1.04 ± 0.56 mmol / L (4.66 ± 0.59) mmol / L] were significantly higher than those in the control group [(17.26 ± 2.75) kg / m 2, (56.19 ± 2.46) cm vs 0.79 ± 0.22 mmol / L, The differences were statistically significant (t = 3.16,6.71,2.97,4.33, P <0.05). After adjusting for age, sex, and BMI, the differences in waist circumference, TG, and FG were still statistically significant. Logistic regression analysis showed that the increase of BMI was positively correlated with the high blood pressure in children (OR = 2.836, P <0.05); and the incidence of abdominal obesity, high triglycerides and hyperglycemia was related to the high blood pressure in children Respectively, 4.357,3.049,6.000, P <0.05). Conclusions There is a positive correlation between the occurrence of high blood pressure and obesity in primary school students. The relationship between metabolic abnormalities and hypertension in primary school students needs to be further studied.