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目的分析浙江省10~18岁儿童青少年体质指数(BM I)与血压等相关因素的关系。方法采用分层不等整群随机抽样,对浙江省四市5 528名10~18岁儿童青少年进行了身高、体重、血压、血脂、血糖及心功能等生理学和生物化学指标的测定。依照中国肥胖问题工作组(WGOC)推荐的中国青少年超重、肥胖标准进行BM I分类;根据中国学生体质与健康调研组推荐的儿童高血压标准,诊断儿童高血压。结果(1)在5 528名儿童青少年中男、女生超重率分别为10.18%和9.97%,肥胖率分别为4.82%和3.75%。(2)根据本次调查要求,筛选出符合标准者4 286人,在控制了年龄、性别的影响后,4 286名儿童青少年的BM I与收缩压(SBP)、舒张压(BDP)独立正相关〔偏相关系数(r)检验P<0.001,〕BM I与SBP、DBP偏r值分别为0.336和0.221。(3)SBP、DBP均值为肥胖组>超重组>正常体重组,差异具有统计学意义(P<0.001)。(4)正常体重、超重、肥胖组间高血压患病率差异有统计学意义(P<0.001);超重、肥胖组高血压患病率分别高达12.07%和22.69%,且与正常体重组相比患高血压的相对危险度(RR)分别为2~3倍和4~7倍。(5)Logistic多因素回归分析结果显示,年龄和体重对SBP、DBP的高低均有影响(P<0.001)。在调整了年龄因素后,正常体重、超重和肥胖组,体重分类每升高一级,患高血压的RR分别是低一级体重分类的2~3倍。结论浙江省10~18岁儿童青少年的BM I与血压呈独立正相关;体重超重和肥胖者患高血压的危险性显著增加。提示控制儿童青少年体重是预防高血压的重要手段之一。
Objective To analyze the relationship between body mass index (BM I) and blood pressure and other related factors in children aged 10-18 years in Zhejiang Province. Methods The stratified unequal cluster random sampling was used to determine the physiological and biochemical indexes such as height, weight, blood pressure, blood lipid, blood glucose and heart function among 5 528 children aged 10-18 in four cities of Zhejiang Province. According to the Chinese Adolescent Overweight and Obese Standard recommended by the Chinese Working Group on Obesity (WGOC) for BM I classification, children’s hypertension was diagnosed according to the standard of children’s hypertension recommended by the Chinese Students Physique and Health Research Group. Results (1) Among 5 528 children and adolescents, the overweight rates of male and female were 10.18% and 9.97%, and the obesity rates were 4.82% and 3.75% respectively. (2) According to the survey, 4 286 people were screened to meet the standards. After controlling for age and gender, 4 286 children and adolescents were independent of BM I, SBP and BDP Correlation (partial correlation coefficient (r) test P <0.001, BM I and SBP, DBP partial r values were 0.336 and 0.221 respectively. (3) SBP and DBP means obesity group> overweight group> normal body weight group, the difference was statistically significant (P <0.001). (4) The prevalence of hypertension in normal weight, overweight and obesity group was significantly different (P <0.001). The prevalence of hypertension in overweight and obesity group was 12.07% and 22.69% respectively, and was significantly higher than that in normal weight group The relative risk (HR) of patients with hypertension was 2 to 3 times and 4 to 7 times respectively. (5) Logistic multivariate regression analysis showed that age and weight had an impact on the level of SBP and DBP (P <0.001). After adjusting for age, normal-weight, overweight and obesity groups, each increase in body weight classification, suffering from high blood pressure RR were low-grade body weight classification of 2 to 3 times. Conclusion The BM I of adolescents aged 10 to 18 years in Zhejiang Province is independently and positively correlated with blood pressure. The risk of overweight and obesity in hypertensive patients is significantly increased. Prompted weight control of children and adolescents is one of the important ways to prevent high blood pressure.