中国7~17岁儿童青少年1993-2011年血压偏高变化趋势分析

了解中国7~17岁儿童青少年1993-2011年血压水平和血压偏高检出率变化趋势,为我国儿童青少年血压偏高防治提供基础数据.方法 基于1993,2000和2011年3次中国健康和营养调查(CHNS)横断面数据,选取具有性别、年龄、身高、体重、腰围和血压完整资料的4 715名7~17岁的儿童青少年作为研究对象,采用Logistic回归模型分析儿童青少年血压偏高的影响因素.结果 1993-2011年儿童青少年SBP和DBP水平分别增长3.4和1.5 mmHg,其中男生、7~12岁和城市儿童增长幅度较大.血压偏高、单纯收缩压偏高和单纯舒张压偏高检出率分别从1993年的10.0%,2.1%和9.3%增加到2011年的12.9%,3.0%和11.7%,分别增长2.9,0.9和2.4百分点.儿童青少年超重、肥胖和腹型肥胖检出率分别从1993年的4.8%,1.4%和4.9%增加到2011年的10.8%,8.8%和19.7%,分别增长6.0,7.4和14.8百分点(x2值分别为61.4,132.7,229.7,P值均<0.05).相对于男生,女生血压偏高的OR值为0.79(95% CI=0.66~ 0.95);与正常体重儿童相比,超重儿童青少年血压偏高的OR值为2.11(95%CI=1.57~2.84),肥胖OR值为3.14(95%CI=2.15~ 4.59);与正常腰围相比,腹型肥胖OR值为1.65(95%CI=1.22~2.22).结论 1993-2011年中国儿童青少年血压水平、血压偏高、超重、肥胖和腹型肥胖检出率均呈增加趋势.儿童青少年血压偏高防治形势依然严峻,肥胖是儿童青少年血压偏高的重要危险因素.     

苏州市儿童青少年体质指数、腰围、腰高比与血压水平关系的研究

目的了解苏州市儿童青少年体质指数、腰围和腰高比与血压水平的关系。方法 2019年9—10月采用分层整群抽样方法,对苏州市3 150名7～17岁儿童青少年进行问卷调查,测量身高、体质量、腰围和血压等指标,计算体质指数(BMI)和腰高比并分析血压Z评分与各项肥胖指标的关系。结果男女组中均呈现,与正常BMI和腰围或腰高比组相比,超重肥胖+中心性肥胖组收缩压和舒张压Z评分较高(均P0.01),如男性中,超重肥胖+中心性肥胖组(腰围)收缩压和舒张压Z评分分别为0.68±1.10和0.07±0.76,正常体重组收缩压和舒张压Z评分分别为-0.10±0.93和-0.25±0.63。BMI、腰围和腰高比Z评分指标均与收缩压、舒张压Z评分呈正相关(均P0.01)。多元线性回归分析结果显示,BMI、腰围和腰高比Z评分均是收缩压、舒张压Z评分升高的危险因素(均P0.01)。BMI Z评分拟合度最高,标准化回归方程分别为:收缩压Z评分=0.336×BMI Z评分+0.016×年龄-0.301×性别+0.263,舒张压Z评分=0.129×BMI Z评分-0.098。结论苏州市儿童青少年BMI、腰围和腰高比均与血压水平呈正相关,BMI比腰围和腰高比有更强的相关性。     

天津市儿童青少年肥胖与血压现状及关系

目的了解天津市儿童青少年肥胖和血压现状及其关系,为有针对性地制定儿童青少年血压偏高防控策略提供理论依据。方法2019年9月,采用分层整群抽样的方法,选取天津市16个区94所中小学7~17岁儿童青少年30403人为研究对象。采用标准方法测量身高体重和血压。采用SPSS 24.0进行χ2检验、方差分析和二元logistic回归分析。结果天津市儿童青少年超重检出率为17.28%,其中男生为19.32%,女生为15.07%;肥胖检出率为22.79%,其中男生为27.20%,女生为18.01%;血压偏高检出率为20.88%,其中男生为20.98%,女生为20.77%。BMI正常组、超重组和肥胖组血压偏高检出率分别为14.03%、23.41%和36.95%,差异有统计学意义(P<0.001)。与BMI正常组比较,超重、肥胖是儿童青少年血压偏高的危险因素(OR=1.872,95%CI:1.735~2.021;OR=3.598,95%CI:3.366~3.827)。结论超重和肥胖是7~17岁儿童青少年发生血压偏高的重要影响因素,控制超重和肥胖是有效应对血压偏高的重要手段。     

广州市中小学生2014年肥胖类型与血压水平的关系

分析2014年广州市中小学生超重肥胖、单纯腹型肥胖、复合型肥胖与血压之间的关联性,旨在为高血压的预防和干预提供依据.方法 选择广州市11个区的15所小学和15所中学的13 004名7~18岁在校学生为研究对象,采用协方差分析以及多因素Logistic回归模型,分析儿童青少年肥胖类型与血压水平[收缩压(systolic blood pressure, SBP)、舒张压(diastolic blood pressure,DBP)]及血压偏高率之间的关系.结果 协方差分析显示,男生和女生中不同肥胖类型学生间SBP和DBP平均水平差异均有统计学意义(P值均<0.01).在男生中,超重肥胖、复合型肥胖的SBP、DBP水平均高于正常体重学生(P值均<0.01);女生中,血压水平在不同类型肥胖的变化趋势大体为复合型肥胖>腹型肥胖>超重肥胖>正常体重.Logistic回归分析显示,男生和女生的复合型肥胖与血压偏高风险的关联性最强(男生:OR=4.40,95%CI=3.61~5.36;女生:OR=5.25,95%CI=4.16 ~ 6.64).在男生中,超重肥胖者的血压偏高风险亦高于正常体重者(OR=2.68,95%CI=1.31 ~5.49),但腹型肥胖者与血压偏高之间未见统计学关联.女生中,腹型肥胖和超重肥胖与血压偏高的关联均无统计学意义.结论 肥胖是引起儿童青少年血压升高的重要危险因素.其中复合型肥胖学生中引起血压升高的风险最高,其次是超重肥胖或腹型肥胖.     

中国东部地区青少年肥胖类型及其与血压的关系

目的探讨2016-2017年我国东部地区12个省(直辖市)12~17岁青少年肥胖类型和血压关系。方法采用多阶段分层随机抽样,选取"2016-2017年中国儿童与乳母营养健康监测"项目中我国东部地区12~17周岁的青少年共8279人作为研究对象。依据体质指数、腰高比将研究对象划分为非肥胖、一般性肥胖、中心型肥胖、复合型肥胖4种类型。依据"中国3~17岁儿童每岁、身高对应的血压标准"判定不同肥胖类型人群的正常高值血压、血压偏高的情况。利用χ²检验、方差分析与多水平线性模型、多水平Logistic回归模型分析不同肥胖类型与血压的关系。结果中国东部地区12~17岁青少年正常高值血压检出率为13.66%(1069人),血压偏高检出率为18.79%(1782人)。其中非肥胖组正常高值血压检出率12.85%(732人),血压偏高检出率13.79%(999人);一般性肥胖组正常高值血压检出率20.45%(99人),血压偏高检出率23.62%(160人);中心型肥胖组正常高值血压检出率6.95%(32人),血压偏高检出率14.64%(87人);复合型肥胖组正常高值血压检出率16.68%(206人),血压偏高检出率42.42%(536人)。血压偏高检出率男女生间(χ²=8.05,P<0.01)差异有统计学意义;多水平模型结果:中心性肥胖仅女生血压偏高风险显著高于非肥胖组(OR=1.50,95%CI 1.12~2.02);肥胖的男、女生正常高值血压(OR=2.05,95%CI 1.62~2.58;OR=1.83,95%CI 1.38~2.42)、血压偏高(OR=2.06,95%CI 1.59~2.67;OR=1.57,95%CI 1.15~2.14)的风险均显著高于非肥胖组,;复合型肥胖的男、女生正常高值血压(OR=3.80,95%CI 3.19~4.51;OR=2.79,95%CI 2.30~3.37)、血压偏高(OR=4.07,95%CI 3.39~4.88;OR=2.84,95%CI 2.32~3.46)的风险显著高于非肥胖组。结论中国东部地区12~17岁青少年群体中,不同肥胖类型与血压水平相关程度不同,复合型肥胖血压偏高风险最高。     

济南市儿童青少年不同肥胖类型与代谢异常的关系

探讨儿童青少年不同肥胖类型与代谢异常的关系,为儿童青少年心血管病危险因素的防制提供科学依据.方法 选取济南市城区1 170名7~17岁儿童青少年,测量身高、体重、腰围(WC)和血压,同时测定空腹血糖、三酰甘油、高密度脂蛋白胆固醇、低密度脂蛋白胆固醇等血生化指标,分析不同肥胖类型与代谢异常的关系.结果 儿童青少年各类生化指标平均水平(血糖、总胆固醇除外)和代谢异常检出率(高血糖除外)在不同肥胖类型组的差异均有统计学意义(P值均<0.05),且表现为复合型肥胖组>全身性肥胖或中心性肥胖组>体质量指数(BMI)和WC均正常组.以BMI与WC均正常为对照组,任意肥胖类型组以及复合型肥胖组罹患各类代谢异常的风险均较高.以预测代谢异常≥2个为例,任意肥胖类型的风险OR值为1.50(95%CI=0.78~ 2.90),复合型肥胖的风险OR值为7.84(95%CI=5.00~ 12.30).结论 在学生体检工作中,应联合使用BMI和WC来判定儿童肥胖,从而更有效地防控儿童青少年心血管病危险因素.     

安徽省儿童青少年人体质量指数与血压关系分析

目的探讨儿童青少年体质量指数（body mass index，BMI）与血压的关系，为心血管疾病的早期干预提供科学依据。方法以2005年“全国学生体质与健康调研”中6600名安徽省7-17岁儿童青少年6600名为研究对象，根据中国肥胖问题工作组推荐的标准，将研究对象分为体重正常、超重和肥胖组，比较各组间血压值Z分和血压偏高检出率的差异，并探讨BMI与血压的关系。结果儿童青少年收缩压（SBP）Z分、舒张压（DBP）Z分以及血压偏高的检出率均呈肥胖组〉超重组〉体重正常组；Logistic多因素回归分析结果显示，超重和肥胖是血压偏高的危险因素（OR=2．358，OR=5．466；95％CI：1．191～1．262，3．648—8．191）。结论超重和肥胖是儿童青少年血压偏高的危险因素。     

父母体重和儿童青少年生命早期因素对其超重肥胖的影响

目的 探究儿童青少年超重肥胖的风险与其生命早期因素以及父母体重的关联,为防制儿童青少年超重肥胖提供理论依据。方法 于2022年6月1—30日,采用分层随机整群抽样方法在呼和浩特市抽取5 370名中小学生,使用问卷调查收集信息,并就父母体质量指数(BMI)和儿童青少年生命早期因素对其超重肥胖影响使用多元Logistic回归模型进行多因素分析。结果 中小学生超重肥胖率为32.2%,男生超重肥胖率为37.8%,高于女生的26.1%(χ²=84.59,P<0.01)。多因素Logistic回归分析结果显示,仅父亲超重(OR=1.52,95%CI=1.30～1.77)、仅母亲超重(OR=1.61,95%CI=1.31～1.97)、父母均超重(OR=2.42,95%CI=2.03～2.87)的儿童青少年超重肥胖风险较高(P值均<0.01)。高出生体重(OR=1.29,95%CI=1.08～1.55),剖宫产(OR=1.32,95%CI=1.17～1.48),母亲孕期增重过多(OR=1.24,95%CI=1.06～1.46)的儿童青少年超重肥胖风险较高(P值均<...     

儿童高血压与体质量指数腰围腰高比及腰臀比的关联性研究

探讨儿童高血压与体质量指数(BMI)、腰围、腰高比、腰臀比的关联性,为儿童高血压和成年期高血压的早期预防提供参考.方法 以2014年安徽省学生体质与健康调研检测中的8 890名7~17岁儿童(男童4 424名,女童4 466名)作为研究对象,测量其身高、体重、腰围、臀围、血压,计算体质量指数、腰高比、腰臀比,并进行Z分转化.分析高血压与各项肥胖相关指标Z分间的关系,采用相关性分析、多元线性回归模型、ROC曲线分析.结果 8 890名儿童的高血压检出率为13.61%(95%CI=12.90%~14.32%),其中男生(16.30%,95%CI=15.21%~17.39%)高于女生(10.95%,95%CI=10.03% ~ 11.87%),差异有统计学意义(x2=54.06,P<0.01).BMI、腰围、腰高比、腰臀比4项人体测量指标Z分均呈正相关(P值均<0.01).Logistic回归分析得出,4项人体测量指标均为高血压的影响因素(P值均<0.01),其中男、女童BMI的Z分指标对高血压的影响最大,OR值分别为1.79(95%CI=1.66~1.93)和1.69(95%CI=1.56~1.84).ROC曲线结果显示,BMI、腰围的Z分指标与血压间的相关性较其他人体测量指标强.结论 BMI和腰围与7~17岁儿童高血压有良好的相关性.     

天津市城乡居民超重肥胖流行现状及其与血压的相关性

目的了解天津市城乡居民超重、肥胖流行现状及其与血压的关系,为超重和肥胖的防控提供科学依据。方法采用多阶段分层随机抽样方法,抽取天津3个城区、3个郊区共12 600名≥15岁的常住人口为调查对象,进行现场问卷调查和体格检查,内容包括人口学特征、生活方式及疾病史等信息,并测量身高、腰围、体重和血压,计算体质指数(BMI)和腰围身高比(WHtR)。用SPSS 20.0统计软件进行t检验、方差分析、χ~2检验、相关分析及logistic回归分析。结果最终共调查12 474人(占调查总人数的99%),超重3 980例(31.9%),肥胖1 770例(14.2%),WHt R≥0.5者6 899例(55.3%);超重或肥胖、中心性肥胖指标在性别、年龄、城乡之间差异均有统计学意义(P<0.01);超重或肥胖、中心性肥胖患者的血压均值及高血压患病率均超过体重正常者,差异均有统计学意义(P<0.01);相关性分析结果显示,BMI和WHt R与收缩压(SBP)、舒张压(DBP)均呈正相关(r值分别为0.300、0.409、0.259和0.264,P<0.01),偏相关分析控制年龄、性别等混杂因素后,BMI和WHt R仍然与SBP、DBP相关(r值分别为0.251、0.271、0.217和0.180,P<0.01)。多因素logistic分析显示,高血压的危险因素为年龄(OR=1.068,95%CI:1.064~1.071)、吸烟(OR=1.163,95%CI:1.010~1.339)、饮酒(OR=1.343,95%CI:1.151~1.567)、农村居住(OR=1.178,95%CI:1.069~1.298)、高血压家族史(OR=1.371,95%CI:1.190~1.581)、超重(OR=1.847,95%CI:1.650~2.067)、肥胖(OR=3.379,95%CI:2.927~3.901)和WHt R≥0.5(OR=1.853,95%CI:1.648~2.084)。结论天津市城乡居民超重或肥胖率处于较高水平,并且在肥胖人群中有着较高的高血压患病率,控制体重对高血压等慢性病的防治具有重要意义。     

Heat-related illnesses, deaths, and risk factors--Cincinnati and Dayton, Ohio, 1999, and United States, 1979-1997

During the summer of 1999, a heat wave occurred in the midwestern and eastern United States. This period of hot and humid weather persisted from July 12 through August 1, 1999, and caused or contributed to 22 deaths among persons residing in Cincinnati (18 deaths) and Dayton (four deaths). A CDC survey of 24 U.S. metropolitan areas indicated that Ohio recorded some of the highest rates for heat-related deaths during the 1999 heat wave, with Cincinnati reporting 21 per million and Dayton reporting seven per million (CDC, unpublished data, 1999). This report describes four heat-related deaths representative of those that occurred in Cincinnati or Dayton during the 1999 heat wave, summarizes heat-related deaths in the United States during 1979-1997, describes risk factors associated with heat-related illness and death, and recommends preventive measures.     

International standards and international reference preparations: amphotericin B, vancomycin, capreomycin, cefalotin, demethylchlortetracycline, gentamycin, gramicidin S, kanamycin and kanamycin B, lincomycin, lymecycline, methacycline, paromomycin, rifamycin SV, ristocetin and ristocetin B, spiramycin, and triacetyloleandomycin

Each of the preparations described here was obtained and evaluated at the request of a WHO Expert Committee on Biological Standardization. Unless otherwise stated, a standard procedure was used to distribute the material into individual ampoules. The procedure was as follows. Upon receipt by the National Institute for Medical Research (NIMR), London, materials were stored temporarily in the dark at a temperature of -10°C or lower, and protected from moisture. At a convenient time they were brought back to room temperature, mixed, and distributed into individual neutral glass ampoules so that each ampoule contained 50-100 mg of powder. If it was known that the material was light-sensitive non-actinic glass ampoules were used. After exhaustive drying in vacuum over phosphorus(V) oxide, the ampoules were either constricted (up to 1963) or fitted with capillary leak plugs, dried for a further period under the same conditions, filled with dry nitrogen, and sealed by fusion of the glass. The total drying period varied from 8 to 38 days according to the nature of the material. After they had been tested for leaks, the ampoules were stored in the dark at -20°C.     

Zinc, copper, and magnesium and risks for all-cause, cancer, and cardiovascular mortality

BACKGROUND: Experimental data suggest that zinc, copper, and magnesium are involved in carcinogenesis and atherogenesis. Few longitudinal studies have related these minerals to cancer or cardiovascular disease mortality in a population. METHODS: Data from the Paris Prospective Study 2, a cohort of 4035 men age 30-60 years at baseline, were used to assess the association between serum zinc, copper, and magnesium and all-cause, cancer, and cardiovascular disease mortality. Serum mineral values measured at baseline were divided into quartiles and classified into low (1st quartile, referent group), medium (2nd-3rd quartiles), and high (4th quartile) values. During 18-year follow up, 339 deaths occurred, 176 as a result of cancer and 56 of cardiovascular origin. Relative risks (RRs) for each element were inferred using Cox's proportional hazard model after controlling for various potential confounders. RESULTS: High copper values (4th quartile) were associated with a 50% increase in RRs for all-cause deaths (RR = 1.5; 95% confidence interval = 1.1-2.1), a 40% increase for cancer mortality (1.4; 0.9-2.2), and a 30% increase for cardiovascular mortality (1.3; 0.6-2.8) compared with low values (1st quartile). High magnesium values were negatively related to mortality with a 40% decrease in RR for all-cause (0.6; 0.4-0.8) and cardiovascular deaths (0.6; 0.2-1.2) and by 50% for cancer deaths (0.5; 0.3-0.8). Additionally, subjects with a combination of low zinc and high copper values had synergistically increased all-cause (2.6; 1.4-5.0) and cancer (2.7; 1.0-7.3) mortality risks. Similarly, combined low zinc and high magnesium values were associated with decreased all-cause (0.2; 0.1-0.5) and cancer (0.2; 0.1-0.8) mortality risks. CONCLUSIONS: High serum copper, low serum magnesium, and concomitance of low serum zinc with high serum copper or low serum magnesium contribute to an increased mortality risk in middle-aged men.     

Psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine

This paper examines the relationship between psychological distress, gender, and health lifestyles in Belarus, Kazakhstan, Russia, and Ukraine. These countries have been subjected to highly stressful and extensive social change associated with the transition out of communism. Data were collected by face-to-face interviews (n = 10,406) in November 2001. Distress was measured by 12 psychological distress symptoms. Health lifestyles focused on measures of alcohol consumption, smoking and diet. We found that females carried a much heavier burden of psychological distress than males, but this distress did not translate into greater alcohol consumption and smoking for these women or for men. The greatest influence of distress on health lifestyle practices was on daily diets in that both less distressed females and males consumed a more balanced diet than more distressed persons. Our findings suggest that it is the normative demands of a particular lifestyle, rather than distress, that principally shapes the pattern of heavy male drinking. This is an important finding as some sources indicate heavy drinking is largely responsible for the health crisis in the former socialist states.     

Dietary sodium, calcium, and potassium, and blood pressure

The cross-sectional association of systolic blood pressure with dietary sodium, calcium, and potassium, as estimated from dietary histories, was investigated by multiple regression analysis of data gathered in the Netherlands in the early 1950s in a general health examination of 2,291 middle-aged civil servants and spouses of civil servants. A statistically significant negative trend with systolic blood pressure was seen for calcium intake in both males and females, even after adjustments for covariates. For sodium and potassium intake, the observed negative trends were not significant after multivariate analyses. In addition, no consistent associations were found between diastolic blood pressure and the micronutrients after multivariate analyses, except for a significant negative association with calcium intake in females. In this study population, blood pressure was a strong independent risk factor of total mortality: 15- and 25-year mortality was about twice as high for hypertensives (greater than or equal to 160 mmHg) as for normotensives (less than 160 mmHg). These findings support the conclusion in recent epidemiologic studies that higher intakes of calcium are associated with lower systolic blood pressure, and they extend the evidence to an earlier time period.     

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