乌鲁木齐市儿童青少年血压状况分析

目的 了解乌鲁木齐市儿童青少年血压与体重指数 (BMI)的相关性,为该地区儿童青少年血压偏高的预防提供依据。方法 2016年9－10月本着方便抽样的原则在乌鲁木齐市分别选取15所高中、初中和小学的41 028名儿童青少年,进行身高、体重和血压的测试,并对结果进行分析。结果 乌鲁木齐市儿童青少年血压偏高检出率为12.75%,男生(13.77%)高于女生(10.92%),差异有统计学意义(χ²=75.31,P＜0.01)。儿童青少年肥胖和超重的学生高收缩压、高舒张压、血压偏高的检出率均高于正常组学生,差异有统计学意义(χ²=758.8、114.2、623.0,P＜0.01)。结论 乌鲁木齐市儿童青少年的血压状况不容乐观,超重肥胖是导致儿童青少年血压偏高的主要原因,今后应对超重肥胖儿童青少年的血压引起足够重视和关注。     

基于中国高血压防治指南的简化方法筛查苏州市儿童青少年血压偏高的效果

  目的  评价不同简化方法筛查苏州市儿童青少年血压偏高的效果。  方法  采用分层整群随机抽样方法,招募7 340名6~17岁儿童青少年,测量身高、体重和血压。以中国高血压防治指南为金标准,评价公式法、身高别法、年龄组别表格法和性别年龄别表格法的筛查效果。  结果  根据金标准和4种简化方法,血压偏高检出率分别为17.3%、17.9%、17.5%、18.5%、17.1%。身高别法和性别年龄别表格法与金标准筛查结果差异均无统计学意义(χ2 =0.593,P=0.477; χ2 =0.865,P=0.383)。与金标准相比,公式法、身高别法、性别年龄别表格法的Kappa值分别为0.818、0.865、0.858,高于年龄组别表格法(0.670)。身高别法和性别年龄别表格法曲线下面积最高,分别为0.934(95% CI: 0.924~0.944)、0.927(95% CI: 0.916~0.938),高于公式法(0.915, 95% CI: 0.904~0.926),年龄组别表格法最低,为0.844(95% CI: 0.829~0.858)。分性别、年龄、身高比较时,4种简化标准的筛查效果与总体基本一致,身高别法、性别年龄别表格法在不同分组呈现各自筛查优势。  结论  4种简化方法筛查效果均较好,考虑身高别法简便易行,更适合用于早期筛查。     

中国七省市儿童青少年不同肥胖类型对血压偏高的影响研究

目的 探讨我国儿童青少年不同肥胖类型对血压偏高的相加交互作用,为有效控制血压水平提供依据。方法 研究数据来自于2012年中国七个省市的儿童青少年的横断面调查。采用多阶段整群抽样的方法,连续变量和分类变量分别采用t检验和χ²检验分析变量之间的组间差异。采用Logistic回归分析不同肥胖类型和血压偏高之间的关联,分析一般性肥胖和单纯性腹型肥胖之间的交互作用。结果 本研究共纳入40 015名儿童青少年,一般性肥胖、单纯腹型肥胖和复合型肥胖儿童青少年血压偏高的比例分别为17.7%、12.0%和23.2%。复合型肥胖对男生和城市儿童青少年血压偏高的影响较大(男生OR=2.80,95%CI:2.55~3.07;城市OR=2.95,95%CI:2.69~3.24 ),收缩压和舒张压偏高呈现相同结果。在儿童青少年血压偏高的人群中,由一般性肥胖和单纯腹型肥胖的相加交互作用所引起的血压偏高的比例占22%。结论 一般性肥胖比单纯腹型肥胖对血压的影响更大,在不同肥胖类型中,复合型肥胖仍然是导致血压偏高最危险的因素。在儿童青少年血压偏高的人群中,一般性肥胖和单纯腹型肥胖具有相加交互作用。     

苏州市9～17岁儿童青少年睡眠时间及血压偏高的关系研究

目的 了解苏州市9～17岁儿童青少年睡眠时间与血压的关系,为儿童高血压综合防控提供依据。方法 2020年9—12月采用分层整群抽样方法,对苏州市2 903名9～17岁儿童青少年进行问卷调查,测量其身高、体重及血压等。结果 2 903名儿童青少年中,男生1 500名(占比51.67%),血压偏高413人(检出率14.23%),睡眠不足的学生共1 762名(检出率60.70%)。睡眠不足者中血压偏高率为16.00%,高于睡眠充足者(11.48%),差异有统计学意义(χ²=11.612,P=0.001),睡眠不足儿童青少年的收缩压z评分、舒张压z评分分别为0.34、0.25,睡眠充足者分别为0.24、0.20,差异均有统计学意义(t值分别为2.564、2.193,P均＜0.05)。调整相关因素后,logistic回归分析显示,与睡眠不足者相比,睡眠充足者发生血压偏高的风险增加32.9%(OR=1.329,95%CI:1.038～1.701)。按照性别、年龄段分层分析发现,男生组(OR=1.480,95%CI:1.079～2.029)、12～14岁组(OR=1.616,95%CI:1.113～2.345)中睡眠不足增加血压偏高发生风险。结论 苏州市儿童青少年睡眠时长不足可能是血压偏高的影响因素之一,应保证儿童青少年充足睡眠时间。     

两种血压标准下杭州市儿童青少年血压偏高检出情况比较

目的 评估两种儿童青少年血压标准对血压偏高检出情况的影响，为儿童青少年血压标准的应用提供参考依据。方法 数据来源于2015年杭州市中小学生健康检查，随机整群抽取杭州市7个县(市、区)7所小学、7所中学和7所高中资料完整的24 550名7～17岁儿童青少年。收集基本情况并进行体格检查。血压偏高的判断分别采用《2010年中国儿童青少年血压参照标准》(2010标准)和2018年国家卫生行业标准《7岁～18岁儿童青少年血压偏高筛查界值》(2018标准)。采用R 4.1.2软件进行简单线性回归和Cochran-Armitage趋势检验、Cohen’s Kappa一致性检验和多因素logistic回归分析。结果 2018标准下儿童青少年血压偏高比例(15.05%)远低于2010标准(23.47%)。两标准判断儿童青少年血压偏高的一致性水平为中等水平(Kappa值为0.71)，但两标准的一致性在不同身高组中存在明显差异，Kappa值在P₅～、P₁₀～、P₂₅～身高组最高，在P₉₀～、P₉₅     

苏州市儿童青少年体质量指数腰围腰高比与血压偏高的关系

探讨苏州市儿童青少年体质量指数(BMI)、腰围和腰高比与血压偏高的关系,为制定适宜的儿童青少年血压综合防控策略和措施提供参考.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、体重、腰围和血压,计算BMI和腰高比,分析血压偏高与各项肥胖指标的关系.结果 苏州市儿童青少年血压偏高率为11.3%,超重肥胖率为28.5%,采用腰围、腰高比标准筛查的中心性肥胖率分别为20.6%和23.7%.不同BMI、腰围和腰高比分组的儿童青少年血压偏高率差异均有统计学意义(x2值分别为157.80,105.87,124.17,P值均<0.01).Logistic回归分析显示,与正常体重组相比,超重肥胖组罹患血压偏高的可能性较大(OR=3.89,95%CI=3.09~4.90);与正常腰围或正常腰高比组相比,中心性肥胖组罹患血压偏高的可能性较大(腰围:OR=3.05,95%CI=2.41~3.86;腰高比:OR=3.35,95%CI=2.67~4.21).与BMI和腰围均正常者相比,同时超重肥胖和中心性肥胖者罹患血压偏高的可能性最大(OR=4.28,95%CI=3.31~5.53).结论 BMI、腰围和腰高比均与血压偏高存在相关,BMI与腰围或腰高比存在联合作用,保持正常体重和正常腰围/腰高比可能利于控制血压偏高.     

郑州市城区7~15岁儿童青少年中心性肥胖流行现况

目的 了解郑州市城区中小学生超重肥胖和中心性肥胖的流行现况,为城区学生的超重肥胖防控提供参考。方法 采用分层整群抽样方法,于2019年选取郑州市城区小学和初中学校的6 859名7~15岁学生进行问卷调查和体格检查,采用体重指数(BMI)、腰围(WC)和腰围身高比(WHtR)3种指标标准分析中小学生的超重肥胖和中心型肥胖流行现况。用R 4.0.3软件进行t检验、完全随机设计χ²检验、配对χ²检验和加权Kappa一致性检验。结果 以BMI标准筛查郑州市城区中小学生的总体超重和肥胖率分别为14.4%和10.3%,以WC标准和WHtR标准筛查的中心型肥胖率分别为19.4%和14.3%。3种筛查标准对各年龄段男生的肥胖和中心型肥胖检出率均高于女生,差异有统计学意义(P<0.01);10~15岁学生的中心型肥胖检出率均高于7~9岁学生,差异有统计学意义(P< 0.01)。在筛查中小学生中心型肥胖上,WC标准 vs. WHtR标准的Kappa值为0.73,其中7~9岁、10~12岁和13~15岁男生的Kappa值分别为0.84、0.85和0.76,一致性程度较高。结论 郑州市城区7~15岁学生超重肥胖和中心型肥胖状况不容乐观,尤其是男生和小学生应重点关注,应及早开展综合干预进行防控。     

天津市3~7岁孤独症谱系障碍儿童体格发育和营养状况研究

目的 了解天津市3~7岁孤独症谱系障碍(ASD)儿童生长发育状况,为改善ASD儿童生长发育提供参考依据。方法 2016-2019年整群抽取天津市221名3~7岁ASD儿童进行体格测量,各项指标依据2015年中国九市7岁以下儿童体格发育和2008年WHO儿童生长发育标准转化为Z评分,以评价ASD儿童的体格和营养状况,采用儿童孤独症评定量表(CARS)评估ASD儿童症状严重程度。结果 天津市ASD儿童超重/肥胖率为19.0%,年龄别体重Z评分(WAZ)、年龄别身高Z评分(HAZ)、年龄别体重指数Z评分(BAZ)分布曲线向右偏移,胸围及腰围的Z评分分布曲线向+3s外延伸,坐高的Z评分分布曲线向左偏移,呈现生长偏离趋势。男童WAZ(Z=2.053,P<0.05)及超重/肥胖率(χ²=6.572,P<0.05)高于女童,6~7岁组超重/肥胖率高于3~岁和4~岁组(P<0.05),不同ASD症状严重程度间营养状况的差异无统计学意义(χ²=5.321,P>0.05)。结论 天津市ASD儿童超重/肥胖检出率较高,存在体格生长偏离,应加强ASD儿童生长发育监测和肥胖的早期干预。     

体质指数正常的儿童青少年中腰围对血压偏高的预测作用

目的 探讨体质指数(BMI)正常的儿童青少年中腰围(WC)对血压偏高的预测作用,为儿童青少年血压偏高防制提供科学依据。方法 基于1993-2011年“中国健康与营养调查” 横断面合并数据,选取BMI正常的7~17岁儿童青少年9 038名作为研究对象。分析指标包括性别、年龄、WC、收缩压、舒张压和血压偏高患病率。校正性别和年龄,采用多元线性回归模型分析血压水平随WC水平增加的变化趋势,采用Logistic回归模型分析血压偏高患病率随WC水平增加的变化趋势以及患病风险。结果 随着WC水平的增加,BMI正常的儿童青少年血压水平和血压偏高率均呈现明显的上升趋势(收缩压/舒张压:96.0/63.1 mmHg~102.4/68.0 mmHg;血压偏高率:6.9%~21.8%,P均<0.001),结果均独立于性别与年龄。以WC25组为参照组,随WC水平的增加(P₂₅≤WC50,P₅₀≤WC75,P₇₅≤WC90和WC≥P₉₀),血压偏高的患病风险分别为1.39,1.70,2.21和3.10(P均<0.01),结果独立于性别与年龄。结论 WC可作为预测BMI正常的儿童青少年血压偏高的重要指标。BMI指标应与WC指标联合应用,从而更有效的预防儿童血压偏高风险。     

上海市4区0~5岁儿童生长发育水平及营养状况评价

目的 了解上海市4区0~5岁儿童的生长发育水平和营养状况,为本地区儿童健康促进和营养改善工作提供科学依据。方法 采用分层整群随机抽样选择上海市4个区的12个社区卫生服务中心作为调查点,以2018年7月-2019年4月前往调查点进行健康体检的0~5岁儿童及其监护人作为调查对象进行健康体检和问卷调查。采用2006年世界卫生组织制定的Z评分法进行评价。结果 除36~60月龄组外,其余各月龄组男童身长/高、体重均大于女童(P<0.05);女童HAZ值在各月龄组间比较差异有统计学意义(χ²=15.166,P=0.004),不同月龄组男女童WAZ值及WHZ值差异均有统计学意义(男童χ²_WAZ=25.192、χ²_WHZ=25.368;女童χ²_WAZ=24.378,χ²_WHZ=24.690,P＜0.001)。生长迟缓、低体重、消瘦、超重和肥胖儿童检出率分别为3.4%,2.0%,2.0%,11.4%和9.5%。结论 上海市4区0~5岁儿童生长发育总体水平正常,仍存在生长迟缓、低体重和消瘦等营养不良问题,超重和肥胖问题突出,应加强本地区儿童健康促进和营养改善工作。     

State-specific trends in self-reported blood pressure screening and high blood pressure--United States, 1991-1999

High blood pressure (HBP) increases the risk for heart disease and stroke, the first and third leading causes of death in the United States, respectively. An estimated one in four U.S. adults has HBP, which is defined as taking antihypertensive medication or having either a systolic blood pressure (SBP) of > or = 140 mmHg or a diastolic blood pressure (DBP) of > or = 90 mmHg. Optimal blood pressure is defined as SBP of < or = 120 mmHg or DBP of < or = 80 mmHg. To reduce the prevalence of HBP in the United States, the National Heart, Lung, and Blood Institute initiated the National High Blood Pressure Education Program (NHBPEP) in 1972, recommending that all adults aged > or = 20 years have their blood pressure (BP) checked at least once every 2 years. Although HBP is easily detectable and can usually be controlled with treatment, greater awareness of BP levels among U.S. adults is needed. This report summarizes data from the Behavioral Risk Factor Surveillance System (BRFSS) on state-specific trends in recent BP screening and prevalence of HBP (both by self-report). The findings indicate that during 1991-1999, BP screening levels were very high, and the percent of adults reporting HBP increased among some populations. Innovative education and intervention programs are needed to prevent and treat HBP in five high-risk groups: men, blacks, Hispanics, persons with less education, and older adults.     

High Blood Pressure in Obese and Nonobese Japanese Children: Blood Pressure Measurement is Necessary Even in Nonobese Japanese Children

Background

Although the prevalences of obesity and hypertension (HT) are increasing in children, there have been few epidemiological studies of HT in Japanese children. We evaluated the prevalences of HT and high-normal blood pressure (HNBP), and examined the relationship between blood pressure (BP) and body mass index (BMI), in Japanese children.

Methods

The subjects of this study were 2420 children living in the town of Ina, Saitama Prefecture, Japan during the period from 2006 through 2008. Body height, weight, and BP were measured. HT and HNBP were defined according to the HT criteria for Japanese children. Children with HNBP or HT were defined as having high blood pressure (HBP).

Results

The prevalences of HBP were 15.9% and 15.8% in fourth-grade boys and girls, respectively, and 11.1% and 10.8% in seventh-grade boys and girls, respectively. Irrespective of sex or grade level, a higher BMI was associated with a higher prevalence of HBP (P < 0.001). When compared with the <50th percentile BMI category, the crude odds ratios (ORs) were statistically significant for the 75th to 84th percentile category in fourth-grade boys (OR: 4.54, 95% CI: 2.36–8.76), the ≥95th percentile in fourth-grade girls (13.29, 5.93–29.77), the 85th to 94th percentile (3.16, 1.46–6.84) in seventh-grade boys, and the ≥95th percentile (7.96, 3.18–19.93) in seventh-grade girls.

Conclusions

BMI was associated with HBP in Japanese school children. In addition, some children in the lower BMI categories also had HBP.Key words: high blood pressure, children, BMI, hypertensive family history     

基于国内外不同标准的苏州市6~17岁儿童青少年营养状况的比较

目的 比较最新颁布的儿童青少年消瘦超重肥胖国家标准与WHO及国际标准,描述苏州市6~17岁儿童青少年营养状况。 方法 选取苏州市7 340名6~17岁儿童青少年,男性3 821名,女性3 519名,测量其身高、体重,计算体质指数。分别采用WHO标准、国际标准、中国标准进行评价。 结果 依据WHO标准、国际标准、中国标准,消瘦检出率分别为2.3%,8.4%,5.2%(两两比较均P<0.05);超重检出率分别为20.0%,19.6%,17.4%(中国标准低于WHO和国际标准,P<0.05);肥胖检出率分别为11.5%,6.7%,14.1%(两两比较均P<0.05)。与此同时,不同年龄、性别分组,基于不同标准的营养状况差异不同。WHO和国际标准一致性(Kappa=0.705)、中国和国际标准一致性(Kappa=0.692)低于WHO和中国标准对不同营养状况检出率的一致性(Kappa=0.811)。 结论 儿童营养健康(消瘦、超重、肥胖)成为苏州的重要公共卫生问题。中国标准与WHO及国际标准检出情况存在一定差异,应谨慎使用。     

Relationship between body composition and blood pressure in Bahraini adolescents

The objective of the present study was to examine the relationship between body composition and blood pressure (BP) in Bahraini adolescents. A sample of 504 Bahraini schoolchildren aged 12-17 years (249 boys and 255 girls) was selected using a multi-stage stratified sampling procedure. BP measurements were performed on the students. Anthropometric data including weight, height, waist circumference (WC), hip circumference, and triceps, subscapular and medial calf skinfold thicknesses were also collected. BMI, percentage body fat, waist:hip (WHR), and subscapular:triceps skinfold ratio were calculated. Mean systolic BP and mean diastolic BP were higher in males than in females. Weight and height in boys and weight only in girls were significantly associated with systolic BP independent of age or percentage fat. Nearly 14 % of the adolescents were classified as having high BP. BMI and percentage body fat were significantly and positively associated with the risk of having high BP in the boys and girls. Adolescents with high WHR or WC, as indicators for central obesity, tended to have higher BP values. The results from the present study indicate that obesity influences the BP of Bahraini adolescents and that simple anthropometric measurements such as WHR and WC are useful in identifying children at risk of developing high BP. These findings together with the known tracking of BP from adolescence into adulthood underline the importance of establishing intervention programmes in order to prevent the development of childhood and adolescent obesity.     

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。     

The association between baroreflex sensitivity and blood pressure in children

Low baroreflex sensitivity (BRS) and heart rate variability (HRV) are associated with the pathogenesis of adult hypertension. However, limited information exists about the negative consequences of elevated childhood blood pressure (BP) and autonomic regulation. Additionally, there are developmental changes in autonomic regulation throughout puberty, yet studies have not appropriately accounted for this. The objective of this study was to investigate BRS and HRV in children with 2 different BP profiles, while controlling for the effects of maturation, age, sex, and body composition. A sample of 11- to 14-year-old participants were divided into 2 BP groups: high BP (HBP; ≥95th percentile; n = 21) and normal BP (NBP; <90th percentile; n = 85). Automated BP was measured at 2 time points. In lab-based testing, 5 min of beat-to-beat BP (Finapres) and R-R interval (RRI) were recorded (standard electrocardiogram) after 15 min of supine rest. Spectral indices were computed using fast Fourier transform, and transfer function analysis was used to compute BRS. High frequency (HF) and low frequency (LF) power spectral areas were set to 0.15-0.4 Hz and 0.04-0.15 Hz, respectively, and BRS was determined for the LF area. After adjustment for age, sex, maturation, and body composition, BRS (p = 0.04), LF (p = 0.008), and HF (p = 0.01) RRI variability, and RRI total power (p = 0.005) were lower in the HBP than in the NBP participants. As well, the LF/HF systolic BP variability ratio was higher in the HBP than in the NBP group (p = 0.03). Despite their young age, these children with high, yet not clinically hypertensive BP, display reduced autonomic regulation.     

Association of leisure time physical activity and sports competition activities with high blood pressure levels: study carried out in a sample of Portuguese children and adolescents

Background A better understanding of the different domains and characteristics of children's and adolescent's physical activity (PA) could be a strategy to clarify the association of this behaviour with the early development of cardiovascular risk factors. Objectives To examine the relationship between leisure time physical activity (LTPA) and sports competition activities (SCA) with high blood pressure (HBP) levels in a sample of children and adolescents from Porto, Portugal. Study design This is a cross‐sectional study, which comprised 503 boys and 572 girls, aged 8–17 years old. LTPA and SCA were assed by self‐reported. Students were assigned as active and non‐active in SCA or LTPA according to their self‐reported participation. Participants were classified as HBP when they are above of the last quartile for systolic and/or diastolic BP adjusted for gender and age. Results Do not be engaged in LTPA (OR: 1.47; 95% CI: 1.12; 1.93) and SCA (OR: 1.36; 95% CI: 1.02; 1.81) was significantly associated with the likelihood of being HBP. However, when cardiorespiratory fitness (CRF) (OR: 1.23; 95% CI: 0.91; 1.67) and body mass index (BMI) (OR: 1.31; 95% CI: 0.98; 1.75) were included on SCA model, the association between SCA with HBP did not showed significant results. Conclusion Children and adolescents who are not engaged in SCA or LTPA are more likely to be classified as having HBP; however, the relationship between SCA and HBP was dependent of CRF and BMI. Further, PA strategies should take these differences on the relationship between HBP, SCA and LTPA.     

北京市6~8岁儿童偶测血压偏高现象

  目的  探索6~8岁儿童不同时期偶测血压偏高检出率的差异,为揭示白大衣高血压现象对儿童血压测量真实现况的影响提供参考依据。  方法  基于北京儿童生长与健康队列(PROC),于2018年10月—2019年6月收集基线身体测量和血压基线及重复3次测量数据,最终纳入1 785名拥有完整数据的儿童进行分析。采用《中国3~17岁儿童性别、年龄别和身高别血压参照标准》对基线、重复测量第1次、重复测量后2次的平均血压偏高检出率进行比较,分析不同时间儿童血压偏高检出率的波动。  结果  6~8岁儿童3次血压偏高的检出率分别为57.65%,25.88%和15.46%,男生基线与重复测量第1次、基线与重复测量后2次、重复测量第1次与重复测量后2次血压偏高检出率均高于女生(58.03%,27.49%,17.08%;57.27%,24.31%,13.87%),基线血压偏高检出率明显高于重复测量第1次和重复测量后2次的平均血压偏高检出率,且差异有统计学意义(P < 0.01)。基线与重复测量后2次的平均收缩压偏高、舒张压偏高、血压偏高的诊断一致性在3组血压一致性比较中最低。3组血压偏高的一致性比较中,收缩压偏高的一致性相对高于舒张压。  结论  基线血压和重复血压测量的第1次均存在血压波动,重复测量后2次的平均值可能会较好地反映儿童真实血压。