中国中年人正常高值血压检出率及影响因素研究——基于中国健康与养老追踪调查数据分析

目的了解中国中年人正常高值血压检出情况及影响因素。方法利用2015年"中国健康与养老追踪调查(CHARLS)"数据,整理7178名45~59岁的中年人血压、腰围、身高、体质量等基本情况和健康行为因素。正常高值血压定义为:收缩压120~139和(或)舒张压80~89mm Hg,且排除高血压病史或正在服用降压药物。结果中年人正常高值血压检出率为45.2%。男性正常高值血压检出率(48.3%)高于女性(42.6%)。在女性中,正常高值血压检出率随着年龄增长而升高(P0.01),在男性中相对稳定。多因素回归分析显示:在男性中,偏瘦(OR=0.264,95%CI0.075~0.929)是正常高值血压的保护因素;腹型肥胖(OR=1.554,95%CI1.027~2.350)、超重(OR=1.734,95%CI1.139~2.640)和肥胖(OR=2.350,95%CI 1.266~4.363)是正常高值血压的危险因素。在女性中,偏瘦(OR=0.509,95%CI 0.280~0.926)是正常高值血压的保护因素;年龄55~59岁(OR=1.553,95%CI1.227~1.966)和肥胖(OR=2.655,95%CI1.976~3.568)是正常高值血压的危险因素。结论中国中年人正常高值血压检出率较高,腹型肥胖、超重和肥胖是中年男性正常高值血压的危险因素,而年龄55~59岁和肥胖为中年女性正常高值血压的危险因素。     

青年学生高血压检出率

目的研究青年学生血压情况、高血压检出率及危险因素。方法利用新生入学体检和毕业生离校体检,对黄冈职业技术学院入学5879名新生和即将离校的5445名毕业生进行血压测量,对初检出的高血压学生进行重复测量,并随机抽取部分新生进行膳食习惯、高血压家族史、肾病病史、生活习惯、精神状况等问卷调查,分析青年学生高血压的流行病学特点。结果青年学生高血压检出率约为9.33%(1056/11 324);男性高血压检出率高于女性(10.94%比7.62%,P0.01),中部省份生源高血压检出率高于西部和东部(10.13%比3.12%,5.69%,均P0.01);超重和肥胖学生高血压检出率高于体质量指数(BMI)正常及以下学生(14.26%,26.96%比7.18%,均P0.01)。多因素Logistic回归分析显示,超重/肥胖(OR=2.086,95%CI 1.193~3.648)、来源于中部省份(OR=2.961,95%CI1.595~5.498)、高血压家族史(OR=1.544,95%CI 1.013~2.352)、吸烟(OR=2.827,95%CI1.256~6.364)、自我感觉孤独(OR=1.700,95%CI1.010~2.860)为高血压的危险因素。结论青年学生高血压与性别、BMI、地域、吸烟及孤独等有关。     

天津市年龄5～6岁儿童偶测高血压检出率及其与超重和肥胖的关系

目的了解年龄5～6岁学龄前儿童偶测高血压现况,分析超重、肥胖与学龄前儿童偶测高血压的关系,为成人期高血压的早期预防提供参考。方法采用整群随机抽样方法,2016-2018年连续3年在天津市16个区1 802所幼儿园随机抽取63所幼儿园,对年龄5～6岁儿童21 393人进行血压、身高、体质量等身体测量,并对儿童生活环境因素进行回顾性问卷调查。调整潜在的生活环境影响因素,采用多因素logistic回归模型分析学龄前儿童超重肥胖与偶测高血压的关系。结果天津市学龄前儿童血压偏高检出率为11.9%,偶测高血压检出率为17.5%。超重、肥胖儿童血压异常检出率明显高于正常体质量儿童(P0.01)。调整儿童生活环境等影响因素后,超重、肥胖的学龄前儿童血压偏高和偶测高血压发生风险增加,超重者发生血压偏高和偶测高血压的OR(95%CI)值分别为1.61(1.41～1.83)和1.79(1.61～1.99);肥胖者发生血压偏高和偶测高血压的OR(95%CI)值分别为2.15(1.85～2.50)和3.16(2.82～3.53)。结论超重、肥胖显著增加学龄前儿童偶测高血压的风险。     

福建沿海地区超重及肥胖人群血压、血脂现状分析

目的:调查福建沿海地区人群超重和肥胖的现状及其与血压、血脂的相关性。方法:通过横断面调查方法,纳入福建省沿海地区30岁以上人群3343例,进行身高、体质量、血压、腰围、血糖、血脂等指标检测,采用统计学方法分析BMI与血压、血脂的相关性。结果:调查地区超重及肥胖检出率为34.6%和10.0%,男性超重率显著高于女性(40.4%比30.7%,P0.05);超重和肥胖人群比例在70岁以前均随年龄增加而逐渐显著增高,70岁以后有下降趋势。与年龄匹配的正常体重人群比较,青年(40岁)超重和肥胖人群血压、腰围显著升高(P均0.01);中老年(40岁)超重和肥胖人群血压、腰围、TC、LDL-C水平显著升高,而HDL-C水平显著降低(P0.05或0.01)。偏相关分析显示BMI与腰围、收缩压、舒张压、TC、LDL-C和HbA1c水平呈显著正相关(r=0.701,0.218,0.238,0.068,0.120,0.135,P均0.01),与TG和HDL-C水平呈显著负相关(r均=-0.069,P均0.01)。多元线性回归分析显示BMI与腰围、性别、年龄、DBP、HDL-C、FBG显著相关。控制年龄、性别、血糖等混杂因素后,二元Logistic回归分析显示:超重(OR=2.283,95%CI 1.915~2.721)和肥胖(OR=4.419,95%CI 3.329~5.865)是高血压、血脂异常的危险因素[超重(OR=1.356,95%CI 1.160~1.584),肥胖(OR=1.691,95%CI 1.319~2.167)],P均0.01。结论:福建沿海地区人群超重/肥胖率较高,超重、肥胖人群中高血压、血脂异常、糖尿病、心血管危险因素聚集比例显著增高,控制体重对高血压、血脂异常及糖尿病等慢性病的防治具有重要意义。     

甘肃省居民高血压前期检出率及影响因素

目的分析甘肃省35岁以上居民高血压前期的检出情况及影响因素。方法 2004～2007年,采用随机、分层、多阶段抽样的方法,对甘肃省86个县常住居民进行问卷调查、体格测量及心血管的健康检查。结果共调查6 672人(男性3 003人,女性3 669人),正常血压1 942名;高血压前期2 251名;高血压2 479名。高血压前期检出率为33.7%,男性高血压前期检出率35.9%高于女性32.0%(P<0.01);随年龄增长男女性高血压前期检出率均降低。正常血压组、高血压前期组、高血压组两两比较,在性别、城乡、年龄、心率、BMI、腰臀比(WHR)、收缩压、舒张压、血液黏度存在显著性差异(P<0.01)。向心性肥胖组中各年龄组女性高血压前期检出率均高于男性,45～岁组以后男女性高血压前期检出率差异有显著意义(P<0.01)。超重肥胖组中45～54岁组男、女性高血压前期检出率差异有显著意义(P<0.01),且总体中女性高血压前期检出率(40.8%)高于男性(35.5%)(P<0.01)。Logistic回归分析结果显示:年龄(OR:1.019,95%CI:1.012～1.026)、心率(1.015,1.009～1.021)、向心性肥胖(1.221,1.061～1.405)、城乡(1.325,1.140～1.541)、性别(1.479,1.289～1.697)、民族(1.418,1.043～1.927)、超重(2.080,1.515～2.855)、肥胖(3.484,2.260～5.369)各因素与高血压前期存在显著相关。结论甘肃省35岁以上人群高血压前期检出率较高,主要的影响因素有向心性肥胖、超重和肥胖,且女性高血压前期与这些因素关联性更大。     

徐州地区青少年中学生高血压流行病学调查

目的了解徐州地区11～17岁青少年中学生高血压、超重、肥胖患病状况。探讨青少年超重、肥胖、腹型肥胖、年龄、性别及不同年级段与高血压发生的关系,为青少年高血压的预防、诊断、干预提供流行病学依据。方法采用整群随机抽样方法抽取徐州地区10所初级及高级中学的初一至高三的中学生作为研究对象,对每位参加初筛的调查对象进行血压、体质量、身高、腰围等的测量。对血压进行非同日3次的测量,按照2017年中国3～17岁儿童性别、年龄别和身高别血压参照标准对高血压进行判别;超重和肥胖的定义采用中国肥胖工作组的标准。腹型肥胖的标准为腰围身高比(WHtR)0.46。结果参加调查的学生10 047人,共采纳样本10 004人(女性4 774人,男性5 230人),年龄为11～17岁。经非同日3次测量得出高血压的总患病率为9.8%,其中女生患病率为7.2%,男生患病率为12.2%。肥胖青少年共1 495名,占总人数的14.9%,超重人数为1 698名,占总调查人数的17.0%。正常体质量青少年高血压患病率为5.6%,超重青少年高血压患病率为12.8%,肥胖青少年高血压患病率为25.4%。多因素分析显示:男生(OR=1.450,95%CI 1.256～1.674)、年龄(OR=1.770,95%CI 1.537～2.037)、超重(OR=1.858,95%CI 1.465～2.357)、肥胖(OR=4.010,95%CI 3.084～5.214)、腹型肥胖(OR=1.497,95%CI 1.184～1.892)、初中和高中三年级(OR=1.488,95%CI 1.250～1.772)是青少年高血压的危险因素。男生中,年龄14岁青少年高血压患病风险是年龄≤14岁的2.456倍(OR=2.456,95%CI 2.050～2.943),而女生中,年龄14岁与年龄≤14岁青少年高血压的患病风险差异无统计学意义(P0.05)。在正常体质量类型中,腹型肥胖患高血压风险是非腹型肥胖的1.848倍(OR=1.848,95%CI 1.334～2.559)。结论徐州地区青少年高血压患病率较高。性别、年龄、体质量指数、腹型肥胖、不同年级为青少年中学生高血压患病的影响因素。超重、肥胖为青少年患高血压的最重要独立危险因素。     

甘肃陇西县35岁及以上人群高血压流行病学现况调查

目的调查甘肃陇西县≥35岁的居民高血压的患病现况,分析其相关危险因素。方法整群分层随机抽取陇西县5个社区≥35岁的居民共12040例,对所选对象进行问卷调查,测量身高、体质量指数(BMI)、腰围、血压,并测定空腹血糖及血脂。计算不同年龄及性别的调查对象高血压及相关疾病的患病率,分析高血压的相关危险因素。结果标化后高血压患病率为26.8%,男性为28.3%,女性为21.4%。Logistic逐步回归分析结果表明,盐摄入量(OR=2.403,95%CI2.066～2.759)、超重(OR=1.566,95%CI1.417～1.730)、高血糖(OR=1.700,95%CI1.303～2.217)、总胆固醇(OR=2.617,95%CI2.294～2.986)、三酰甘油(OR=2.147,95%CI1.960～2.351)、脑力劳动(OR=0.640,95%CI0.490～0.830)、吸烟(烟龄>10年)(OR=1.567,95%CI1.413～1.738)、饮酒(每周>2次)(OR=1.372,95%CI1.340～1.479)是高血压的独立危险因素。结论陇西县35岁以上居民中高血压患病率较高,年龄、男性、高盐饮食、超重及肥胖、高血糖、腰围超标、血脂异常、高三酰甘油是高血压的危险因素。     

河北唐山地区40～<70岁女性血压水平分布现况调查

目的了解唐山地区女性血压水平状况及高血压相关危险因素。方法于2009-03-04选取唐山地区40～<70岁女性居民4384人进行血压检测;高血压定义为收缩压≥140mmHg和(或)舒张压≥90mmHg,或近期服用降压药。结果有效调查4293人,年龄(54.7±6.7)岁,收缩压(136.3±22.5)mmHg,舒张压为(85.3±11.9)mmHg,血压水平农村高于城市且随体质量指数(BMI)的升高而升高(均P<0.01);高血压粗患病率为56.0%,年龄标化患病率为52.9%,高血压患病率随年龄和BMI的增加而增加,且农村高于城市(57.4%比52.6%,P<0.01);超重/肥胖、老龄、糖尿病、农村居民和高盐饮食是高血压的重要危险因素,OR值分别为1.871、1.813、1.715、1.529和1.256(均P<0.01);高血压知晓率为46.3%,且随年龄和BMI的增加而增加。结论河北唐山地区中高龄女性血压水平及高血压患病率较高,高血压患病率农村高于城市,应及时制定相应的公共卫生策略以改进农村女性高血压预防和诊疗状况。     

一项关于中国学校青少年高血压和肥胖的人口学调查

有关中国儿童高血压的肥胖流行病学调查和危险因素的资料很少。该研究旨在确定长沙市青少年高血压和正常高值血压的检出率以及相关的危险因素。方法:2009年共检查长沙市49所中学12～17岁的青少年88974人,所有入选者均测量身高、体质量和血压。根据中国高血压防治指南的年龄和性别参考标准定义高血压和正常高值血压。结果:正常高值血压和高血     

基诺族老年人高血压检出率及其影响因素

目的了解基诺族老年人原发性高血压的患病情况,探讨相关影响因素。方法 2015年8月,采用多阶段分层整群抽样方法抽取年龄≥60岁基诺族老年人793人,调查高血压患病情况,并收集病史和体检资料。结果调查基诺族老年人793人,高血压检出率为39.1%(95%CI35.7%~42.5%),低于我国年龄≥60岁人群高血压患病率(49.0%,P0.05)。高血压、单纯收缩期高血压(ISH)和正常高值血压的检出率均呈随年龄增长而增加(P0.05)。离婚或丧偶后未再婚人群的高血压和ISH检出率高于在婚人群,经济发展水平中等地区的高血压检出率高于较低地区(P0.05)。多元Logistic回归分析结果表明,经济发展水平与饮酒之间有跨层交互作用(P0.05);个体水平协变量中,与高血压正相关的是体质量指数(BMI,OR=1.146,95%CI 1.053~1.248)、年龄(OR=1.365,95%CI 1.105~1.685)、离婚或丧偶后未再婚(OR=1.847,95%CI 1.033~3.304)、吸烟(OR=1.601,95%CI1.001~2.560)和高盐膳食(OR=5.898,95%CI3.499~9.942),而经常食用蔬菜与高血压呈负相关(OR=0.462,95%CI0.273~0.781)。结论基诺族老年人高血压检出率低于全国水平,主要危险因素包括经济发展水平、饮酒、BMI、年龄、离婚或丧偶、吸烟和高盐膳食,而经常食用蔬菜是保护因素。     

Obesity in adolescence is associated with left ventricular hypertrophy and hypertension

Background: Obesity is a risk factor for hypertension (HTN) and left ventricular hypertrophy (LVH). However, the association between obesity, HTN or LVH in adolescents has not been studied in a large population. Method: Utilizing a database of screening echocardiograms, we assessed for the presence of LVH and HTN (defined as systolic blood pressure (SBP) > 140 mmHg or diastolic blood pressure (DBP) > 90 mmHg) in obese adolescents (BMI > 30) using univariate and multivariate analysis. Results: A total of 2072 subjects were identified between the ages of 13-19 years. LVH was significantly more prevalent in obese subjects (47/166 [28.3%] vs. nonobese subjects (99/1612 [6.1%]) with a P-value of <0.001. Using multivariate analysis adjusting for age, gender and blood pressure, obesity remained strongly associated with the presence of LVH (OR 4.51, CI: 2.83-7.19, P < 0.001). Elevated SBP and DBP were also strongly associated with obesity. SBP > 140 was present in 38% of obese subjects (54/142) versus 12.7% of nonobese subjects (172/1, 353). DBP > 90 was present in 10.6% of obese subjects (15/141) of versus 3.1% of nonobese subjects (42/1352). After adjustment for age, gender and LVH, obesity remained independently associated with HTN (for SBP > 140, OR 2.24, CI: 1.46-3.45, P < 0.001, and for DBP > 90, OR 2.10, CI: 1.063-4.17, P = 0.03). Conclusion: Obese adolescents have a significantly higher prevalence of HTN and LVH. Our analysis suggests a direct negative effect of obesity on cardiovascular function starting early in teenage years. (Echocardiography 2011;28:150-153).     

Medidas Hipertensivas em Escolares: Risco da Obesidade Central e Efeito Protetor da Atividade Física Moderada-Vigorosa

BackgroundThe proportion of arterial hypertension (AH) has increased in children and adolescents and is associated with several comorbidities.ObjectiveTo verify the association of arterial hypertension with central and general obesity as well as according to the level of physical activity in schoolchildren.Methods336 children and adolescents aged 11 to 17 participated in the study. Height, body weight, waist circumference (WC) and blood pressure (BP) were measured. The body mass index z-score (BMI-z) was calculated. The level of physical activity was assessed by the short form of the International Physical Activity Questionnaire (IPAQ) according to the practice of moderate-to-vigorous physical activities (AF-mv). Students with systolic (SBP) and/or diastolic blood pressure (DBP) higher than the 95^thpercentile according to sex, age and height or ≥120/80 were considered hypertensive. Statistical tests of t-Student, Chi-square, Mann-Whitney and binary logistic regression model were used, considering the significance level of p<0.05.ResultsIt was found that 40.5% of the students had AH, 35.11% were overweight (12.5% obese), 13.39% had high WC and 40.2% were considered insufficiently active in AF-mv. The chances of AH were related to high WC (OR = 6.11; 95% CI: 2.59¬–14.42) and overweight (OR = 2.91; 95% CI: 1.76–4.79). In addition, adolescents who practiced AF-mv had a lower risk of high DBP (OR = 0.33; 95% CI: 0.15–0.72).ConclusionCentral obesity was the best predictor of AH in children and adolescents, as well as general obesity and males. The practice of AF-mv demonstrated a protective effect on high DBP in schoolchildren. (Arq Bras Cardiol. 2020; 115(1):42-49)     

Nationwide prevalence study of hypertension and related non-communicable diseases in The Gambia

The prevalence of hypertension, diabetes and obesity in The Gambia was assessed in a 1% population sample of 6048 adults over 15 years of age. 572 (9.5%) subjects were hypertensive according to WHO criteria (a diastolic blood pressure (DBP) of 95 mmHg or above and/or a systolic blood pressure (SBP) of 160 mmHg or above); 325 (5.4%) had a DBP of 95 mmHg or above, and 39 (2.3%) a DBP of 105 mmHg or above; 428 (7.1%) had a SBP of 160 mmHg or above. By less conservative criteria (a DBP of 90 mmHg or above and/or SBP of 140 mmHg or above), 24.2% of subjects were hypertensive. The prevalence of hypertension was similar in the major ethnic groups and in urban and rural communities. Age and obesity were risk factors for hypertension; female sex was an additional risk factor for diastolic hypertension. Several communities had a prevalence of diastolic hypertension double the national rate, and significant community clustering of diastolic hypertension ( P < 0.01) was confirmed by Monte Carlo methods. Genetic and/or localized environmental factors (such as diet or Schistosoma haematobium infection), may be involved. 140 (2.3%) subjects were obese. Obesity was associated with female sex, increasing age, urban environment, non-manual work and diastolic hypertension. Only 14 (0.3%) subjects were found to be diabetic. Hypertension appears to be very prevalent in The Gambia, with a substantial population at risk of developing target organ damage. Further studies to delineate this risk and appropriate interventions to reduce it are needed.     

Impact of body mass index on blood pressure levels in patients with polycystic ovary syndrome

As there is controversy about the prevalence of hypertension in patients with polycystic ovary syndrome (PCOS) and, up to the present moment, no studies have evaluated the impact of body mass index (BMI) on blood pressure levels (BP) in these patients, we studied retrospectively sixty-nine patients with PCOS, with BMI of 29.0 +/- 6.7 kg/m(2) and aged 25.6 +/-5.6 yr, subdivided into three groups according to BMI (normal, overweight and obese) and evaluated regarding BP (mercury sphygmomanometer), basal hormonal profile, fasting glucose, and insulin sensitivity (HOMA-IR). Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) were normal (118.1 +/- 17.0 and 74.7+/- 11.5 mmHg, respectively), with a hypertension prevalence of 20.3%. Of these patients, 78.6% were obese and 21.4% were overweight. When the groups were compared according to BMI, a significant increase in SBP and DBP was observed (higher in overweight and obese patients for SBP and higher in obese for DBP), as well as a significant progressive increase in glucose, insulin, homeostatic model assessment, and a significant progressive decline in LH levels. When the patients were subdivided as normotensive or hypertensive, a significant difference was observed only for BMI (28.2 +/- 6.1 and 34.7 +/- 8.6 kg/m(2), respectively; p = 0.007). In conclusion, we observed a significant and progressive impact of BMI on blood pressure levels in our patients with polycystic ovary syndrome.     

Independent role of blood pressure on cardiovascular risk factors in nondiabetic,obese African-American women with family history of type 2 diabetes: Implications for metabolic syndrome components

African-American women (AAW) suffer disproportionately from hypertension and its consequences. We investigated the significance of systolic and diastolic blood pressure (SBP/DBP) as components of metabolic syndrome (MetS) in nondiabetic, overweight/obese AAW. We studied 258 AAW (mean age, 42.4 ± 8.4 years and body mass index (BMI), 33.4 ± 8.0 kg/m²) in a cross-sectional manner. We estimated the prevalence of MetS and its components using Adult Treatment Panel (ATP III) criteria, insulin sensitivity (Si), insulin resistance (HOMA-IR), and cardiovascular disease risk factors according to the tertiles of blood pressure (BP). Mean age and BMI did not differ with increases in BP tertiles. At screening, 35.7% of our subjects were hypertensive. MetS was found in 32.2% of our AAW. Prevalence of MetS increased as the tertiles of BP increased (SBP = first [10.5%], second [15.1%], third [58.1%], and DBP = first [9.3%], second [23.3%], third [54.7%]). We found that the components of Adult Treatment Panel (ATP) did not track with the corresponding BP tertiles. However, the prevalence of individuals meeting ATP III criteria for BP was highest in the third tertile of both SBP and DBP. Consequently, the prevalence of MetS was highest in the third vs. first and second tertiles. Using linear regression analysis, SBP and DBP did not correlate with the conventional cardiovascular risk factors, HOMA-IR, or Si. In overweight/obese AAW, we found the components of MetS do not track with BP. In the absence of elevated BP, the prevalence of MetS appears to be very low in overweight and obese AAW. Conversely, elevated BP or hypertension was associated with remarkably higher rates of MetS in our AAW. Therefore BP criteria constitute an important and independent determinant of ATP III definition of MetS in AAW.     

Body mass, fat distribution and blood pressure in Southern Italian children: results of the ARCA project

OBJECTIVE: To investigate the association between the degree of adiposity, assessed using the international reference values for body mass index (BMI) of the International Obesity Task Force (IOTF), the fat distribution pattern and the blood pressure (BP) profile in children. METHODS: Anthropometric indices and blood pressure were measured in 3923 children aged 6-11 years in southern Italy. RESULTS: The prevalence of overweight and obesity (by IOTF references) and pediatric hypertension was, respectively: 27, 21 and 10% for boys; 25, 21 and 14% for girls. Body mass index and waist z-scores were the strongest determinants of BP by regression analysis. Overweight and obesity were associated with a greater tendency for central fat deposition and higher BP (waist, cm; boys: 59.2+/-6.0, 69.5+/-7.9, 79.0+/-9.7; girls: 58.8+/-6.5, 68.2+/-7.4, 75.3+/-8.9; SBP/DBP, mmHg; boys: 94/60+/-12/9, 99/62+/-13/8, 103/64+/-15/10; girls: 93/59+/-12/9, 99/62+/-14/9, 101/63+/-14/9; normal weight, overweight and obese, respectively; P<0.0001; M+/-SD), and a higher risk of hypertension (overweight: RR=2.33; 95% CI 1.76-3.08; obesity: RR=3.69; 95% CI 2.78-4.90), independent of age, physical activity, birth weight, parental adiposity and education. Among normal weight children, 99% had waist <85th percentile and 93% were normotensive. CONCLUSIONS: Overweight and obese children, identified according to the IOTF growth charts, are characterized by a central fat distribution pattern and higher BP.     

Metabolic Syndrome and Importance of Associated Variables in Children and Adolescents in Guabiruba - SC,Brazil

Background

The risk factors that characterize metabolic syndrome (MetS) may be present in childhood and adolescence, increasing the risk of cardiovascular disease in adulthood.

Objective

Evaluate the prevalence of MetS and the importance of its associated variables, including insulin resistance (IR), in children and adolescents in the city of Guabiruba-SC, Brazil.

Methods

Cross-sectional study with 1011 students (6-14 years, 52.4% girls, 58.5% children). Blood samples were collected for measurement of biochemical parameters by routine laboratory methods. IR was estimated by the HOMA-IR index, and weight, height, waist circumference and blood pressure were determined. Multivariate logistic regression models were used to examine the associations between risk variables and MetS.

Results

The prevalence of MetS, IR, overweight and obesity in the cohort were 14%, 8.5%, 21% and 13%, respectively. Among students with MetS, 27% had IR, 33% were overweight, 45.5% were obese and 22% were eutrophic. IR was more common in overweight (48%) and obese (41%) students when compared with eutrophic individuals (11%; p = 0.034). The variables with greatest influence on the development of MetS were obesity (OR = 32.7), overweight (OR = 6.1), IR (OR = 4.4; p ≤ 0.0001 for all) and age (OR = 1.15; p = 0.014).

Conclusion

There was a high prevalence of MetS in children and adolescents evaluated in this study. Students who were obese, overweight or insulin resistant had higher chances of developing the syndrome.     

Parameters of childhood obesity and their relationship to cardiovascular risk factors in healthy prepubescent children.

OBJECTIVE: To investigate which of the currently applied parameters to assess childhood overweight best predict cardiovascular risk factors. DESIGN: Cross-sectional study comparing five different methods to define overweight with respect to their power to predict cardiovascular risk factors. SUBJECTS: A total of 838 healthy children from the Prevention-Education-Program (Nuremberg, Germany; age 4-9 y, 405 boys, 433 girls). MEASUREMENTS: Obesity parameters-body mass index (BMI), ponderal index (PI), the sum of triceps and subscapular skinfold thickness (SFT), percentage body fat (%BF) using SFT and two different regression formulas (Slaughter, %BF-SL; Dezenberg, %BF-DZ). Overweight defined by the 90th age- and sex-specific percentile of each obesity parameter. Comparison of LDL- and HDL-cholesterol, apolipoprotein-B (apo-B), triglycerides (TG), fibrinogen and blood pressure values (SBP/DBP) between normal-weight and overweight children. RESULTS: When overweight is defined by BMI or PI, all cardiovascular risk factors are significantly (P<0.01) different between overweight and normal-weight children (BMI: TG+20.5%, HDL-chol.-8.6%, LDL-chol.+9.6%, apo-B+6.8%, SBP+7.4%, DBP+8.6%, fibrinogen+13.2%; PI: TG+24.3%, HDL-chol.-6.1%, LDL-chol.+9.0%, apo-B+7.4%, SBP+5.9%, DBP+6.7%, fibrinogen+13.9%), while SFT, %BF-SL and %BF-DZ did not predict all cardiovascular risk factors. A sex-specific analysis showed that in girls BMI and PI both predict cardiovascular risk factors, while in boys this is only valid for BMI. CONCLUSION: In prepubescent children, height-to-weight indices such as BMI or PI better predict cardiovascular risk factors than obesity parameters using skinfold measurement. The BMI may be superior to the PI as the association between BMI and cardiovascular risk factors is less affected by gender.     

辽宁西部地区农村人群体质指数和腰围对血压的影响

目的 探讨辽宁西部地区农村人群体质指数(BMI)和腰围(WC)对血压均值及高血压患病率的影响.方法 采用分层整群随机抽样的方法,于2004-2006年对辽宁省阜新县35～74岁常住居民43 692人进行流行病学调查.采用Epidata3.1软件建立数据库,使用SPSS 12.0统计软件包对数据进行统计分析.结果 共调查43 692人,男性21 680人(49.6%),女性22 012人(50.4%).平均BMI为(23.31±3.08)kg/m2,平均WC为(80.87±9.40)cm.不论男性还是女性以20 kg/m2起始,收缩压随着BMI的增加而逐渐增加;舒张压随BMI的增加而逐渐升高.多因素logistic回归分析显示,男性中以BMI<18 kg/m2组为对照,其他各组患病危险OR值均有显著统计学意义,28～30 kg/m2组OR及95%CI为6.285(4.612～8.566),在20～30 kg/m2范围内,OR值随着等级的增高而逐渐增高;女性从20～22 kg/m2组起始OR值随着BMI等级的增高而逐渐增高,在≥30kg/m2组OR及95%CI为7.764(6.009～10.032).男性和女性收缩压和舒张压及高血压患病率均随着WC的增加而逐渐增加(P<0.001).不论是在男性还是女性,当BMI<24 kg/m2,或WC男性<85cm、女性WC<80 cm时,其平均血压水平、高血压患病率最低;当BMI达到超重或肥胖标准时或WC超标时,血压均值和高血压患病率均明显增高;调整年龄等危险因素后,男性超重和肥胖对高血压的患病危险OR分别为1.704(1.592～1.825)及3.710(3.148～4.371),女性为1.527(1.428～1.632)和3.014(2.668～3.405);WC超标时,男女性高血压患病危险OR及95%CI分别为1.231(1.153～1.314)和1.353(1.269～1.442).结论 BMI和WC均与高血压患病明显相关.有效预防和控制超重和肥胖等高血压发病危险因素,是我国目前急需解决的公共卫生问题.