苏州儿童青少年体质量指数与血压水平非线性效应分析  

Non-linear effects of body mass index on blood pressure in children and adolescents

作　　者：徐双 田昌伟[1] 陈林[1] 王文明[1] 沈蕙[2] XU Shuang;TIAN Changwei;CHEN Lin;WANG Wenming;SHEN Hui(Kunshan Center For Disease Control and Prevention,Kunshan（215300）,Jiangsu Province,China)

机构地区：[1]江苏省昆山市疾病预防控制中心,215300 [2]苏州市疾病预防控制中心

出　　处：《中国学校卫生》2018年第9期1347-1349,共3页Chinese Journal of School Health

摘　　要：目的探讨6～17岁正常体重儿童和青少年体质量指数(BMI)对高血压前期和高血压的非线性效应,为控制儿童青少年血压水平并制定针对性的干预措施提供参考。方法排除肥胖、超重和信息不完整者之后,共有522 646名苏州地区2017年中小学生健康体检者被纳入分析。根据2010年中国学生体质与健康调研报告中分年龄和性别的结果计算BMI标准分。高血压前期和高血压根据近期针对6～17岁正常体重儿童和青少年确立的血压参考标准进行确定。BMI对高血压前期和高血压的非线性效应根据限制性立方样条模型进行分析,采用立方样条Logistic回归估计发生风险,并且根据年龄、性别进行分层分析。结果与BMI得分为0相比,BMI得分为-2.0,-1.5,-1.0,-0.5,0.5,0.8和1.0相对应的高血压前期的OR值(OR值95%CI)分别为0.58(0.56～0.61),0.67(0.65～0.69),0.77(0.75～0.78),0.88(0.87～0.89),1.12(1.11～1.13),1.20(1.18～1.22)和1.26(1.23～1.28),相对应的高血压的OR值(OR值95%CI)分别为0.51(0.49～0.53),0.60(0.59～0.62),0.72(0.70～0.73),0.85(0.84～0.86),1.17(1.16～1.18),1.29(1.27～1.31)和1.37(1.34～1.40)。结论正常体重儿童和青少年BMI对高血压前期和高血压的效应为非线性。相对超重和肥胖者,血压控制在正常体重儿童和青少年人群中仍需引起关注。Objective To assess the non-linear effects of body mass index（ BMI） on the risks of pre-hypertension and hypertension in children and adolescents aged 6-17,and to provide the reference for controlling children＇s blood pressure levels and targeted interventions. Methods After excluding subjects with missing data and overweight or obese subjects,a total of 522 646 children from the Suzhou Annual Surveys on Students＇ Constitution and Health in 2017 were finally included in this analysis. BMI was standardized（ Z-score） based on the 2010 age-and gender-standardized national references. Pre-hypertension and hypertension were assessed according to the recent international blood pressure references. The dose resP〈0nse relationships between BMI Z-score and risk of pre-hypertension and hypertension were assessed by using a restricted cubic spline-logistic function. Results Compared with 0,BMI scored-2.0,-1.5,-1.0,-0.5,0.5,0.8,and 1.0. The odds ratios and 95% confidence intervals OR（ 95%CI） of pre-hypertension were 0.58（ 0.56-0.61）,0.67（ 0.65-0.69）,0.77（ 0.75-0.78）,0.88（ 0.87-0.89）,1.00,1.12（ 1.11-1.13）,1.20（ 1.18-1.22） and 1.26（ 1.23-1.28） for BMI Z-scores of-2.0,-1.5,-1.0,-0.5,0（ references） 0.5,0.8 and 1.0,respectively,and the corresP〈0nding OR（ 95%CI） of hypertension were 0.51（ 0.49-0.53）,0.60（ 0.59-0.62）,0.72（ 0.70-0.73）,0.85（ 0.84-0.86）,1.00,1.17（ 1.16-1.18）,1.29（ 1.27-1.31） and 1.37（ 1.34-1.40）,respectively. Conclusion Non-linear relationships of BMI Z-scores with pre-hypertension and hypertension are found in children and adolescents with normal weight. Interventions to control blood pressure are also imP〈0rtant in non-overweight children.

关 键 词：人体质量指数 血压 因素分析 统计学 高血压 儿童 青少年 

分 类 号：R725.4[医药卫生—儿科]