北京市儿童青少年体重增长与收缩压变化性别差异纵向研究  

A longitudinal study on sex difference in weight growth and systolic blood pressure change among children and adolescents in Beijing

作　　者：段军伟[1] 李子昂 赵瑞兰[1] 李莉[1] 赵芳芳[1] 李梦龙 书文 奴比娅·阿马尔江 加吾兰·祖农 肖惠迪 胡翼飞 DUAN Junwei;LI Ziang;ZHAO Ruilan;LI Li;ZHAO Fangfang;LI Menglong;SHU Wen;NUBIYA Amaerjiang;JIAWULAN Zunong;XIAO Huidi;HU Yifei(Department of School Health,Shunyi District Center for Disease Control and Preven-tion,Beijing 101300,China)

机构地区：[1]北京市顺义区疾病预防控制中心学校卫生科,101300 [2]首都医科大学公共卫生学院儿少卫生与妇幼保健学系

出　　处：《中国学校卫生》2021年第5期652-655,共4页Chinese Journal of School Health

基　　金：国家自然科学基金项目(82073574);北京市自然科学基金项目(7202009);北京市教委科技计划项目(KM201810025009)。

摘　　要：目的探索北京市学龄儿童青少年体重增长与收缩压变化的性别差异,为控制体重和血压的快速增长提供依据。方法基于北京市顺义区2009—2018年中小学生体检资料,经匹配个人信息后形成70 288人具有完整体重、收缩压的纵向数据库,计算年龄别体重、收缩压及其增长速度,与以体重增速高峰年龄(PWA)为基点的收缩压增长速度,采用混合效应线性模型分析增速的性别差异。结果男、女生体重、收缩压均随年龄增长而升高,各年龄段男生体重、收缩压均高于女生。混合效应线性模型结果显示,体重和收缩压增长速度存在性别年龄交互作用(β值分别为-0.35,-0.40,P值均<0.01),即各年龄段体重、收缩压增长速度具有性别差异。年龄别增长速度曲线显示,男生分别于12和13岁达到体重增速高峰和收缩压增速高峰,比女生晚1年和3年,但增长速度高峰均高于女生。收缩压调整PWA后的增长速度曲线显示,PWA出现前2年,男、女生发生增速高峰,在PWA出现次高峰,在PWA后显著下降且男生收缩压增长速度始终高于女生。结论北京学龄儿童青少年体重与收缩压增长速度和规律存在性别差异,并且收缩压变化与体重增加密切相关。Objective To explore sex differences between weight and systolic blood pressure(SBP) changes among school-age children and adolescents in Beijing, and to provide a basis for priority intervention to control the rapid growth of body weight and blood pressure. Methods Anthropometric measurement data of 70 288 children and adolescents from primary and high schools in Shunyi District were collected from 2009 to 2018, and a longitudinal dataset with complete data related to weight and BP after individual data linkage was compiled. The age-specific weight and SBP growth rates were calculated, and a linear mixed-effects model was used to identify sex differences in chronological growth rates. Results Weight and SBP increased with age in both boys and girls, and the mean weight and SBP were higher in boys than in girls across all age groups. The result of the linear mixed-effects model indicated apparent sex differences in weight and SBP growth rates, with an age and sex interaction term(β=-0.35,-0.40, P<0.01). The age at peak weight velocity(PWA) was 12 years old and the age at peak SBP velocity was 13 years old in boys, which occurred one and three years later than for girls, respectively. In addition, the peak weight and SBP velocity were higher in boys than in girls. The curves of the SBP growth rate adjusted for the PWA, showed that the peak SBP velocity occurred two years before PWA and the second peak SBP velocity occurred at the PWA, which indicated "double peaks" in both boys and girls. The SBP growth rate was always higher in boys than in girls, and the rates declined after PWA. Conclusion Sex differences in weight and SBP growth rates were persistent and obvious in school-age children and adolescents in Beijing and the change in SBP was highly time synchronized with the increase in weight.

关 键 词：体重增长 血压 性别因素 线性模型 儿童 青少年 

分 类 号：R179[医药卫生—妇幼卫生保健] R723.14[医药卫生—公共卫生与预防医学]