青岛市市北区中小学生血压偏高与体质量指数的剂量反应关系  

Doseresponse relationship between elevated blood pressure and body mass index in primary and secondary school students in Shibei District,Qingdao

作　　者：王春辉 胡宝翠 任志盛[2] 陈暕 贺倩倩 WANG Chunhui;HU Baocui;REN Zhisheng;CHEN Jian;HE Qianqian(Health Emergency De-partment,Shibei District Center for Disease Control and Prevention,Qingdao(266011),Shandong Province,China;不详)

机构地区：[1]山东省青岛市市北区疾病预防控制中心卫生应急办公室,266011 [2]青岛市疾病预防控制中心学校卫生所

出　　处：《中国学校卫生》2024年第8期1181-1185,共5页Chinese Journal of School Health

基　　金：山东省人文社会科学课题项目(2022-ZXJK-23)。

摘　　要：目的探讨青岛市市北区中小学生血压偏高患病风险与体质量指数(BMI)的剂量反应关系,为采取精准干预措施提供参考依据。方法对青岛市市北区2022年92091名中小学生健康体检数据进行统计分析,应用《学龄儿童青少年超重与肥胖筛查》标准对超重与肥胖进行评估;应用《7~18岁儿童青少年血压偏高筛查界值》对血压等级进行评定。运用方差分析、χ^(2)检验、多因素Logistic回归以及结合限制性立方样条分析BMI与血压偏高的关系。结果根据不同年龄性别下的标准化评分,将BMI分为5类,与BMI-Z分0~<1组相比,随着BMI-Z分的减少,血压偏高风险逐渐降低(OR值分别为0.55,0.53);随着BMI-Z分增加,血压偏高风险不断增大(OR值分别为1.90,3.71)(P值均<0.05)。分层分析表明,BMI在不同性别(男、女)、年龄(7~8,9~11,12~14,15~16岁)、腰臀比(≤0.83,>0.83)下与血压偏高患病风险均呈正相关(OR值分别为1.18,1.19,1.15,1.22,1.19,1.18,1.19,1.18,P值均<0.01)。BMI和性别、BMI和年龄、BMI和腰臀比之间均存在相乘交互作用(OR值分别为1.53,1.08,2.31,P值均<0.01)。限制性立方样条分析表明,随着BMI水平的上升,7,10~16岁人群发生血压偏高的风险均呈非线性增高趋势(χ^(2)值分别为27.56,10.69,6.10,27.26,18.32,25.71,10.53,6.14,P值均<0.05)。结论随着BMI增高,中小学生血压偏高的风险随之增大,基本呈非线性剂量-反应关系。应及时开展监测,采取综合有效防控措施预防儿童青少年血压偏高。Objective To investigate the doseresponse relationship between the risk of elevated blood pressure and body mass index(BMI)in primary and secondary school students in Shibei District,Qingdao,so as to provide a reference for precise interventions of elevated blood pressure.Methods Statistical analysis was conducted on the health examination data of 92091 primary and secondary school students in Shibei District,Qingdao,in 2022.Overweight and obesity were assessed using the standards from the Screening for Overweight and Obesity among Schoolaged Children and Adolescents,and blood pressure levels were evaluated using the Reference of Screening for Elevated Blood Pressure among Children and Adolescents Aged 7-18 Years.The relationship between BMI and elevated blood pressure was examined using analysis of variance,Chisquare test,multifactorial Logistic regression,and a combination of restricted cubic spline after data cleaning.Results Based on the standardized scores under different age and gender,BMI was classified into 5 categories.Compared with the group of BMIZ scores 0-<1,the risk of developing high blood pressure gradually decreased with BMIZ scores(OR=0.55,0.53,P<0.05).Conversely,the risk of developing high blood pressure increased with increasing BMIZ scores(OR=1.90,3.71,P<0.05).Stratified analyses showed that BMI was positively associated with elevated blood pressure by gender(male,female),age(aged 7-8,9-11,12-14,15-16),and waisttohip ratio(≤0.83,>0.83)(OR=1.18,1.19,1.15,1.22,1.19,1.18,1.19,1.18,P<0.01).There were multiplicative interactions between BMI and gender,between BMI and age,between BMI and waisttohip ratio(OR=1.53,1.08,2.31,P<0.01).Restricted cubic spline analysis showed that as BMI levels increased,the risk of developing elevated blood pressure showed a nonlinear increasing trend in both the 7yearold and the 10 to 16yearold(χ^(2)=27.56,10.69,6.10,27.26,18.32,25.71,10.53,6.14,P<0.05).Conclusions The risk of elevated blood pressure in primary and secondary school students increases with BMI,showing

关 键 词：血压 人体质量指数 回归分析 学生 

分 类 号：R179[医药卫生—妇幼卫生保健] R544.1[医药卫生—公共卫生与预防医学] R194.3