中国西南三省市学龄儿童体成分与血压相关性的横断面调查  

Association between body composition and blood pressure among school-age children in two southwestern provinces and one municipality in China:A cross-sectional survey

作　　者：刘琴 彭支莲 袁双贵 李兴贵[4] 马军[4] 安曦州 陈镜宇[1] 罗顺清[1] 贺向前[5] 陈栏灵 黄道超[1] 梁小华[1] LIU Qin;PENG Zhilian;YUAN Shuanggui;LI Xinggui;MA Jun;AN Xizhou;CHEN Jingyu;LUO Shunqing;HE Xiangqian;CHEN Lanling;HUANG Daochao;LIANG Xiaohua(Children's Hospital of Chongqing Medical University,National Clinical Research Center for Child Health and Disorders,Key Laboratory of Child Development and Disorders of Ministry of Education,Chongqing Key Laboratory of Pediatrics,Chongqing 400014,China;Chongqing Jiulongpo Traditional Chinese Medicine Hospital,Chongqing 400014,China;Xishui County Maternal and Child Health Hospital,Zunyi 564600,China;Shimian County People's Hospital,Ya'an 625499,China;Chongqing Medical University,Chongqing 400014,China)

机构地区：[1]重庆医科大学附属儿童医院儿研所,国家儿童健康与疾病临床医学研究中心,儿童发育疾病研究教育部重点实验室,儿科学重庆市重点实验室,重庆400014 [2]重庆市九龙坡区中医院,重庆400014 [3]贵州省习水县妇幼保健院,遵义564600 [4]四川省石棉县人民医院,雅安625499 [5]重庆医科大学,重庆400014

出　　处：《中国循证儿科杂志》2024年第5期360-365,共6页Chinese Journal of Evidence Based Pediatrics

基　　金：国家自然科学基金:82373590;重庆市技术创新与应用发展专项重点项目:CSTC2021jscx-gksb-N0001;重庆医科大学科研创新团队项目:W0088。

摘　　要：背景依靠BMI等传统指标难以全方位评估儿童的营养状况和健康风险,体成分分析能够更精准地反映儿童体内脂肪、肌肉、水分等成分的分布情况,为儿童健康状况的评估开辟了新途径。目的探讨中国西南三省市(四川、重庆、贵州)中小学生体成分与血压的相关性,为儿童高血压的早期预防提供科学依据。设计横断面调查。方法采用多阶段分层整群抽样方法,选取西南三省市中小学生作为研究对象。以问卷调查方式收集基本信息、家庭基本情况、青春期发育、家族疾病史、营养状况和儿童饮食等变量。统一体格测量、血压测量,使用生物电阻抗法测量体成分指标(体脂率、肌肉占比、含水率、蛋白质和无机盐占比)。对纳入分析的变量进行单因素分析,使用限制性立方样条分析探讨体成分与血压偏高风险的剂量反应关系。主要结局指标体成分与血压的相关性。结果西南三省市(四川、重庆、贵州)6所中小学8397人进入本文分析,其中小学生5722人,中学生2675人;城区4593人,乡村3804人;平均年龄(10.9±2.4)岁,男生4445人(52.9%),女生3952人;检出血压偏高784人(9.3%),血压偏高检出率男生高于女生、超重肥胖儿童高于非超重肥胖、青春期发动高于未青春期发动、饮食偏咸高于非饮食偏咸(P均<0.05);体成分5项指标(体脂率、含水率、肌肉占比、蛋白质占比、无机盐占比)均与血压相关(P均<0.05);男女生的体成分指标与血压偏高风险呈现不同的关联模式,女生体脂率、含水率、肌肉占比、蛋白质占比与血压偏高风险呈线性相关,无机盐占比与血压偏高风险呈非线性相关;男生体脂率和无机盐占比与血压偏高呈现近似线性相关,肌肉占比、含水率和蛋白质占比与血压偏高均呈非线性关联。在体脂率、肌肉占比、含水率、蛋白质占比和无机盐占比5项体成分指标中,以男女生各自的中水平Background Traditional indicators like BMI are insufficient for comprehensive assessment of children's nutritional status and health risks.Body composition analysis offers a more precise method to evaluate the distribution of fat,muscle,and water content in children's bodies,providing new avenues for health assessment.Objective To investigate the correlation between body composition and blood pressure levels among school-age children in two southwestern provinces and one municipality(Sichuan,Guizhou,Chongqing)of China,providing scientific evidence for early prevention of childhood hypertension.Design Cross-sectional survey.Methods Using multi-stage stratified cluster sampling,students from primary and secondary schools in the three areas were recruited.Data on basic information,family circumstances,pubertal development,family medical history,nutritional status,and dietary habits were collected through questionnaires.Standardized physical measurements,blood pressure measurements,and body composition parameters(body fat percentage,muscle ratio,water content,protein,and mineral content)were obtained using bioelectrical impedance analysis.Univariate analysis was conducted for included variables,and restricted cubic splines(RCS)analysis was used to explore the dose-response relationship between body composition and elevated blood pressure risk.Main outcome measures Association between body composition and blood pressure.Results The study analyzed 8,397 students from six schools across the three areas,including 5,722 primary school students and 2,675 secondary school students;4,593 from urban areas and 3,804 from rural areas.The mean age was(10.9±2.4)years,with 4,445 boys(52.9%)and 3,952 girls.Elevated blood pressure was detected in 784 students(9.3%),with higher prevalence in boys compared to girls,overweight/obese children compared to non-overweight/obese children,those who had entered puberty compared to those who had not,and those with high salt intake compared to those without(all P<0.05).All five body compositio

关 键 词：中小学生 体成分 血压 

分 类 号：R179[医药卫生—妇幼卫生保健]