城区学龄前儿童肥胖与血压的关系
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摘要
目的调查青岛市城区学龄前儿童血压现状,明确学龄前儿童肥胖与血压的关系。方法采用整群方便抽样,抽取青岛市城区13家中等规模幼儿园,测量大、中、小班儿童身高、体重、腰围、臀围和血压,评价体质指数(body mass index, BMI)、腰臀比、腰围身高比,分析儿童肥胖与血压间的关系。结果青岛市城区学龄前儿童收缩压(systoblic blood pressure, SBP)和舒张压(diastolic blood pressure, DBP)均值分别为(95.52±7.66)mmHg和(62.78±6.52)mmHg;调查儿童中高血压检出率为13.50%;儿童SBP和DBP与BMI、腰围、臀围和腰围身高比均呈正相关;BMI和年龄与血压存在线性回归关系;超重组和肥胖组儿童高血压患病风险分别为正常体重组的5.191和2.824倍。结论青岛市城区学龄前儿童高血压发病率较高,超重和肥胖是其血压升高的危险因素,因此在防控学龄前儿童肥胖的同时,学龄前儿童血压监测与高血压早期干预应尽快提上工作日程。
Objective To investigate the blood pressure status of preschool children in urban areas of Qingdao, and to determine the relationship between obesity and blood pressure in preschool children. Methods A stratified cluster sampling method was used to select a total of 13 kindergartens in urban districts of Qingdao. Height, weight, waist circumference, hip circumference and blood pressure of children in three classes were measured. Body mass index(BMI), waist to hip ratio and waist to height ratio were calculated and the relationship between obesity and blood pressure was analyzed. Results The mean values of systolic and diastolic blood pressure in preschool children in urban areas of Qingdao were(95.52±7.66) and(62.78±6.52) mmHg, respectively.The detection rate of hypertension in preschool children was 13.50%. The SBP and DBP were positively correlated with BMI, waist circumference, hip circumference and waist to height ratio. There was a linear regression relationship between body mass index and age and blood pressure. The risk of hypertension in overweight and obese children was 5.191 and 2.824 times of normal body weight, respectively. Conclusions The prevalence of hypertension in preschool children in Qingdao urban areas is high.Overweight and obesity are risk factors for elevated blood pressure.Therefore, while preventing preschool children from obesity, preschool children's blood pressure monitoring and blood pressure monitoring and early intervention of hypertension of preschool children should be implemented.
Objective To investigate the blood pressure status of preschool children in urban areas of Qingdao, and to determine the relationship between obesity and blood pressure in preschool children. Methods A stratified cluster sampling method was used to select a total of 13 kindergartens in urban districts of Qingdao. Height, weight, waist circumference, hip circumference and blood pressure of children in three classes were measured. Body mass index(BMI), waist to hip ratio and waist to height ratio were calculated and the relationship between obesity and blood pressure was analyzed. Results The mean values of systolic and diastolic blood pressure in preschool children in urban areas of Qingdao were(95.52±7.66) and(62.78±6.52) mmHg, respectively.The detection rate of hypertension in preschool children was 13.50%. The SBP and DBP were positively correlated with BMI, waist circumference, hip circumference and waist to height ratio. There was a linear regression relationship between body mass index and age and blood pressure. The risk of hypertension in overweight and obese children was 5.191 and 2.824 times of normal body weight, respectively. Conclusions The prevalence of hypertension in preschool children in Qingdao urban areas is high.Overweight and obesity are risk factors for elevated blood pressure.Therefore, while preventing preschool children from obesity, preschool children's blood pressure monitoring and blood pressure monitoring and early intervention of hypertension of preschool children should be implemented.
引文
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[9] 牟建军, 杨军, 刘治全, 等. 超重对青少年远期血压变化的影响 [J]. 中华高血压杂志, 2007(08):633-636. DOI:10.16439/j.cnki.1673-7245.2007.08.001. Mu JJ, Yang J, Liu ZQ, et al. Obesity predicts changes in blood pressure and hypertension in young adults [J]. Chin J Hyperten, 2007,15(8):633-636. DOI:10.16439/j.cnki.1673-7245.2007.08.001.
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[12] Simmonds M, Burch J, Llewellyn A, et al. The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis [J]. Health Technol Assess (Winch Eng), 2015,19(43):1-336. DOI: 10.3310/hta19430.
[13] Munthali RJ, Kagura J, Lombard Z, et al. Childhood adiposity trajectories are associated with late adolescent blood pressure: birth to twenty cohort [J]. BMC Public Health, 2016,16:665. DOI: 10.1186/s12889-016-3337-x.
[14] Dulskiene V, Kuciene R, Medzioniene J, et al. Association between obesity and high blood pressure among Lithuanian adolescents: a cross-sectional study [J]. Ital J Pediatr, 2014,40(1):102. DOI: 10.1186/s13052-014-0102-6.
[15] 田祯,王萍,戴丽娜,等. 天津市3～6岁儿童血压状况调查[J]. 中国儿童保健杂志,2007,15(1):76-78. Tian Z, Wang P, Dai LN, et al. Investigation of the blood pressure condition among 3～6 years children of Tianjin [J]. Chin CHC, 2007,15(1):76-78.
[16] 侯冬青,程红,米杰. 北京3～6岁儿童体质指数及腰围与血压的关系 [J]. 中国儿童保健杂志,2010,18(6):453-455. Hou DQ, Cheng H, Mi J. Association between blood pressure and BMI, waist circumference among children aged 3～6 years in Beijing [J]. Chin J CHC, 2010,18(6):453-455.
[17] 陈卫红,钱慧霞,王慧文,等.衢州市5649名2～6岁儿童血压调查[J].浙江预防医学,2009,21(04):57-58. DOI:10.19485/j.cnki.issn1007-0931.2009.04.034. Chen WH, Qian HX, Wang HW, et al. Blood pressure survey of 5649 children aged 2-6 years in Quzhou City [J]. Zhejiang Journal of Preventive Medicine, 2009,21(04):57-58. DOI: 10.19485/j.cnki.issn1007-0931.2009.04.034.
[18] 张永青,施小明,武鸣,等. 江苏省7～13岁儿童血压与超重和肥胖的相关性研究[J]. 中华疾病控制杂志,2013,17(11):926-929. Zhang YQ, Shi XM, Wu M, et al. Association study of blood pressure levels with overweight and obesity among 7-13 years old children in JiangsuProvince [J]. Chin J Dis Control Prev, 2013,17(11):926-929.
[19] 张明明,米杰,王琍,等. 北京市412例儿童18年后血压纵向对照调查 [J]. 中国循证儿科杂志, 2006,1(3):187-192. Zhang MM, Mi J, Wang L, et al. Blood pressure tracking from childhood to adulthood in 412 individuals[J]. Chin J Evid Based Pediatr, 2006,1(3):187-192.
[2] 刘力生. 中国高血压防治指南2010 [J]. 中华高血压杂志, 2011,19(8):701-743. DOI: 10.16439/j.cnki.1673-7245.2011.08.009. Liu LS.2010 Chinese guidelines for the management of hypertension [J].Chin J Hyperten, 2011,19(8):701-743.DOI: 10.16439/j.cnki.1673-7245.2011.08.009.
[3] 杨巧玲,刘淑娟,安康,等. 北京市海淀区9～14岁儿童营养过剩和血压偏高关系分析 [J]. 中国学校卫生, 2010,31(10):1273-1274. DOI: 10.16835/j.cnki.1000-9817.2010.10.061. Yang QL, Liu SJ, An K, et al. Analysis of relationship between overnutrition and high blood pressure in children aged 9-14 years in Haidian District, Beijing [J]. Chin J Sch Health, 2010,31(10):1273-1274. DOI: 10.16835/j.cnki.1000-9817.2010.10.061.
[4] 黄彩,谢震华,叶承刚,等. 深圳市6～12岁儿童高血压及肥胖现况研究[J]. 中国慢性病预防与控制, 2008,16(3):301-303. Huang C, Xie ZH, Ye CG, et al. The cross-section study on the obesity and hypertension in children aged 6 to 12 years, in Shenzhen [J]. Chin J Prev Contr Chron Non-Commun Dis, 2008,16(3):301-303.
[5] 高曼,肖纫霞,孙寒. 单纯性肥胖儿童血压与体重指数的关系[J]. 中国妇幼保健, 2010,25(36):5414-5416. Gao M, Xiao RX, Sun H. Relationshipbetweenbloodpressureandbodymassindexinchildrenwithsimpleobesity [J]. Maternal and Child Health Care of China,2010,25(36):5414-5416.
[6] 赵地,张明明,王天有,等. 儿童至成年体质指数变化对成年血压水平的影响[J]. 临床儿科杂志, 2008,26(8):682-685,689. Zhao D, Zhang MM, Wang TY, et al. The prediction of elevated blood pressure in childhood for adult hypertension [J]. J Clin Pediatr, 2008,26(8):682-685,689.
[7] World Health Organization. WHO Child Growth Standards[EB/OL]. (2006-04-20)[2019-01-02]. http://www.who.int/en/htm.
[8] 王兴田,孙金华,郭子宏,等.3～6岁儿童血压自然变化规律及儿童血压的轨迹现象[J].中国妇幼保健,2006(11):1499-1502. Wang XT, Sun JH, Guo ZH, et al. The blood pressure’s natural changed regularity and the track of children’s blood pressure at the age of three to six in Yunnan Province [J]. Maternal and Child Health Care of China, 2006(11):1499-1502.
[9] 牟建军, 杨军, 刘治全, 等. 超重对青少年远期血压变化的影响 [J]. 中华高血压杂志, 2007(08):633-636. DOI:10.16439/j.cnki.1673-7245.2007.08.001. Mu JJ, Yang J, Liu ZQ, et al. Obesity predicts changes in blood pressure and hypertension in young adults [J]. Chin J Hyperten, 2007,15(8):633-636. DOI:10.16439/j.cnki.1673-7245.2007.08.001.
[10] Han JC, Lawlor DA, Kimm SYS. Childhood obesity[J]. The Lancet, 2010,375(9727):1737-1748.DOI: 10.1016/S0140-6736(10)60171-7.
[11] Singh AS, Mulder C, Twisk JW, et al. Tracking of childhood overweight into adulthood: a systematic review of the literature [J]. Obes Rev,2008,9(5):474-488. DOI: 10.1111/j.1467-789X.2008.00475.x.
[12] Simmonds M, Burch J, Llewellyn A, et al. The use of measures of obesity in childhood for predicting obesity and the development of obesity-related diseases in adulthood: a systematic review and meta-analysis [J]. Health Technol Assess (Winch Eng), 2015,19(43):1-336. DOI: 10.3310/hta19430.
[13] Munthali RJ, Kagura J, Lombard Z, et al. Childhood adiposity trajectories are associated with late adolescent blood pressure: birth to twenty cohort [J]. BMC Public Health, 2016,16:665. DOI: 10.1186/s12889-016-3337-x.
[14] Dulskiene V, Kuciene R, Medzioniene J, et al. Association between obesity and high blood pressure among Lithuanian adolescents: a cross-sectional study [J]. Ital J Pediatr, 2014,40(1):102. DOI: 10.1186/s13052-014-0102-6.
[15] 田祯,王萍,戴丽娜,等. 天津市3～6岁儿童血压状况调查[J]. 中国儿童保健杂志,2007,15(1):76-78. Tian Z, Wang P, Dai LN, et al. Investigation of the blood pressure condition among 3～6 years children of Tianjin [J]. Chin CHC, 2007,15(1):76-78.
[16] 侯冬青,程红,米杰. 北京3～6岁儿童体质指数及腰围与血压的关系 [J]. 中国儿童保健杂志,2010,18(6):453-455. Hou DQ, Cheng H, Mi J. Association between blood pressure and BMI, waist circumference among children aged 3～6 years in Beijing [J]. Chin J CHC, 2010,18(6):453-455.
[17] 陈卫红,钱慧霞,王慧文,等.衢州市5649名2～6岁儿童血压调查[J].浙江预防医学,2009,21(04):57-58. DOI:10.19485/j.cnki.issn1007-0931.2009.04.034. Chen WH, Qian HX, Wang HW, et al. Blood pressure survey of 5649 children aged 2-6 years in Quzhou City [J]. Zhejiang Journal of Preventive Medicine, 2009,21(04):57-58. DOI: 10.19485/j.cnki.issn1007-0931.2009.04.034.
[18] 张永青,施小明,武鸣,等. 江苏省7～13岁儿童血压与超重和肥胖的相关性研究[J]. 中华疾病控制杂志,2013,17(11):926-929. Zhang YQ, Shi XM, Wu M, et al. Association study of blood pressure levels with overweight and obesity among 7-13 years old children in JiangsuProvince [J]. Chin J Dis Control Prev, 2013,17(11):926-929.
[19] 张明明,米杰,王琍,等. 北京市412例儿童18年后血压纵向对照调查 [J]. 中国循证儿科杂志, 2006,1(3):187-192. Zhang MM, Mi J, Wang L, et al. Blood pressure tracking from childhood to adulthood in 412 individuals[J]. Chin J Evid Based Pediatr, 2006,1(3):187-192.