臀围相关肥胖指数筛查儿童高血压的诊断价值
摘要
目的比较臀围相关肥胖指数识别儿童高血压的诊断价值,为促进儿童高血压的早期筛查提供参考。方法采用分层整群随机抽样法,抽取秦皇岛市5所小学1 352名7～12岁汉族学生进行问卷调查及身高、体重、臀围、血压等指标测量。结果共检出高血压小学生82例(6.1%),其中男生46例,检出率为6.8%;女生36例,检出率为5.3%。男生收缩压(SBP)与体质量指数(BMI)(r=0.49)、腰围(WC)(r=0.50)、臀围(HC)(r=0.50)、人体肥胖指数(BAI)(r=0.26)和儿童人体肥胖指数(BAIp)(r=0.45)均呈正相关,舒张压(DBP)与BMI(r=0.23),WC(r=0.24),HC(r=0.24),BAI(r=0.11)和BAIp(r=0.21)均呈正相关(P值均<0.01)。女生SBP与BMI(r=0.44),WC(r=0.40),HC(r=0.48),BAI(r=0.20)和BAIp(r=0.44)均呈正相关,DBP与BMI(r=0.30),WC(r=0.28),HC(r=0.34),BAI(r=0.14)和BAIp(r=0.31)均呈正相关(P值均<0.01)。男生各臀围相关指数识别高血压的ROC曲线下面积分别为HC:0.87,BAI:0.61,BAIp:0.79(P值均<0.05),女生各臀围相关指数识别高血压的ROC曲线下面积分别为HC:0.84,BAI:0.71,BAIp:0.82(P值均<0.01)。HC识别儿童高血压的ROC曲线下面积与BMI和WC比较差异无统计学意义(P值均>0.05)。结论臀围相关肥胖指标可作为识别儿童高血压的有效指标。BAI和BAIp并不优于HC。
引文
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[11] 李杰,钱玲玲,李华婷,等.身体肥胖指数在上海地区中国人中的应用初探[J].中华糖尿病杂志,2016,8(5):278-282.
[12] DONG B,WANG Z,WANG H J,et al.Associations between adiposity indicators and elevated blood pressure among Chinese children and adolescents[J].J Hum Hypertens,2015,29(4):236-240.
[13] DOBASHI K,TAKAHASHI K,NAGAHARA K,et al.Evaluation of hip/heightp ratio as an index for adiposity and metabolic complications in obese children:comparison with waist-related indices[J].J Atheroscler Thromb,2017,24(1):47-54.
[14] THIVEL D,O’MALLEY G,PEREIRA B,et al.Comparison of total body and abdominal adiposity indexes to dual x-ray absorptiometry scan in obese adolescents[J].Am J Hum Biol,2015,27(3):334-338.
[15] SANKAR J,MOHAN G,PARIYARATH R,et al.Visceral fat assessment in over nourished children by ultrasonography and its relation to anthropometry[J].Indian J Pediatr,2012,79(10):1338-1341.
[2] 李健,吕海涛.2004-2014年儿童青少年原发性高血压危险因素Meta分析[J].中国心血管病研究,2017,15(6):533-539.
[3] BERGMAN R N,STEFANOVSKI D,BUCHANAN T A,et al.A better index of body adiposity[J].Obesity (Silver Spring),2011,19(5):1083-1089.
[4] EL A T,SAMOUDA H,ZITOUNI D,et al.Does the body adiposity index (BAI) apply to paediatric populations?[J].Ann Hum Biol,2013,40(5):451-458.
[5] 中国高血压防治指南修订委员会.中国高血压防治指南2010[J].中华高血压杂志,2011,19(8):701-743.
[6] MELMER A,LAMINA C,TSCHONER A,et al.Body adiposity index and other indexes of body composition in the SAPHIR study:association with cardiovascular risk factors[J].Obesity(Silver Spring),2013,21(4):775-781.
[7] MARIUSZ STEPIEń,ANNA STEPIEń,RAFA N WLAZE,et al.Obesity indices and inflammatory markers in obese non-diabetic normo-and hypertensive patients:a comparative pilot study[J].Lip Health Dis,2014,13:29.DOI:10.1186/1476-511X-13-29.
[8] SNIJDER M B,NICOLAOU M,VAN VALKENGOED I G,et al.Newly proposed body adiposity index (BAI) by Bergman et al is not strongly related to cardiovascular health risk[J].Obesity,2012,20(6):1138-1139.
[9] D’ELIA L,MANFREDI M,SABINO P,et al.The olivetti heart study:predictive value of a new adiposity index on risk of hypertension,blood pressure,and subclinical organ damage[J].Nutr Metab Cardiovasc Dis,2016,26(7):630-636.
[10] 何双涛,刘军.人体肥胖指数(BAI)作为中国人肥胖新指标的可行性探讨[J].复旦学报(医学版),2014,41(6):760-764.
[11] 李杰,钱玲玲,李华婷,等.身体肥胖指数在上海地区中国人中的应用初探[J].中华糖尿病杂志,2016,8(5):278-282.
[12] DONG B,WANG Z,WANG H J,et al.Associations between adiposity indicators and elevated blood pressure among Chinese children and adolescents[J].J Hum Hypertens,2015,29(4):236-240.
[13] DOBASHI K,TAKAHASHI K,NAGAHARA K,et al.Evaluation of hip/heightp ratio as an index for adiposity and metabolic complications in obese children:comparison with waist-related indices[J].J Atheroscler Thromb,2017,24(1):47-54.
[14] THIVEL D,O’MALLEY G,PEREIRA B,et al.Comparison of total body and abdominal adiposity indexes to dual x-ray absorptiometry scan in obese adolescents[J].Am J Hum Biol,2015,27(3):334-338.
[15] SANKAR J,MOHAN G,PARIYARATH R,et al.Visceral fat assessment in over nourished children by ultrasonography and its relation to anthropometry[J].Indian J Pediatr,2012,79(10):1338-1341.