Prevalence of overweight and obesity and analysis of blood pressure related factors among children and adolescents in Xinzhuang community, Shanghai

doi:10.16150/j.1671-2870.2019.05.017

Abstract

Abstract:

Objective: To investigate the prevalence of overweight and obesity and blood pressure related factors among children and adolescents in Xinzhuang community, Shanghai, for providing reference information for the prevention and treatment of hypertension in children and adolescents. Methods: Students aged 7-17 yearsin primary and secondary schools in Xinzhuang district, Shanghai, were invited to participate in the study. Body height, weight, waist and hip circumference were measured. Omron HBP1100 electronic sphygmomanometer was used to measure brachial blood pressure for three times at sitting position. Questionnaires were used to collect basic information, including disease history, birth history, use of medications, maternal pregnancy and delivery history, parents' smoking habits and history of hypertension and diabetes, and family history, etc. Results: ①Among all the 14 715 students (male 7703, female 7 012), the prevalences of overweight, obesity and high waist circumference were 17.3%, 13.9% and 18.0%, respectively. ② Both the brachial systolic and diastolic blood pressure were positively associated with age, body height, BMI, waist circumference, father or mother hypertension history and mother pregnancy hypertension history (r= 0.03-0.37, P≤0.01). Students whose both parents had hypertension had a higher blood pressure (120/77 mmHg) than those with single parent having hypertension (118/75 mmHg) and those having both normotensive parents (116/74 mmHg, P for trend ≤0.001). ③ Obese students had higher blood pressure (122/76 mmHg) than those overweight (119/75 mmHg) and those with normal weight (115/74 mmHg). Similar trend was observed between students with high(121/76 mmHg), high-normal (118/75 mmHg) and normal (115/74 mmHg) waist circumference. P values were all <0.001 after adjustment for age and other factors. Conclusions: In addition to factors could not be revised such as age and parent's hypertension, blood pressure of children and adolescents is related to obesity indices such as BMI and waist circumference, indicating that obesity control should be the key for the prevention and control of hypertension in children and adolescents.

Key words: Blood pressure, Hypertension, Obesity, Waist circumference, Children, Adolescents

CLC Number:

R544.1

WANG Yajuan, GUO Qianhui, ZHANG Dongyan, CHENG Yibang, CHEN Ling, ZHU Dingliang, LI Yan. Prevalence of overweight and obesity and analysis of blood pressure related factors among children and adolescents in Xinzhuang community, Shanghai[J]. Journal of Diagnostics Concepts & Practice, 2019, 18(05): 575-580.

Figures/Tables 5

References 22

[1]	中国高血压防治指南修订委员会, 高血压联盟中国中华医学会心血管病学分会, 中国医师协会高血压专业委员会, 等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24(1): 24-56.
[2]	陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告2017》概要[J]. 中国循环杂志, 2018, 33(1):1-8.
[3]	Chen X, Wang Y. Tracking of blood pressure from childhood to adulthood: a systematic review and meta-regression analysis[J]. Circulation, 2008, 117(25):3171-3180. doi: 10.1161/CIRCULATIONAHA.107.730366 URL
[4]	张媛媛, 杨丽丽, 席波. 济南市城区年龄6-17岁儿童青少年血压偏高现状[J]. 中华高血压杂志, 2018, 26(1):72-77.
[5]	王卉, 朱国伟, 陈津津, 等. 上海市徐汇区学龄前儿童高血压和肥胖的关系研究[J]. 中国妇幼保健, 2019, 34(14):3250-3252.
[6]	WS/T 586—2018. 学龄儿童青少年超重与肥胖筛查[S]. 中华人民共和国国家卫生健康委员会, 2018.
[7]	WS/T 611—2018. 7岁-18岁儿童青少年高腰围筛查界值[S]. 中华人民共和国国家卫生健康委员会, 2018.
[8]	I'Allemand D, Wiegand S, Reinehr T, et al. Cardiovascular risk in 26,008 European overweight children as established by a multicenter database[J]. Obesity (Silver Spring), 2008, 16(7):1672-1679. doi: 10.1038/oby.2008.259 URL
[9]	Raj M, Sundaram KR, Paul M, et al. Obesity in Indian children: time trends and relationship with hypertension[J]. Natl Med J India, 2007, 20(6):288-293.
[10]	Kotchen TA. Obesity-related hypertension: epidemiology, pathophysiology, and clinical management[J]. Am J Hypertens, 2010, 23(11):1170-1178. doi: 10.1038/ajh.2010.172 URL
[11]	Lim K, Jackson KL, Sata Y, et al. Factors Responsible for Obesity-Related Hypertension[J]. Curr Hypertens Rep, 2017, 19(7):53. doi: 10.1007/s11906-017-0750-1 URL
[12]	Grassi G, Biffi A, Seravalle G, et al. Sympathetic Neural Overdrive in the Obese and Overweight State[J]. Hypertension, 2019, 74(2):349-358. doi: 10.1161/HYPERTENSIONAHA.119.12885 pmid: 31203727
[13]	Alvarez GE, Beske SD, Ballard TP, et al. Sympathetic neural activation in visceral obesity[J]. Circulation, 2002, 106(20):2533-2536. pmid: 12427647
[14]	Kumar J, Deshmukh PR, Garg BS. Prevalence and correlates of sustained hypertension in adolescents of rural Wardha, central India[J]. Indian J Pediatr, 2012, 79(9):1206-1212. doi: 10.1007/s12098-011-0663-y URL
[15]	王政和, 董彦会, 宋逸, 等. 中国2014年9-22岁学生体育锻炼时间不足1小时的流行现状与影响因素分析[J]. 中华流行病学杂志, 2017, 38(3):341-345.
[16]	Goossens GH. The Metabolic Phenotype in Obesity: Fat Mass, Body Fat Distribution, and Adipose Tissue Function[J]. Obes Facts, 2017, 10(3):207-215. doi: 10.1159/000471488 URL
[17]	Liu J, Tse LA, Liu Z, et al. Predictive Values of Anthropometric Measurements for Cardiometabolic Risk Factors and Cardiovascular Diseases Among 44 048 Chinese[J]. J Am Heart Assoc, 2019, 8(16):e010870.
[18]	Tebar WR, Ritti-Dias RM, Farah BQ, et al. High blood pressure and its relationship to adiposity in a school-aged population: body mass index vs waist circumference[J]. Hypertens Res, 2018, 41(2):135-140. doi: 10.1038/hr.2017.93 URL
[19]	Rangel-Baltazar E, Villalpando S. Waist-to-height ratio as a predictor of blood pressure in Mexican children. Follow-up study[J]. Rev Invest Clin, 2014, 66(1):17-23. pmid: 24762723
[20]	Choi D, Choi S, Son JS, et al. Impact of Discrepancies in General and Abdominal Obesity on Major Adverse Cardiac Events[J]. J Am Heart Assoc, 2019, 8(18):e013471.
[21]	王锐, 尹福在, 马春明, 等. 不同肥胖指标筛查儿童高血压[J]. 中华内分泌代谢杂志, 2012, 28(11):919-921.
[22]	Hovi P, Vohr B, Ment LR, et al. Blood Pressure in Young Adults Born at Very Low Birth Weight: Adults Born Preterm International Collaboration[J]. Hypertension, 2016, 68(4):880-887. doi: 10.1161/HYPERTENSIONAHA.116.08167 URL

变量名称	男性	女性	总体
人数	7 703（52.4）	7 012（47.7）	14 715
年龄（岁）	10.5±2.5	10.4±2.5	10.4±2.5
身高（cm）	145.9±15.7	143.4±14.2^a)	144.7±15.1
BMI（kg/m²）	19.1±3.9	17.9±3.3^a)	18.5±3.7
腰围（cm）	65.6±11.2	60.6±8.4^a)	63.2±10.3
臀围（cm）收缩压 (mmHg)	73.2±11.0	71.9±10.7^a)	72.6±10.9
第一次	122.4±14.5	119.0±13.9^a)	120.8±14.3
第二次	117.8±13.3	114.6±12.6^a)	116.3±13.1
第三次	115.9±13.1	112.3±12.2^a)	114.2±12.8
平均舒张压(mmHg)	118.6±12.4	115.2±11.8^a)	117.0±12.3
第一次	75.9±10.3	75.7±9.7	75.8±10.0
第二次	74.1±9.2	74.3±8.9	74.2±9.1
第三次	73.0±9.2	73.3±9.0^a)	73.1±9.1
平均	74.3±7.8	74.4±7.7	74.4±7.8
平均心率（次/分）	87.9±11.9	90.2±12.2^a)	89.0±12.1
BMI分组[n(%)]
正常	4 366（61.2）	4 988（77.2）^a)	9 354（68.8）
超重	1 467（20.6）	888（13.8）	2 355（17.3）
肥胖	1 299（18.2）	583（9.0）	1 882（13.9）
腰围分组[n(%)]
正常腰围	4 330（60.9）	4 493（69.7）^a)	8 823（65.1）
正常腰围高值	1 217（17.1）	1 087（16.9）	2 304（17.0）
高腰围	1 569（22.1）	867（13.5）	2 436（18.0）
妊娠期高血压	174（2.3）	179（2.6）	353（2.4）
妊娠糖尿病	212（2.8）	211（3.0）	423（2.9）
父亲高血压	605（7.9）	533（7.6）	1 138（7.7）
母亲高血压	124（1.6）	122（1.7）	246（1.7）
父亲现在吸烟	2 306（29.9）	2 191（31.3）	4 497（30.6）
母亲现在吸烟	24（0.31）	32（0.46）	56（0.38）
本人现在吸烟	3（0.04）	3（0.04）	6（0.04）
本人现在饮酒	10（0.13）	5（0.07）	15（0.10）

变量	男性			女性			男女合并
变量	β±SE	R²	P值	β±SE	R²	P值	β±SE	R²	P值
年龄（岁）	0.51±0.07	0.008	<0.001	0.62±0.11	0.085	<0.001	0.20±0.05	0.001	<0.001
性别（男1,女2）	-	-	-	-	-	-	-1.95±0.23	0.007	<0.001
BMI（kg/m²）	0.97±0.05	0.121	<0.001	0.19±0.04	0.004	<0.001	0.75±0.07	0.114	<0.001
腰围（cm）	-	-	-	-	-	-	0.11±0.03	0.002	<0.001
出生体重（kg）	-0.40±0.18	0.001	0.029	-	-	-	-	-	-
父亲高血压	1.37±0.52	0.001	0.009	1.37±0.54	0.001	0.011	1.41±0.38	0.001	<0.001
母亲妊娠期高血压	-	-	-	2.88±0.91	0.002	0.002	2.34±0.64	0.001	<0.001

变量	男性			女性			男女合并
变量	β±SE	R²	P值	β±SE	R²	P值	β±SE	R²	P值
年龄（岁）	-0.17±0.05	0.002	<0.001	0.30±0.03	0.017	<0.001	-0.08±0.03	0.001	0.014
BMI（kg/m²）	0.26±0.03	0.011	<0.001	-	-	-	0.26±0.02	0.013	<0.001
父亲高血压	1.50±0.35	0.003	<0.001	1.23±0.37	0.002	0.001	1.39±0.25	0.003	<0.001
母亲高血压	-	-	-	1.49±0.76	0.001	0.05	1.04±0.53	0.0003	0.049
母亲妊娠期高血压	-	-	-	1.50±0.63	0.002	0.017	1.18±0.45	0.001	0.008