Current status of overweight and obesity and its impact on hypertension among students aged 6-18 between 2017 and 2019 in Longhua District, Shenzhen
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摘要:
目的 了解深圳市龙华区2017―2019年6~18岁学生超重、肥胖情况和高血压的检出率,探索超重和肥胖与高血压之间的关系,为有针对性地开展相关预防工作提供依据。 方法 利用深圳市龙华区中心医院2017―2019年的学生体检数据,描述不同年份、性别和年龄学生的超重、肥胖情况与高血压检出率,采用logistic回归分析模型分析超重和肥胖对高血压患病的影响。 结果 2017―2019年学生体检人数分别为41 275人、46 907人和51 222人,超重检出率分别为9.66%、9.01%和9.89%,肥胖检出率分别为6.84%、6.22%和7.07%,高血压检出率分别为22.07%、21.16%和17.53%。调整年龄和性别后,2017年超重和肥胖组高血压的患病风险分别为正常组的2.191倍(OR=2.191, 95% CI: 2.038~2.355, P < 0.001)和3.984倍(OR=3.984, 95% CI: 3.566~4.186, P < 0.001),2018年为2.338倍(OR=2.338, 95% CI: 2.179~2.509, P < 0.001)和3.861倍(OR=3.861, 95% CI: 3.565~4.181, P < 0.001),2019年为2.076倍(OR=2.076, 95% CI: 1.937~2.226, P < 0.001)和3.753倍(OR=3.753, 95% CI: 3.486~4.040, P < 0.001)。 结论 深圳市龙华区儿童和青少年超重、肥胖和高血压检出率均相对较高,超重和肥胖是高血压检出的危险因素,需要引起足够的重视。 Abstract:Objective This study aims to determine the detection rate of overweight, obesity, and hypertension in students aged 6-18 years between 2017 and 2019 in the Longhua District, Shenzhen, and to examine their interrelation, thus providing a basis for relevant preventive measures. Methods The study used student health examination data from 2017 to 2019 sourced from the Central Hospital of Longhua District, Shenzhen. We delineated the prevalence of overweight, obesity, and hypertension among students across different years, genders, and ages. And a logistic regression model was used to analyze their effects. Results The total number of students who underwent health examinations from 2017 to 2019 were 41 275, 46 907, and 51 222, respectively. The detection rates for overweight were 9.66%, 9.01%, and 9.89%; for obesity, 6.84%, 6.22%, and 7.07%; and for hypertension, 22.07%, 21.16%, and 17.53%, respectively. After adjusting for age and gender, compared with the normal group, the risk of hypertension in the overweight and obesity groups was significantly higher, with 2.191 times (OR=2.191, 95% CI: 2.038-2.355, P < 0.001) and 3.984 times (OR=3.894, 95% CI: 3.566-4.186, P < 0.001) in 2017; 2.338 times (OR=2.338, 95% CI: 2.179-2.509, P < 0.001) and 3.861 times (OR=3.861, 95% CI: 3.565-4.181, P < 0.001) in 2018; 2.076 times (OR=2.076, 95% CI: 1.937-2.226, P < 0.001) and 3.753 times (OR=3.753, 95% CI: 3.486-4.040, P < 0.001) in 2019. Conclusions The detection rates of overweight, obesity, and hypertension in children in Longhua District, Shenzhen, were considerably elevated. Overweight and obesity were found to significantly escalate the risk of hypertension, underscoring the need for increased vigilance and prevention efforts. -
Key words:
- Overweight /
- Obesity /
- Hypertension /
- Adolescent
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表 1 2017―2019年研究对象的具体分布情况
Table 1. Distribution of research subjects in 2017-2019
年龄组/岁
Age group/years男性① Male ① 女性① Female ① 2017年year 2018年year 2019年year 2017年year 2018年year 2019年year 6~<7 27(0.11) 14(0.05) 17(0.06) 22(0.12) 19(0.09) 20(0.09) 7~<8 2 907(12.33) 3 217(12.16) 3 781(13.20) 2 329(13.16) 2 784(13.61) 3 080(13.64) 8~<9 3 451(14.63) 3 663(13.85) 3 822(13.34) 2 593(14.66) 2 874(14.05) 3 118(13.81) 9~<10 3 196(13.55) 3 629(13.72) 3 645(12.72) 2 430(13.73) 2 818(13.77) 2 886(12.78) 10~<11 2 845(12.06) 3 381(12.78) 3 581(12.50) 2 065(11.67) 2 619(12.80) 2 789(12.35) 11~<12 2 456(10.41) 3 008(11.37) 3 266(11.40) 1 784(10.08) 2 164(10.58) 2 552(11.30) 12~<13 2 104(8.92) 2 451(9.27) 2 782(9.71) 1 535(8.68) 1 825(8.92) 2 005(8.88) 13~<14 1 989(8.43) 2 114(7.99) 2 117(7.39) 1 342(7.58) 1 493(7.30) 1 592(7.05) 14~<15 1 607(6.81) 1 762(6.66) 1 902(6.64) 1 085(6.13) 1 209(5.91) 1 394(6.17) 15~<16 1 190(5.05) 1 286(4.86) 1 487(5.19) 892(5.04) 944(4.61) 1 153(5.11) 16~<17 1 014(4.30) 1 063(4.02) 1 284(4.48) 862(4.87) 990(4.84) 1 134(5.02) 17~<18 688(2.92) 738(2.79) 849(2.96) 661(3.74) 634(3.10) 759(3.36) 18 108(0.46) 121(0.46) 114(0.40) 93(0.53) 87(0.43) 93(0.41) 合计Total 23 582 26 447 28 647 17 693 20 460 22 575 注:①以[人数(占比/%)]表示。
Note: ① [Number of people (proportion/%)].表 2 2017―2019年不同性别研究对象超重、肥胖和高血压的检出情况
Table 2. Detection status of overweight, obesity, and hypertension in participants across gender in 2017-2019
性别
Sex2017年year 2018年year 2019年year 超重①
Overweight ①肥胖①
Obesity ①高血压①
Hypertension ①超重①
Overweight ①肥胖①
Obesity ①高血压①
Hypertension ①超重①
Overweight ①肥胖①
Obesity ①高血压①
Hypertension ①男性Male 2 339(9.92) 2 125(9.01) 6 498(27.55) 2 480(9.38) 2 235(8.45) 7 046(26.64) 2 937(10.25) 2 736(9.55) 6 532(22.80) 女性Female 1 649(9.32) 698(3.95) 2 612(14.76) 1 744(8.52) 681(3.33) 2 881(14.08) 2 129(9.43) 886(3.92) 2 447(10.84) 合计Total 3 988(9.66) 2 823(6.84) 9 110(22.07) 4 224(9.01) 2 916(6.22) 9 927(21.16) 5 066(9.89) 3 622(7.07) 8 979(17.53) χ2值value 4.15 407.17 961.71 10.25 519.18 1 090.87 9.56 608.15 1 249.71 P值value 0.042 < 0.001 < 0.001 0.001 < 0.001 < 0.001 0.002 < 0.001 < 0.001 注:①以[人数(占比/%)]表示。
Note: ① [Number of people (proportion/%)].表 3 2017―2019年不同年龄段研究对象超重、肥胖和高血压的检出情况
Table 3. Detection status of overweight, obesity and hypertension in participants across age from 2017 to 2019
年龄组/岁
Age group/years2017年year 2018年year 2019年year 超重①
Overweight ①肥胖①
Obesity ①高血压①
Hypertension ①超重①
Overweight ①肥胖①
Obesity ①高血压①
Hypertension ①超重①
Overweight ①肥胖①
Obesity ①高血压①
Hypertension ①6~<7 14(28.57) 4(8.16) 11(22.45) 4(12.12) 1(3.03) 9(27.27) 6(16.22) 5(13.51) 7(18.92) 7~<8 491(9.38) 376(7.18) 1 193(22.78) 467(7.78) 392(6.53) 1 042(17.36) 558(8.13) 529(7.71) 1 021(14.88) 8~<9 482(7.97) 504(8.34) 1 178(19.49) 522(7.99) 427(6.53) 1 038(15.88) 597(8.60) 542(7.81) 952(13.72) 9~<10 540(9.60) 503(8.94) 967(17.19) 535(8.30) 505(7.83) 1 006(15.60) 585(8.96) 532(8.15) 928(14.21) 10~<11 465(9.47) 335(6.82) 891(18.15) 558(9.30) 469(7.82) 1 033(17.22) 642(10.08) 552(8.67) 954(14.98) 11~<12 392(9.25) 284(6.70) 812(19.15) 463(8.95) 295(5.70) 886(17.13) 615(10.57) 479(8.23) 841(14.46) 12~<13 397(10.91) 212(5.83) 981(26.96) 425(9.94) 245(5.73) 984(23.01) 503(10.51) 268(5.60) 895(18.70) 13~<14 353(10.60) 187(5.61) 861(25.85) 392(10.87) 159(4.41) 1 085(30.08) 416(11.22) 178(4.80) 737(19.87) 14~<15 249(9.25) 149(5.53) 773(28.71) 289(9.73) 142(4.78) 1 030(34.67) 369(11.20) 179(5.43) 836(25.36) 15~<16 222(10.66) 104(5.00) 650(31.22) 193(8.65) 117(5.25) 735(32.96) 294(11.14) 126(4.77) 768(29.09) 16~<17 217(11.57) 95(5.06) 466(24.84) 212(10.33) 105(5.11) 607(29.57) 271(11.21) 134(5.54) 602(24.90) 17~<18 143(10.60) 66(4.89) 324(24.02) 146(10.64) 53(3.86) 470(34.26) 182(11.31) 91(5.66) 437(27.18) 18 23(11.44) 4(1.99) 3(1.49) 18(8.65) 6(2.88) 2(0.96) 28(13.53) 7(3.38) 1(0.48) 合计Total 3 988(9.66) 2 823(6.84) 9 110(22.07) 4 224(9.01) 2 916(6.22) 9 927(21.16) 5 066(9.89) 3 622(7.07) 8 979(17.53) χ2值value 63.98 118.29 477.31 55.17 117.66 1359.09 79.73 157.87 858.16 P值value < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 < 0.001 注:①以[人数(占比/%)]表示。
Note: ① [Number of people (proportion/%)].表 4 超重和肥胖影响高血压患病的logistic回归分析模型分析
Table 4. The logistic regression analysis for the association between overweight and obesity and hypertension
变量Variable 2017年year 2018年year 2019年year β值
valueOR值value
(95% CI)P值
valueβ值
valueOR值value
(95% CI)P值
valueβ值
valueOR值value
(95% CI)P值
value正常Normal weight 1.000 1.000 1.000 超重Overweight 0.784 2.191(2.038~2.355) < 0.001 0.849 2.338(2.179~2.509) < 0.001 0.731 2.076(1.937~2.226) < 0.001 肥胖Obesity 1.352 3.984(3.566~4.186) < 0.001 1.351 3.861(3.565~4.181) < 0.001 1.323 3.753(3.486~4.040) < 0.001 -
[1] Chen X, Wang Y, Appel LJ, et al. Impacts of measurement protocols on blood pressure tracking from childhood into adulthood: a metaregression analysis[J]. Hypertension, 2008, 51(3): 642-649. DOI: 10.1161/HYPERTENSIONAHA.107.102145. [2] Jackson LV, Thalange NK, Cole TJ. Blood pressure centiles for great Britain[J]. Arch Dis Child, 2007, 92(4): 298-303. DOI: 10.1136/adc.2005.081216. [3] Ejike CE, Ugwu C. Hyperbolic relationship between blood pressure and body mass index in a Nigerian adolescent population[J]. Webmedcentral, 2010, 1(10): wmc00797. DOI: 10.9754/journal.wmc.2010.00797. [4] Franco OH, Peeters A, Bonneux L, et al. Blood pressure in adulthood and life expectancy with cardiovascular disease in men and women: life course analysis[J]. Hypertension, 2005, 46(2): 280-286. DOI: 10.1161/01.HYP.0006173433.67235.ab. [5] Bao W, Threefoot SA, Srinivasan SR, et al. Essential hypertension predicted by tracking of elevated blood pressure from childhood to adulthood: the Bogalusa heart study[J]. Am J Hypertens, 1995, 8(7): 657-665. DOI: 10.1016/0895-7061(95)00116-7. [6] Nkeh-Chungag BN, Sekokotla AM, Sewani-Rusike C, et al. Prevalence of hypertension and pre-hypertension in 13-17 year old adolescents living in Mthatha-South Africa: a cross-sectional study[J]. Cent Eur J Public Health, 2015, 23(1): 59-64. DOI: 10.21101/cejph.a3922. [7] Hothan KA, Alasmari BA, Alkhelaiwi OK, et al. Prevalence of hypertension, obesity, hematuria and proteinuria amongst healthy adolescents living in Western Saudi Arabia[J]. Saudi Med J, 2016, 37(10): 1120-1126. DOI: 10.15537/smj.2016.10.14784. [8] Prasad S, Masood J, Srivastava AK, et al. Elevated blood pressure and its associated risk factors among adolescents of a North Indian city - a cross-sectional study[J]. Indian J Community Med, 2017, 42(3): 155-158. DOI: 10.4103/ijcm.ijcm_106_16. [9] Goel M, Pal P, Agrawal A, et al. Relationship of body mass index and other life style factors with hypertension in adolescents[J]. Ann Pediatr Card, 2016, 9(1): 29-34. DOI: 10.4103/0974-2069.171393. [10] Moraes LI, Nicola TC, Jesus JS, et al. High blood pressure in children and its correlation with three definitions of obesity in childhood[J]. Arq Bras Cardiol, 2014, 102(2): 175-180. DOI: 10.5935/abc.20130233. [11] Oduwole AA, Ladapo TA, Fajolu IB, et al. Obesity and elevated blood pressure among adolescents in Lagos, Nigeria: a cross-sectional study[J]. BMC Public Health, 2012, 12: 616. DOI: 10.1186/1471-2458-12-616. [12] Qaddumi J, Holm M, Alkhawaldeh A, et al. Prevalence of hypertension and pre-hypertension among secondary school students[J]. Int J Adv Nurs Stud, 2016, 5(2): 240-245. DOI: 10.14419/ijans.v5i2.6878. [13] 北京大学儿童青少年卫生研究所, 中国疾病预防控制中心营养与健康所, 中国疾病预防控制中心妇幼保健中心. WS/T 586―2018学龄儿童青少年超重与肥胖筛查[S]. 北京: 中华人民共和国国家卫生和计划生育委员会, 2018: 1-3.Department of Maternal and Child Health, School of Public Health, Peking University, National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention. Screening for overweight and obesity among school-age children and adolescents WS/T 586—2018[S]. Beijing: National Health and Family Planning Commission of the People's Republic of China, 2018: 1-3. [14] 米杰, 王天有, 孟玲慧, 等. 中国儿童青少年血压参照标准的研究制定[J]. 中国循证儿科杂志, 2010, 5(1): 4-14. DOI: 10.3969/j.issn.1673-5501.2010.01.002.Mi J, Wang TY, Meng LH, et al. Development of blood pressure reference standards for Chinese children and adolescents[J]. Chin J Evid Based Pediatr, 2010, 5(1): 4-14. DOI: 10.3969/j.issn.1673-5501.2010.01.002. [15] 赵仁兵, 王予川, 崔玉霞, 等. 贵阳市7~17岁少年儿童体质指数分布及超重肥胖状况[J]. 临床儿科杂志, 2009, 27(1): 63-66. DOI: 10.3969/j.issn.1000-3606.2009.01.016.Zhao RB, Wang YC, Cui YX, et al. The prevalence of overweight and obesity and body mass index distribution among children aged 7 to 17 years in Guiyang City[J]. J Clin Pediatr, 2009, 27(1): 63-66. DOI: 10.3969/j.issn.1000-3606.2009.01.016. [16] 马军, 蔡赐河, 王海俊, 等. 1985-2010年中国学生超重与肥胖流行趋势[J]. 中华预防医学杂志, 2012, 46(9): 776-780. DOI: 10.3760/cma.j.issn.0253-9624.2012.09.002.Ma J, Cai CH, Wang HJ, et al. Prevalence of overweight and obesity among Chinese students in 1985-2010[J]. Chin J Prev Med, 2012, 46(9): 776-780. DOI: 10.3760/cma.j.issn.0253-9624.2012.09.002. [17] 师春立, 周亮, 陈剑宇, 等. 2018年与2014年四川省7~18周岁中小学生形态发育现状对比分析[J]. 中国儿童保健杂志, 2020, 28(10): 1173-1177. DOI: 10.11852/zgetbjzz2019-1392.Shi CL, Zhou L, Chen JY, et al. Comparative analysis of the morphological development of primary and secondary school students aged 7 to 18 years in Sichuan Province in 2018 and 2014[J]. Chin J Child Health Care. 2020, 28(10): 1173-1177. DOI: 10.11852/zgetbjzz2019-1392. [18] 罗春燕, 周月芳, 严琼, 等. 上海市中小学生肥胖和哮喘的流行特征及其影响因素[J]. 环境与职业医学, 2020, 37(1): 44-50. DOI: 10.13213/j.cnki.jeom.2020.19599.Luo CY, Zhou YF, Yan Q, et al. Epidemiological characteristics and influencing factors of combination of obesity and asthma in elementary and middle school students in Shanghai[J]. J Environ Occup Med, 2020, 37(1): 44-50. DOI: 10.13213/j.cnki.jeom.2020.19599. [19] 杨志锋. 慈溪市9~17岁儿童青少年肥胖流行情况及其与高血压的关系[J]. 现代实用医学, 2016, 28(8): 1064-1065. DOI: 10.3969/j.issn.1671-0800.2016.08.045.Yang ZF. Prevalence of obesity and its relationship with hypertension in children and adolescents aged 9-17 in Cixi[J]. Modern Practical Medicine, 2016, 28(8): 1064-1065. DOI: 10.3969/j.issn.1671-0800.2016.08.045. [20] 陈伟伟, 高润霖, 刘力生, 等. 《中国心血管病报告2015》概要[J]. 中国循环杂志, 2016, 31(6): 521-528. DOI: 10.3969/j.issn.1000-3614.2016.06.001.Chen WW, Gao RL, Liu LS, et al. Summary of China cardiovascular disease report 2015[J]. Chin Circul J, 2016, 31(6): 521-528. DOI: 10.3969/j.issn.1000-3614.2016.06.001. [21] Shipp E, Cooper S, Jiang LH, et al. Influence of work on elevated blood pressure in hispanic adolescents in south texas[J]. Int J Environ Res Public Health, 2019, 16(7): 1096. DOI: 10.3390/ijerph16071096. [22] 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. [23] 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. DOI: 10.1097/md.0b013e31815d5386. [24] 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. [25] 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. [26] 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.