Relationship of BMI to the incidence of hypertension: a 4 years' cohort study among children in Guangzhou, 2007-2011.
Relationship of BMI to the incidence of hypertension: a 4 years' cohort study among children in Guangzhou, 2007-2011.
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DOI：
10.1186/s12889-015-1997-6
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发表时间：
2015-08-14
影响因子：
4.5
通讯作者：
Ma L
中科院分区：
文献类型：
--
作者：
Wang J;Zhu Y;Jing J;Chen Y;Mai J;Wong SH;O'Reilly J;Ma L
在中国，近几十年来，儿童和青少年超重和肥胖的人数急剧增加。然而，很少有纵向研究报道体重指数与中国儿童患高血压的风险有关。我们通过一项回溯性队列研究，研究了中国学龄儿童BMI与高血压的纵向关系。对广州市7203名6-8岁儿童(男3821名，女3382名)进行了队列研究，并进行了连续4年的随访。参与者通过身体质量指数(BMI)进行评估，被分为瘦、正常体重、超重和肥胖组。中国肥胖工作组新制定的年龄和性别BMI临界值被用来定义超重和肥胖。瘦的定义是由国际上特定年龄和性别的BMI对瘦1级的分界点。高血压的定义是根据身高、年龄和性别的收缩和舒张值的百分位数。用COX比例风险模型估计BMI对高血压风险的单独或联合作用。本研究由中山大学公共卫生学院伦理委员会批准。在4年的跟踪调查中，中国超重(50.1%)和肥胖(70%)的学龄儿童高血压累积发病率惊人地高。超重肥胖组儿童高血压患病率(24.3%，18.5%)明显高于正常体重组(11.1%，7.4%)。与正常体重组比较，瘦、超重、肥胖组患高血压的校正HR和95%CI分别为0.972(0.851，1.110)、1.313(1.179，1.461)和1.816(1.634，2.081)。此外，瘦对高血压的保护作用在男孩0.808(0.666，0.981)中观察到，但在女孩1.158(0.966，1.389)中没有观察到。4年的纵向研究表明，超重和肥胖可以预测中国儿童患高血压的风险较高，而瘦只预测男孩患高血压的风险较低。
In China, there has been a dramatic increase in overweight and obesity among children and adolescents in recent decades. However, little longitudinal studies reported BMI in relation to the risk for hypertension among children in China. We examined the longitudinal relations between BMI and hypertension in Chinese schoolchildren via a retrospective cohort study. The cohort study was carried out in 7203 children (3821 boys and 3382 girls) in Guangzhou aged 6–8 years, with a continuous 4 years of follow-up. The participants, evaluated by body mass index (BMI), were categorized as thinness, normal weight, overweight, and obesity groups. The age and gender-specific BMI cutoffs newly developed by the Working Group on Obesity in China (WGOC) were used to define overweight and obesity. The thinness was defined by the international age- and gender-specific cut-off points for BMI for thinness grade 1. Hypertension was defined by using percentiles of systolic and diastolic values on the basis of height percentile, age, and gender. The Cox proportional hazards model was used to estimate the single or joint effect of BMI on the risk of hypertension. This study was approved by The Ethical Committee of School of Public Health, Sun Yat-sen University. During a follow-up of 4 years, a shocking high cumulative incidence of hypertension was found in Chinese overweight (50.1 %) and obesity (70 %) schoolchildren. The incidence of children hypertension were markedly higher among overweight and obesity group than normal weight and thinness group (24.3 %, 18.5 % vs 11.1 %, 7.4 %). Compared with the children in the normal weight group, the adjusted HRs and 95 % CIs of developing hypertension in thinness, overweight, and obesity group were 0.972 (0.851, 1.110), 1.313 (1.179, 1.461), and 1.816 (1.634, 2.081), respectively. Additionally, the protective effect of thinness on hypertension was observed in boys 0.808 (0.666, 0.981), but not in girls 1.158 (0.966, 1.389). The 4-year longitudinal study indicated that the overweight and obesity can predict the higher risk of hypertension in Chinese children, whereas, the thinness predict the lower risk of hypertension only in boys.