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中国循证儿科杂志

中国循证儿科杂志 ›› 2024, Vol. 19 ›› Issue (5): 360-366.DOI: 10.3969/j.issn.1673-5501.2024.05.008

• 论著 • 上一篇    下一篇

中国西南三省市学龄儿童体成分与血压相关性的横断面调查

刘琴1，彭支莲2，袁双贵3，李兴贵4，马军4，安曦州1，陈镜宇1，罗顺清1，贺向前5，陈栏灵1，黄道超1，梁小华1   

  1. 1 重庆医科大学附属儿童医院儿研所，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室重庆，400014；2 重庆市九龙坡区中医院重庆，400014；3 贵州省习水县妇幼保健院遵义，564600；4 四川省石棉县人民医院雅安，625499；5 重庆医科大学重庆，400014

  • 收稿日期:2024-12-23 修回日期:2024-12-23 出版日期:2024-10-25 发布日期:2024-10-25
  • 通讯作者: 梁小华

Association between body composition and blood pressure among schoolage children in two southwestern provinces and one municipality in China: A crosssectional survey

LIU Qin1, PENG Zhilian2, YUAN Shuanggui3, LI Xinggui4, MA Jun4, AN Xizhou1, CHEN Jingyu1, LUO Shunqing1, HE Xiangqian5, CHEN Lanling1, HUANG Daochao1, LIANG Xiaohua1   

  1. 1 Children's Hospital of Chongqing Medical University, National Clinical Research Center for Child Health and Disorders, Key Laboratory of Child Development and Disorders of Ministry of Education, Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China; 2 Chongqing Jiulongpo Traditional Chinese Medicine Hospital, Chongqing 400014, China; 3 Xishui County Maternal and Child Health Hospital, Zunyi 564600, China; 4 Shimian County People's Hospital, Ya'an 625499, China; 5 Chongqing Medical University, Chongqing 400014, China

  • Received:2024-12-23 Revised:2024-12-23 Online:2024-10-25 Published:2024-10-25
  • Contact: LIANG Xiaohua, email: xiaohualiang@hospital.cqmu.edu.cn

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摘要： 背景：依靠BMI等传统指标难以全方位评估儿童的营养状况和健康风险，体成分分析能够更精准地反映儿童体内脂肪、肌肉、水分等成分的分布情况，为儿童健康状况的评估开辟了新途径。 目的：探讨中国西南三省市（四川、重庆、贵州）中小学生体成分与血压的相关性，为儿童高血压的早期预防提供科学依据。 设计：横断面调查。 方法：采用多阶段分层整群抽样方法，选取西南三省市中小学生作为研究对象。以问卷调查方式收集基本信息、家庭基本情况、青春期发育、家族疾病史、营养状况和儿童饮食等变量。统一体格测量、血压测量，使用生物电阻抗法测量体成分指标（体脂率、肌肉占比、含水率、蛋白质和无机盐占比）。对纳入分析的变量进行单因素分析，使用限制性立方样条分析探讨体成分与血压偏高风险的剂量反应关系。 主要结局指标：体成分与血压的相关性。 结果：西南三省市（四川、重庆、贵州）6所中小学8 397人进入本文分析，其中小学生5 722人，中学生2 675人；城区4 593人，乡村3 804人；平均年龄（10.9±2.4）岁，男生4 445人（52.9%），女生3 952人；检出血压偏高784人（9.3%），血压偏高检出率男生高于女生、超重肥胖儿童高于非超重肥胖、青春期发动高于未青春期发动、饮食偏咸高于非饮食偏咸（P均<0.05）；体成分5项指标（体脂率、含水率、肌肉占比、蛋白质占比、无机盐占比）均与血压相关（P均<0.05）；男女生的体成分指标与血压偏高风险呈现不同的关联模式，女生体脂率、含水率、肌肉占比、蛋白质占比与血压偏高风险呈线性相关，无机盐占比与血压偏高风险呈非线性相关；男生体脂率和无机盐占比与血压偏高呈现近似线性相关，肌肉占比、含水率和蛋白质占比与血压偏高均呈非线性关联。在体脂率、肌肉占比、含水率、蛋白质占比和无机盐占比5项体成分指标中，以男女生各自的中水平为参照，仅男生体脂率低水平、含水率和蛋白质占比高水平组的舒张压、收缩压和平均动脉压的差异无统计学意义，其余均有显著升高或降低变化。 结论：中小学男女生体成分与血压偏高密切相关，将体成分分析纳入儿童心血管健康风险评估可能有助于早期识别儿童血压偏高。

关键词: 中小学生, 体成分, 血压

Abstract: Background: Traditional indicators like BMI are insufficient for comprehensive assessment of children's nutritional status and health risks. Body composition analysis offers a more precise method to evaluate the distribution of fat, muscle, and water content in children's bodies, providing new avenues for health assessment. Objective: To investigate the correlation between body composition and blood pressure levels among schoolage children in two southwestern provinces and one municipality (Sichuan, Guizhou, Chongqing) of China, providing scientific evidence for early prevention of childhood hypertension. Design: Crosssectional survey. MethodsUsing multistage stratified cluster sampling, students from primary and secondary schools in the three areas were recruited. Data on basic information, family circumstances, pubertal development, family medical history, nutritional status, and dietary habits were collected through questionnaires. Standardized physical measurements, blood pressure measurements, and body composition parameters (body fat percentage, muscle ratio, water content, protein, and mineral content) were obtained using bioelectrical impedance analysis. Univariate analysis was conducted for included variables, and restricted cubic splines (RCS) analysis was used to explore the doseresponse relationship between body composition and elevated blood pressure risk. Main outcome measures: Association between body composition and blood pressure. Results: The study analyzed 8,397 students from six schools across the three areas, including 5,722 primary school students and 2,675 secondary school students; 4,593 from urban areas and 3,804 from rural areas. The mean age was (10.9±2.4) years, with 4,445 boys (52.9%) and 3,952 girls. Elevated blood pressure was detected in 784 students (9.3%), with higher prevalence in boys compared to girls, overweight/obese children compared to nonoverweight/obese children, those who had entered puberty compared to those who had not, and those with high salt intake compared to those without (all P<0.05). All five body composition indicators showed significant correlations with blood pressure (all P<0.05). Genderspecific patterns emerged in the relationship between body composition indicators and elevated blood pressure risk. In girls, body fat percentage, water content, muscle ratio, and protein content showed linear correlations with elevated blood pressure risk, while mineral content showed a nonlinear correlation. In boys, body fat percentage and mineral content showed nearly linear correlations with elevated blood pressure, while muscle ratio, water content, and protein content showed nonlinear correlations. Using medium levels of each gender as reference, only low body fat percentage and high water and protein content in boys showed no statistically significant differences in systolic blood pressure, diastolic blood pressure, and mean arterial pressure, while other parameters showed significant increases or decreases. Conclusion: Body composition is closely associated with elevated blood pressure in both male and female primary and secondary school students. Incorporating body composition analysis into cardiovascular health risk assessment may aid in early identification of elevated blood pressure in children.

Key words: School-age children, Body composition, Blood pressure