Abstract: Objective To examine the waist circumference (WC)'s predict role to elevate blood pressure (BP) among children and adolescents aged 7~17 years old who have normal body mass index (BMI),and provide scientific evidence for prevention and intervention of elevated BP in children and adolescents. Methods Data were combined from the China Health and Nutrition Survey,which was conducted during the period of 1993-2011.A total of 9 038 children and adolescents aged 7~17 years old who had normal BMI were included in the final data analysis.Data were on gender,age,WC,systolic blood pressure (SBP),diastolic blood pressure (DBP),and the prevalence of elevated BP.After adjusted for sex and age,the multiple liner regression model was used to analyze the trend in mean BP with increase of WC levels.Logistic regression model was conducted to examine the trend in elevated BP prevalence and the risk of elevated BP with increase of WC levels. Results Both the mean value of BP and prevalence of elevated BP showed rising trends with the increase of WC levels among children and adolescents with normal BMI (SBP/DBP ranged from 96.0/63.1 mmHg to 102.4/ 68.0 mmHg; prevalence of elevated BP ranged from 6.9% to 21.8%,all P<0.001),independently of age and sex.When WC<P₂₅ as the referent group,the risk for elevated BP were1.39,1.70,2.21 and 3.10,for groups of WC≥P₂₅ and WC<P₅₀,WC≥P₅₀ and WC<P₇₅,WC≥P₇₅ and WC<P₉₀,and WC≥P₉₀,respectively,independently of age and sex(P<0.01). Conclusions WC can be used as an important predictor of elevated BP in children and adolescents.BMI should be in combined with WC in order to more effectively prevent risk of elevated BP in children and adolescents.

Key words: body mass index, waist circumference, elevated blood pressure, children, adolescents

摘要： 目的 探讨体质指数(BMI)正常的儿童青少年中腰围(WC)对血压偏高的预测作用,为儿童青少年血压偏高防制提供科学依据。方法 基于1993-2011年“中国健康与营养调查” 横断面合并数据,选取BMI正常的7~17岁儿童青少年9 038名作为研究对象。分析指标包括性别、年龄、WC、收缩压、舒张压和血压偏高患病率。校正性别和年龄,采用多元线性回归模型分析血压水平随WC水平增加的变化趋势,采用Logistic回归模型分析血压偏高患病率随WC水平增加的变化趋势以及患病风险。结果 随着WC水平的增加,BMI正常的儿童青少年血压水平和血压偏高率均呈现明显的上升趋势(收缩压/舒张压:96.0/63.1 mmHg~102.4/68.0 mmHg;血压偏高率:6.9%~21.8%,P均<0.001),结果均独立于性别与年龄。以WC<P₂₅组为参照组,随WC水平的增加(P₂₅≤WC<P₅₀,P₅₀≤WC<P₇₅,P₇₅≤WC<P₉₀和WC≥P₉₀),血压偏高的患病风险分别为1.39,1.70,2.21和3.10(P均<0.01),结果独立于性别与年龄。结论 WC可作为预测BMI正常的儿童青少年血压偏高的重要指标。BMI指标应与WC指标联合应用,从而更有效的预防儿童血压偏高风险。

关键词: 体质指数, 腰围, 血压偏高, 儿童, 青少年