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目的探讨腰围(WC)与腰围身高比(WHt R)预测儿童青少年血压偏高的效果,为选择儿童青少年血压偏高的早期预警指标提供科学依据。方法纳入1993—2011年中国健康和营养调查(CHNS)数据库中10 163名年龄在7~17岁儿童青少年为研究对象,利用受试者工作特征曲线(ROC)比较腰围与腰围身高比预测血压偏高的曲线下面积(AUC),采用Logistic回归模型分析腰围与腰围身高比诊断腹型肥胖预测血压偏高的风险。结果腰围预测7~11岁男生、12~17岁男生、7~11岁女生和12~17岁女生血压偏高的ROC曲线下面积分别为0.64(95%CI=0.62~0.66),0.63(95%CI=0.61~0.65),0.57(95%CI=0.55~0.59)和0.58(95%CI=0.56~0.60),腰围身高比对应值分别为0.60(95%CI=0.58~0.62),0.59(95%CI=0.57~0.61),0.51(95%CI=0.49~0.53)和0.56(95%CI=0.54~0.58)。两指标的ROC曲线下面积差异均有统计学意义(P值均<0.05)。腰围与腰围身高比诊断的腹型肥胖均是儿童青少年血压偏高的危险因素,腰围诊断的腹型肥胖预测7~11岁男生、12~17岁男生、7~11岁女生和12~17岁女生血压偏高的OR(95%CI)值分别为4.12(2.76~6.16),2.65(2.01~3.50),2.21(1.40~3.49)和2.50(1.88~3.31),腰围身高比对应的OR(95%CI)值分别为2.74(1.98~3.80),2.27(1.75~2.94),1.63(1.14~2.32)和1.75(1.37~2.24),腰围略优于腰围身高比。结论腰围与腰围身高比均可作为儿童青少年血压偏高的重要预测因子,腰围的预测效果略优于腰围身高比。但考虑到腰围身高比界值的简单易记性,仍可推荐为儿童血压偏高的早期筛查指标。
Objective To investigate the effect of waist circumference (WC) and waist circumference ratio (WHt) on predicting high blood pressure in children and adolescents, and to provide a scientific basis for selecting early warning indicators of high blood pressure in children and adolescents. Methods A total of 10 163 adolescents aged 7-17 years from 1993 to 2011 China Health and Nutrition Survey (CHNS) database were included in this study. The waist circumference and waist circumference were compared with predicted partial pressure of blood pressure (BPH) by using receiver operating characteristic curve (ROC) High area under the curve (AUC), the use of Logistic regression model analysis of waist circumference and waist circumference than the diagnosis of abdominal obesity high blood pressure risk. Results The area under the ROC curve for high blood pressure of 7 to 11 years old boys, 12 to 17 years old boys, 7 to 11 years old girls and 12 to 17 years old girls was 0.64 (95% CI = 0.62-0.66) and 0.63 (95% CI = 0.55-0.59) and 0.58 (95% CI = 0.56-0.60), respectively. The waist circumference height ratios were 0.60 (95% CI = 0.58-0.62) and 0.59 ( 95% CI = 0.57-0.61), 0.51 (95% CI = 0.49-0.53) and 0.56 (95% CI 0.54-0.58). The area under the ROC curve of the two indicators were statistically significant (P <0.05). Waist circumference and waist circumference than the diagnosis of abdominal obesity are high risk factors for hypertension in children and adolescents, abdominal obesity diagnosis of 7 to 11-year-old boy, 12 to 17-year-old boys, 7 to 11-year-old girl and 12 to 17 years old The OR (95% CI) values of girls with high blood pressure were 4.12 (2.76-6.18), 2.65 (2.01-3.50), 2.21 (1.40-3.49) and 2.50 (1.88-3.31) % CI) were 2.74 (1.98-3.80), 2.27 (1.75-2.94), 1.63 (1.14-2.32) and 1.75 (1.37-2.24), respectively. The waist circumference was slightly better than the waist circumference. Conclusion The ratio of waist circumference to waist circumference can be used as an important predictor of high blood pressure in children and adolescents. The prediction of waist circumference is slightly better than that of waist circumference. However, in view of the simple and easy-to-remember waist circumference threshold, it can be recommended as an early screening indicator for high blood pressure in children.