摘要
目的 分析江苏省淮安市12~17岁中学生不同肥胖指标与血压偏高的关系,探讨不同肥胖指标对血压偏高的预测价值。方法 依托2022年江苏省学生常见病和健康影响因素监测项目,采用分层整群随机抽样方法对淮安市12~17岁中学生进行身高、体重、腰围(waist circumference,WC)和血压测量。采用二分类logistic回归模型分析体质量指数(body mass index,BMI)、WC、腰围身高比(waist-to-height ratio,WHtR)与血压偏高的关系,并应用受试者工作特征(receiver operating characteristic,ROC)曲线评价不同肥胖指标及其联合应用对血压偏高的预测价值。结果 5 681名12~17岁中学生中,检出血压偏高995例,检出率为17.51%。协方差分析结果显示,肥胖、高腰围、腹型肥胖学生的收缩压和舒张压水平均较高(均P<0.05)。肥胖、高腰围、腹型肥胖学生的血压偏高检出率均较高(均P<0.01)。二分类logistic回归分析结果显示,BMI、WC、WHtR与血压偏高患病风险均呈正向关联(均P<0.01)。ROC曲线分析结果显示,BMI、WC、WHtR预测血压偏高的曲线下面积(the area under the curve,AUC)均>0.67(均P<0.01),男生、女生及总人群中预测效果最好的单一肥胖指标均为BMI,AUC分别为0.727、0.684、0.709(均P<0.05)。与BMI比较,BMI联合WC、BMI联合WHtR、BMI联合WC和WHtR预测血压偏高的AUC差异均无统计学意义(均P>0.05)。结论 江苏省淮安市12~17岁中学生BMI、WC、WHtR与血压偏高正相关,单一肥胖指标预测血压偏高效果最佳的是BMI,与WC、WHtR联合预测血压偏高没有显现更优的效果。
Objective To analyze the relationship between different obesity indices and elevated blood pressure(BP)among 12-17-year-old students in Huai'an,Jiangsu Province,and to evaluate the predictive value of different obesity indicators for elevated BP.Methods Utilizing data from the 2022 Jiangsu Provincial Student Common Diseases and Health Risk Factors Surveillance Program,a stratified cluster random sampling method was employed to measure height,weight,waist circumference(WC),and BP in adolescents aged 12-17 in Huai'an.Binary logistic regression was used to analyze the associations between body mass index(BMI),WC,waist-to-height ratio(WHtR),and elevated BP.Receiver operating characteristic(ROC)curve analysis was performed to assess the predictive performance of individual and combined obesity indices.Results Among 5681 adolescents,995(17.51%)exhibited elevated BP.Analysis of covariance revealed that obese,high-WC,and abdominal obesity groups had significantly higher systolic and diastolic BP levels(all P<0.05).The prevalence of elevated BP was also significantly higher in these groups(all P<0.01).Binary logistic regression demonstrated positive associations between BMI,WC,WHtR,and elevated BP risk(all P<0.01).ROC analysis showed that BMI,WC,and WHtR all had area under the curve(AUC)values>0.67(all P<0.001).BMI emerged as the strongest single predictor(AUC:0.727 in males,0.684 in females,0.709 overall;all P<0.05).No statistically significant improvement in AUC was observed when combining BMI with WC,WHtR,or both(all P>0.05).Conclusions Among adolescents in Huai'an,BMI,WC,and WHtR were positively associated with elevated BP.BMI demonstrated superior predictive performance as a single indicator,with no additional benefit from combining it with WC or WHtR.These findings suggest that BMI alone may suffice for BP risk stratification in this population.
作者
付瑞
张锡彦
李鸿萱
陈俐如
朱鹏
葛恒康
王小莉
FU Rui;ZHANG Xiyan;LI Hongxuan;CHEN Liru;ZHU Peng;GE Hengkang;WANG Xiaoli(Huai'an Center for Disease Control and Prevention,Huai'an,Jiangsu 223001,China;Jiangsu Province Field Epidemiology Training Program;Jiangsu Provincial Center for Disease Control and Prevention;Nanjing Medical University)
出处
《华南预防医学》
2025年第8期845-850,共6页
South China Journal of Preventive Medicine
关键词
中学生
肥胖指标
体质指数
腰围
腰围身高比
血压偏高
Middle school students
Obesity indices
Body mass index
Waist circumference
Waist-to-height ratio
Elevated blood pressure
