目的建立儿童青少年血压多状态马尔可夫模型,探讨不同腰围分型与血压高值累积状态间的转移规律,估计状态间的转移概率和转移强度,并探讨血压状态变化的可能影响因素。方法基于1993—2022年中国健康与营养调查(China Health and Nutritio...目的建立儿童青少年血压多状态马尔可夫模型,探讨不同腰围分型与血压高值累积状态间的转移规律,估计状态间的转移概率和转移强度,并探讨血压状态变化的可能影响因素。方法基于1993—2022年中国健康与营养调查(China Health and Nutrition Survey,CHNS),对基线6~<18岁儿童青少年血压状态的转移进行纵向分析。将状态划分为正常血压(S0)、高血压前期(S1)和高血压(S2)。采用时间连续、状态离散的多状态马尔可夫模型估算转移强度与转移概率,并分析相关影响因素。结果共纳入2440名儿童青少年,男生1311名,女生1129名,中位随访时间7年,共观察到4569人次血压状态转移。基线中心型肥胖者S0→S1、S1→S2转移强度最高;高腰围者S0→S2转移强度高于腰围正常者。各转移概率随时间先升高后趋于平稳,既往出现高腰围者发展为高血压的概率均高于腰围持续正常者。与腰围持续正常组儿童青少年相比,首次高腰围发生在≥15岁者,S0→S1概率更高;发生在6~<18岁者,S1→S2概率更高;发生在6~<15岁者,S0→S2概率更高。影响因素分析显示,饮酒(HR=2.53)和米饭摄入(HR=1.49)增加S0→S1风险;吸烟(HR=2.88)、禽肉(HR=1.30)和烹调油(HR=1.13)摄入增加S0→S2风险;猪肉摄入(HR=2.12)增加S1→S2风险。猪肉(HR=0.77)、膳食钠(HR=0.70)不利于S1→S0,女性(HR=2.84)促进该逆转;面类摄入促进S2→S0(HR=1.72),面类(HR=2.31)、薯类(HR=1.45)、水产类(HR=1.34)促进S2→S1逆转。结论儿童青少年高腰围,尤其是中心型肥胖,与血压升高风险增加相关。与成年期出现高腰围者相比,6~<18岁发生高腰围者未来高血压患病风险更高。部分生活方式和膳食因素与血压状态转变相关。儿童青少年期是腰围管理和血压防控的关键窗口,应将防控关口前移。展开更多
目的 探讨孕妇孕晚期膳食酸负荷与婴儿体质指数Z评分(body mass index for age Z-score, BMIZ)轨迹的关系。方法 于2010年9月—2011年11月招募广州市468名孕晚期妇女为研究对象,孕妇分娩后随访其子代至1岁。孕妇于孕晚期完成基本情况问...目的 探讨孕妇孕晚期膳食酸负荷与婴儿体质指数Z评分(body mass index for age Z-score, BMIZ)轨迹的关系。方法 于2010年9月—2011年11月招募广州市468名孕晚期妇女为研究对象,孕妇分娩后随访其子代至1岁。孕妇于孕晚期完成基本情况问卷和连续3天24小时膳食回顾调查,于分娩后完成分娩情况及胎儿健康状况问卷调查。孕晚期膳食酸负荷采用潜在肾脏酸负荷(potential renal acid load, PRAL)、内源性酸净产生量(net endogenous acid production, NEAP)和动物蛋白与钾的比率(A∶K比率)进行计算,并根据各指标的四分位数进行分组。前瞻性追踪调查婴儿出生、1月龄、3月龄、6月龄以及1岁时的体重和身长,计算其BMIZ并采用潜类别增长模型(latent class growth model, LCGM)分析婴儿BMIZ轨迹。采用多元Logistic回归分析孕晚期膳食酸负荷与婴儿BMIZ轨迹的关系。结果 孕晚期PRAL[M(P25,P75)]为28.02(21.88,36.51)mEq/d, NEAP和A∶K比率(χ±s)为(81.58±15.41)mEq/d和22.62±6.80。膳食酸负荷与蔬菜、水果和豆类的摄入量呈显著负相关,与蛋类、禽肉、畜肉和海鲜类的摄入量呈显著正相关(P<0.01)。根据潜类别增长模型,识别出3类婴儿BMIZ轨迹组:较慢生长组(n=52)、适宜生长组(n=307)和较快生长组(n=54)。其中,较快生长组的婴儿其母亲的孕晚期NEAP低于另2个轨迹组(P<0.05)。多元Logistic回归分析显示,与最低四分位数组相比,孕晚期NEAP (OR=4.03,95%CI 1.01~16.14)和A∶K比率(OR=4.04,95%CI 1.30~12.59)处于最高四分位数组的孕妇其后代更有可能出现较慢生长轨迹。结论 孕晚期膳食酸负荷较高,尤其是NEAP和A∶K比率水平较高容易使婴儿出现较慢生长模式。展开更多
Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between ...Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between the adult NHHR and stroke occurrence in the United States of America(USA).Methods To clarify the relationship between the NHHR and stroke risk,this study used a multivariable logistic regression model and a restricted cubic spline(RCS)model to investigate the association between the NHHR and stroke,and data from the National Health and Nutrition Examination Survey(NHANES)from 2005 to 2018.Subgroup and sensitivity analyses were conducted to test the robustness of the results.Results This study included 29,928 adult participants,of which 1,165 participants had a history of stroke.Logistic regression analysis of variables demonstrated a positive association between NHHR and stroke(OR 1.24,95%CI:1.03-1.50,P=0.026).Compared with the lowest reference group of NHHR,participants in the second,third,and fourth quartile had a significantly increased risk of stroke after full adjustments(OR:1.35,95%CI:1.08-1.69)(OR:1.83,95%CI:1.42-2.36)(OR:2.04,95%CI:1.50-2.79).In the total population,a nonlinear dose-response relationship was observed between the NHHR and stroke risk(P non-linearity=0.002).This association remained significant in several subgroup analyses.Further investigation of the NHHR may enhance our understanding of stroke prevention and treatment.Conclusion Our findings suggest a positive correlation between the NHHR and an increased prevalence of stroke,potentially serving as a novel predictive factor for stroke.Timely intervention and management of the NHHR may effectively mitigate stroke occurrence.Prospective studies are required to validate this association and further explore the underlying biological mechanisms.展开更多
文摘目的建立儿童青少年血压多状态马尔可夫模型,探讨不同腰围分型与血压高值累积状态间的转移规律,估计状态间的转移概率和转移强度,并探讨血压状态变化的可能影响因素。方法基于1993—2022年中国健康与营养调查(China Health and Nutrition Survey,CHNS),对基线6~<18岁儿童青少年血压状态的转移进行纵向分析。将状态划分为正常血压(S0)、高血压前期(S1)和高血压(S2)。采用时间连续、状态离散的多状态马尔可夫模型估算转移强度与转移概率,并分析相关影响因素。结果共纳入2440名儿童青少年,男生1311名,女生1129名,中位随访时间7年,共观察到4569人次血压状态转移。基线中心型肥胖者S0→S1、S1→S2转移强度最高;高腰围者S0→S2转移强度高于腰围正常者。各转移概率随时间先升高后趋于平稳,既往出现高腰围者发展为高血压的概率均高于腰围持续正常者。与腰围持续正常组儿童青少年相比,首次高腰围发生在≥15岁者,S0→S1概率更高;发生在6~<18岁者,S1→S2概率更高;发生在6~<15岁者,S0→S2概率更高。影响因素分析显示,饮酒(HR=2.53)和米饭摄入(HR=1.49)增加S0→S1风险;吸烟(HR=2.88)、禽肉(HR=1.30)和烹调油(HR=1.13)摄入增加S0→S2风险;猪肉摄入(HR=2.12)增加S1→S2风险。猪肉(HR=0.77)、膳食钠(HR=0.70)不利于S1→S0,女性(HR=2.84)促进该逆转;面类摄入促进S2→S0(HR=1.72),面类(HR=2.31)、薯类(HR=1.45)、水产类(HR=1.34)促进S2→S1逆转。结论儿童青少年高腰围,尤其是中心型肥胖,与血压升高风险增加相关。与成年期出现高腰围者相比,6~<18岁发生高腰围者未来高血压患病风险更高。部分生活方式和膳食因素与血压状态转变相关。儿童青少年期是腰围管理和血压防控的关键窗口,应将防控关口前移。
文摘Objective The relationship between non-high-density lipoprotein(NHDL)cholesterol to high-density lipoprotein cholesterol(HDL-C)ratio(NHHR)and stoke remains unknown.This study aimed to evaluate the association between the adult NHHR and stroke occurrence in the United States of America(USA).Methods To clarify the relationship between the NHHR and stroke risk,this study used a multivariable logistic regression model and a restricted cubic spline(RCS)model to investigate the association between the NHHR and stroke,and data from the National Health and Nutrition Examination Survey(NHANES)from 2005 to 2018.Subgroup and sensitivity analyses were conducted to test the robustness of the results.Results This study included 29,928 adult participants,of which 1,165 participants had a history of stroke.Logistic regression analysis of variables demonstrated a positive association between NHHR and stroke(OR 1.24,95%CI:1.03-1.50,P=0.026).Compared with the lowest reference group of NHHR,participants in the second,third,and fourth quartile had a significantly increased risk of stroke after full adjustments(OR:1.35,95%CI:1.08-1.69)(OR:1.83,95%CI:1.42-2.36)(OR:2.04,95%CI:1.50-2.79).In the total population,a nonlinear dose-response relationship was observed between the NHHR and stroke risk(P non-linearity=0.002).This association remained significant in several subgroup analyses.Further investigation of the NHHR may enhance our understanding of stroke prevention and treatment.Conclusion Our findings suggest a positive correlation between the NHHR and an increased prevalence of stroke,potentially serving as a novel predictive factor for stroke.Timely intervention and management of the NHHR may effectively mitigate stroke occurrence.Prospective studies are required to validate this association and further explore the underlying biological mechanisms.
