Objective: To examine the association of joint effect of overweight (including obesity) and elevated blood pressure (BP) with left ventricular hypertrophy (LVH) in children. Methods: A convenient cluster sampling method was used to conduct a cross-sectional survey from November 2017 to January 2018 in a primary school in Huantai County, Zibo City, Shandong Province. A total of 1 319 children aged 6-11 years old who had complete data on anthropometric indices and variables collected using a questionnaire were included in the study. LVH was defined as left ventricular mass index (LVMI) ≥90 th percentile for sex and age of this population. Based on weight status (yes vs. no) and elevated BP status (yes vs. no), all participants were divided into four subgroups (normal weight and normal BP, normal weight and elevated BP, overweight and normal BP, overweight and elevated BP). LVMI levels or prevalence of LVH across four subgroups were compared. The multivariate logistic regression model was used to examine the association of joint effect between overweight and elevated BP with LVH in children. Results: The age of children was (8.4±1.6) years, and boys accounted for 53.3% (n=703). There were significant differences in LVMI levels and prevalence of LVH across four subgroups (P<0.05); Children with both overweight and elevated BP (n=184) had the highest LVMI levels and prevalence of LVH [LVMI: (30.69±0.32) g/m(2.7); the prevalence of LVH: 24.46%]. After the adjustment for potential covariates, compared to children with both normal weight and normal BP (n=657), the risk of LVH in children with elevated BP alone (n=136) was not increased [OR (95%CI) was 0.89 (0.30-2.62)]. Children with overweight alone (n=342) [OR (95%CI) was 5.69(3.39-9.55)] and those with both overweight and elevated BP [OR (95%CI) was 9.45 (5.47-16.33)] were at higher risk of LVH. Conclusion: The joint effect between overweight and elevated BP could be highly correlated with LVH in children.
目的： 探讨儿童超重肥胖和血压偏高的联合作用与左心室肥厚的关系。 方法： 采用方便整群抽样的方法，以山东省淄博市桓台县某所小学作为调查点，于2017年11月至2018年1月进行了横断面调查，选取了该学校年龄6~11岁的所有儿童，所有体测指标和问卷变量均完整者共计1 319名。以左心室质量指数（LVMI）≥本人群性别和年龄别的P(90)作为左心室肥厚的判定标准。根据超重肥胖（是或否）和血压偏高（是或否），将研究对象分成4组，比较不同组之间的LVMI水平及左心室肥厚检出率，采用多因素logistic回归模型分析超重肥胖和血压偏高联合作用与左心室肥厚的关系。 结果： 调查对象年龄为（8.4±1.6）岁，男生占53.3%（703名）。4组中LVMI水平及左心室肥厚检出率差异均有统计意义（P<0.05）；超重肥胖且血压偏高组（184例）的LVMI水平及左心室肥厚检出率最高，分别为（30.69±0.32）g/m(2.7)和24.46%。与正常体重且正常血压组（657名）相比，正常体重且血压偏高组（136例）罹患左心室肥厚的风险未增加（OR=0.89，95%CI：0.30~2.62），超重肥胖且正常血压组（342例）罹患左心室肥厚的风险较高（OR=5.69，95%CI：3.39~9.55）。超重肥胖且血压偏高组罹患左心室肥厚的风险最高（OR=9.45，95%CI：5.47~16.33）。 结论： 儿童期超重肥胖和血压偏高与左心室肥厚存在较强关联。.
Keywords: Cross-sectional studies; Hypertension; Hypertrophy, left ventricular; Overweight.