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Jeong SI, Kim SH. Obesity and hypertension in children and adolescents. Clin Hypertens 2024; 30:23. [PMID: 39217385 PMCID: PMC11366140 DOI: 10.1186/s40885-024-00278-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 05/28/2024] [Indexed: 09/04/2024] Open
Abstract
As childhood obesity rates increase worldwide, the prevalence of obesity-related hypertension is also on the rise. Obesity has been identified as a significant risk factor for hypertension in this age group. National Health Surveys and meta-analyses show increasing trends in obesity and pediatric hypertension in obese children. The diagnosis of hypertension in children involves percentiles relative to age, sex, and height, unlike in adults, where absolute values are considered. Elevated blood pressure (BP) in childhood is consistently associated with cardiovascular disease in adulthood, emphasizing the need for early detection and intervention. The pathogenesis of hypertension in obesity involves multiple factors, including increased sympathetic nervous system activity, activation of the renin-angiotensin-aldosterone system (RAAS), and renal compression due to fat accumulation. Obesity disrupts normal RAAS suppression and contributes to impaired pressure natriuresis and sodium retention, which are critical factors in the development of hypertension. Risk factors for hypertension in obesity include degree, duration, and distribution of obesity, patient age, hormonal changes during puberty, high-sodium diet, sedentary lifestyle, and socioeconomic status. Treatment involves lifestyle changes, with weight loss being crucial to lowering BP. Medications such as angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers may be considered first, and surgical approaches may be an option for severe obesity, requiring tailored antihypertensive medications that consider individual pathophysiology to avoid exacerbating insulin resistance and dyslipidemia.
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Affiliation(s)
- Soo In Jeong
- Department of Pediatrics, Ajou University Hospital, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sung Hye Kim
- Department of Pediatrics, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam-si, Gyeonggido, Republic of Korea.
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Wang Q, Xie T, Huo X, Snieder H, Corpeleijn E. Diet Quality at 3 Years of Age Relates to Lower Body Mass Index but Not Lower Blood Pressure at 10 Years of Age. Nutrients 2024; 16:2634. [PMID: 39203771 PMCID: PMC11356893 DOI: 10.3390/nu16162634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Revised: 07/26/2024] [Accepted: 07/31/2024] [Indexed: 09/03/2024] Open
Abstract
A healthy diet prevents overweight problems and hypertension. We investigated the associations of a healthy diet with the body mass index (BMI) and blood pressure (BP) in early childhood. In the GECKO birth cohort, height, weight, and BP were measured at 5 and 10 years of age. Diet was evaluated at 3 years using three diet scores: the Dietary Approaches to Stop Hypertension (DASH), the Mediterranean Diet Score (MDS), and the Lifelines Diet Score (LLDS). Linear and logistic regression models assessed the associations of diet scores with the BMI and BP. Of the 1077 children included, 10.8% were overweight or obese at 5 years. That number was 16.5% at 10 years. In addition, 34.5% had elevated BP at 5 years. That number was 23.9% at 10 years. Higher DASH, MDS, and LLDS, which indicate healthier diets, were all associated with lower BMI z-scores at 10 years of age. Higher DASH is related to lower overweight risk at 10 years. None of the diet scores were associated with BP or elevated BP at either 5 or 10 years. Also, in an overweight subset, diet was not related to BP. A healthy diet in early childhood is related to children being less overweight but not having lower BP at 10 years of age.
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Affiliation(s)
- Qihua Wang
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, College of Environment and Climate, Jinan University, Guangzhou 511443, China;
| | - Tian Xie
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
| | - Xia Huo
- Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, College of Environment and Climate, Jinan University, Guangzhou 511443, China;
| | - Harold Snieder
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
| | - Eva Corpeleijn
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, 9713 GZ Groningen, The Netherlands; (Q.W.); (H.S.)
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Chen Y, Dangardt F, Gelander L, Friberg P. Childhood BMI trajectories predict cardiometabolic risk and perceived stress at age 13 years: the STARS cohort. Obesity (Silver Spring) 2024; 32:583-592. [PMID: 38112244 DOI: 10.1002/oby.23966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 10/30/2023] [Accepted: 11/08/2023] [Indexed: 12/21/2023]
Abstract
OBJECTIVE The aim of this study was to examine BMI trajectories from birth throughout childhood, associations with health outcomes at age 13 years, and time frames during which early-life BMI influenced adolescent health. METHODS Participants (1902, 44% male) reported perceived stress and psychosomatic symptoms and were examined for waist circumference (WC), systolic blood pressure (SBP), pulse wave velocity, and white blood cell counts (WBC). BMI trajectory was analyzed using group-based trajectory modeling of retrospective data of weight/height from birth throughout childhood. The authors performed linear regression to assess associations between BMI trajectories and health outcomes at age 13 years, presented as estimated mean differences with 95% CI among trajectories. RESULTS Three BMI trajectories were identified: normal; moderate; and excessive gain. Adjusting for covariates, adolescents with excessive gain had higher WC (19.2 [95% CI: 18.4-20.0] cm), SBP (3.6 [95% CI: 2.4-4.4] mm Hg), WBC (0.7 [95% CI: 0.4-0.9] × 109 /L), and stress (1.1 [95% CI: 0.2-1.9]) than adolescents with normal gain. Higher WC (6.4 [95% CI: 5.8-6.9] cm), SBP (1.8 [95% CI: 1.0-2.5] mm Hg), and stress (0.7 [95% CI: 0.1-1.2]) were found in adolescents with moderate versus normal gain. The association of early-life BMI with SBP started around age 6 years with the excessive gain group, which was earlier than in the normal and moderate gain groups, in which it started at age 12 years. CONCLUSIONS An excessive gain BMI trajectory from birth predicts cardiometabolic risk and stress in 13-year-old individuals.
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Affiliation(s)
- Yun Chen
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Frida Dangardt
- Paediatric Heart Centre, The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Lars Gelander
- Department of Physiology/Endocrinology, Institute of Neuroscience & Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Peter Friberg
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Wang Y, Li W, Chen S, Zhang J, Liu X, Jiang J, Chen L, Tang Z, Wan X, Lian X, Liang B, Xie S, Ma J, Guo X, Dong Y, Wu L, Li J, Koutrakis P. PM 2.5 constituents associated with childhood obesity and larger BMI growth trajectory: A 14-year longitudinal study. ENVIRONMENT INTERNATIONAL 2024; 183:108417. [PMID: 38199130 DOI: 10.1016/j.envint.2024.108417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 12/31/2023] [Accepted: 01/02/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND The association of specific PM2.5 chemical constituents with childhood overweight or obesity (OWOB) remain unclear. Furthermore, the long-term impacts of PM2.5 exposure on the trajectory of children's body mass index (BMI) have not been explored. METHODS We conducted a longitudinal study among 1,450,830 Chinese children aged 6-19 years from Beijing and Zhongshan in China during 2005-2018 to examine the associations of PM2.5 and its chemical constituents with incident OWOB risk. We extracted PM2.5 mass and five main component exposure from Tracking Air Pollution in China (TAP) dataset. Cox proportional hazards models were applied to quantify exposure-response associations. We further performed principal component analysis (PCA) to handle the multi-collinearity and used quantile g-computation (QGC) approach to analyze the impacts of exposure mixtures. Additionally, we selected 125,863 children with at least 8 physical examination measurements and combined group-based trajectory models (GBTM) with multinomial logistic regression models to explore the impacts of exposure to PM2.5 mass and five constituents on BMI and BMI Z-score trajectories during 6-19 years. RESULTS We observed each interquartile range increment in PM2.5 exposure was significantly associated with a 5.1 % increase in the risk of incident OWOB (95 % confidence Interval [CI]: 1.036-1.066). We also found black carbon, sulfate, organic matter, often linked to fossil combustion, had comparable or larger estimates of the effect (HR = 1.139-1.153) than PM2.5. Furthermore, Exposure to PM2.5 mass, sulfate, nitrate, ammonium, organic matter and black carbon was significantly associated with an increased odds of being in a larger BMI trajectory and being assigned to persistent OWOB trajectory. CONCLUSIONS Our findings provide evidence that the constituents mainly from fossil fuel combustion may have a perceptible influence on increased OWOB risk associated with PM2.5 exposure in China. Moreover, long-term exposure to PM2.5 contributes to an increased odds of being in a lager BMI and a persistent OWOB trajectories.
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Affiliation(s)
- Yaqi Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Weiming Li
- Beijing Health Center for Physical Examination, Beijing 100191, China; Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing 100069, China
| | - Shuo Chen
- Beijing Health Center for Physical Examination, Beijing 100191, China; Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing 100069, China
| | - Jingbo Zhang
- Beijing Health Center for Physical Examination, Beijing 100191, China; Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing 100069, China
| | - Xiangtong Liu
- Beijing Health Center for Physical Examination, Beijing 100191, China; Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing 100069, China
| | - Jun Jiang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Li Chen
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Ziqi Tang
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Xiaoyu Wan
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Xinyao Lian
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Baosheng Liang
- Department of Biostatistics, School of Public Health, Peking University, Beijing 100191, China
| | - Shaodong Xie
- State Key Joint Laboratory of Environment Simulation and Pollution Control, College of Environmental Sciences and Engineering, Peking University, Beijing 100871, China
| | - Jun Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China
| | - Xiuhua Guo
- Beijing Health Center for Physical Examination, Beijing 100191, China; Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing 100069, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Lijuan Wu
- Beijing Health Center for Physical Examination, Beijing 100191, China; Department of Epidemiology and Health Statistics, Capital Medical University School of Public Health, Beijing 100069, China.
| | - Jing Li
- Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing 100191, China.
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Li Y, Guo L, Zhang J, Tang X, Zhao F, Hu Y, Guo Y, Du X, Yang X, Lu C. Trajectories of spherical equivalent refraction from grades 1 to 4 in Chinese children. BMC Public Health 2023; 23:2500. [PMID: 38093233 PMCID: PMC10720137 DOI: 10.1186/s12889-023-17420-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/05/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The development trajectories of children's SER remain unknown. This study aimed to characterize spherical equivalent refraction (SER) trajectories during grades 1-4 in Chinese children. METHODS This prospective cohort study included 1226 first-grade non-myopic children from 12 public primary schools, randomly selected in two districts in Guangzhou, China. From November 2018 to March 2022, four-wave ocular examinations and questionnaire surveys have been completed. The group-based trajectory modeling was used to explore SER trajectories in grades 1-4. RESULTS All five trajectories showed an upward trend and rose faster after grade 2. Children in the sharp-developing (n = 44), high-developing (n = 136), and rapid-developing (n = 237) myopia groups developed myopia before grades 2, 3, and 4, respectively. Their SER development speed remained at a relatively high level after myopia, almost consistent with that before myopia. Children in the moderate-developing (n = 418) and low-developing (n = 391) non-myopia groups did not develop myopia before grade 4. Some characteristics in grade 1 were independently associated with SER trajectories, including sex, axial length, number of parents with myopia, residence, academic achievement, and the duration of outdoor activity. Based on the baseline characteristics, we established the model predicting the probability of children belonging to each group. CONCLUSIONS Myopia interventions are best started in grade 1 or preschool age. If interventions are not taken in time, the latest intervention window might be in grades 1, 2, and 3 for children with a high probability of belonging to the sharp-developing, high-developing, and rapid-developing myopia groups, respectively. The above probabilities might be predicted using the model we established. Moreover, the interventions for myopic children shouldn't be ignored.
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Affiliation(s)
- Yanzhi Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Jiayu Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Xianghua Tang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China
| | - Feng Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Guangzhou, 510060, China
| | - Yin Hu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Guangzhou, 510060, China
| | - Yangfeng Guo
- Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Xueying Du
- Health Promotion Center for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou, China
| | - Xiao Yang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, 54 Xianlie South Road, Guangzhou, 510060, China.
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-Sen University, 74 Zhongshan Rd 2, Guangzhou, 510080, China.
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Cui Y, Zhang F, Wang H, Wu J, Zhang D, Xing Y, Shen X. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension: a 6-year longitudinal study in Yantai, China. Hypertens Res 2023; 46:1840-1849. [PMID: 37095339 DOI: 10.1038/s41440-023-01286-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 03/28/2023] [Accepted: 04/04/2023] [Indexed: 04/26/2023]
Abstract
Few longitudinal studies have examined the effect of weight status change on blood pressure change over time and incidence of hypertension among Chinese children. The longitudinal study enrolled 17,702 Chinese children aged 7 years in Yantai in 2014 as baseline, with a continuous 5 years of follow-up to 2019. Generalized estimating equation model was fitted to examine the main and interaction effects of weight status change and time with blood pressure and the incidence of hypertension. Compared with the participants who remained normal weight, the participants who remained overweight or obese had higher systolic blood pressure (SBP) (β = 2.89, p < 0.001) and diastolic blood pressure (DBP) (β = 1.79, p < 0.001). Significant interactions were identified between weight status change and time with SBP (χ2interaction = 697.77, p < 0.001) and DBP (χ2interaction = 270.49, p < 0.001). The odds ratio (OR) and 95% confidence interval (CI) of hypertension were 1.70 (1.59-1.82) for participants who appeared overweight or obese, 2.26 (2.14-2.40) for participants who remained overweight or obese, compared with the participants who remained normal weight. Those who switched from overweight or obesity to normal weight had almost the same risk of developing hypertension (OR = 1.13, 95% CI: 1.02 to 1.26) as children who remained normal weight. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension, whereas losing weight could reduce blood pressure and the risk of hypertension. Children who appeared or remained overweight or obese predict a higher follow-up blood pressure and higher risk of hypertension, whereas losing weight could reduce blood pressure and the risk of hypertension.
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Affiliation(s)
- Yixin Cui
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Fan Zhang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Hao Wang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Jianyan Wu
- Department of Anesthetized One, Jiaozhou People's Hospital of Qingdao, Qingdao, Shandong Province, China
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China
| | - Yufang Xing
- Institute of Infectious Disease Control and Prevention, Shandong Center for Disease Control and Prevention, Jinan, Shandong Province, China.
| | - Xiaoli Shen
- Department of Epidemiology and Health Statistics, Medical College of Qingdao University, Qingdao, 266071, China.
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Suwannawong PR, Auemaneekul N, Powwattana A, Chongsuwat R. Ecological system theory and community participation to promote healthy food environments for obesity and non-communicable diseases prevention among school-age children. Public Health Nutr 2023; 26:1488-1500. [PMID: 36847284 PMCID: PMC10346019 DOI: 10.1017/s136898002300040x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/20/2022] [Accepted: 11/15/2022] [Indexed: 03/01/2023]
Abstract
OBJECTIVES To implement and evaluate the effectiveness of the community participatory program between school and family based on ecological system theory and participatory action research. The intervention covers three levels at the individual, family and school levels and involves educating students and parents by using technology, reducing sedentary behaviours, increasing exercise and changing to healthy food environments at school and at home. DESIGN A quasi-experimental design was used in this study. SETTING Public primary school in Thailand. SUBJECTS The participants in the study included 138 school-age children in grades 2-6 with their parents/guardians. The control group consisted of 134 school-age children at a school of the same size with their parents/guardians. RESULTS Results show that nutritional status was significantly improved within the experimental group (P value = 0·000) and between groups during follow-up (P value = 0·032). Students' knowledge about obesity and non-communicable chronic diseases (NCD) prevention, as well as physical activity and exercise behaviours, in the experimental group was significantly higher than that in the control group (P value = 0·000 and 0·044, respectively). Parents' perceptions of child obesity and family modelling behaviours in the experimental group were also significantly higher than that in the control group; P value = 0·013 and 0·000, respectively). CONCLUSION The community participation program was found to be successful. Not only students, families and schools improved health behaviours and healthy food environments at home and school, but the students' long-term nutritional status also improved.
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Affiliation(s)
- Pennapa Ritwong Suwannawong
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Thung Phaya Thai, Ratchathewi District, Bangkok10400, Thailand
| | - Naruemon Auemaneekul
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Thung Phaya Thai, Ratchathewi District, Bangkok10400, Thailand
| | - Arpaporn Powwattana
- Department of Public Health Nursing, Faculty of Public Health, Mahidol University, 420/1 Ratchawithi Road, Thung Phaya Thai, Ratchathewi District, Bangkok10400, Thailand
| | - Rewadee Chongsuwat
- Department of Nutrition, Faculty of Public Health, Mahidol University, Bangkok, Thailand
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Hu J, Yang YD. Editorial: Dietary and lifestyle factors associated with hypertension among children and adolescents. Front Pediatr 2023; 11:1212385. [PMID: 37388291 PMCID: PMC10305749 DOI: 10.3389/fped.2023.1212385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 05/12/2023] [Indexed: 07/01/2023] Open
Affiliation(s)
- Jia Hu
- Department of School Health, Suzhou Center for Disease Prevention and Control, Suzhou, China
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, China
- Suzhou Institute of Advanced Study in Public Health, Gusu School, Nanjing Medical University, Suzhou, China
| | - Yi-De Yang
- Key Laboratory of Molecular Epidemiology of Hunan Province, School of Medicine, Hunan Normal University, Changsha, China
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Wang X, Dong Y, Huang S, Dong B, Ma J, Liang W. Change of weight status during school age and its association with late adolescent blood pressure: Results from a 15-year longitudinal study in China. Front Public Health 2022; 10:980973. [PMID: 36062130 PMCID: PMC9437432 DOI: 10.3389/fpubh.2022.980973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
Background Change in obesity risk could be related to shift in high blood pressure (HBP) risk, while individualized influence of weight change on high blood pressure is in need of exploration. Methods A total of 16,446 children (53.47% boys) and 13,9021 effective annual measurements from 2006 to 2020 were recruited. Children's weight status, both at baseline and endpoint, was categorized as underweight, normal, overweight, and obese according to the age and sex-specific Body Mass Index z scores. HBP at late adolescence was defined with the last two measurements for each child. Populational attributable risk (PAR) of weight trait on HBP risk was calculated. Results Compared to children who maintained normal weight during follow-up, staying obese was associated with the highest HBP risk with OR of 6.39 (95% CI: 4.46, 9.15; p < 0.001) and PAR of 28.71% (95% CI: 21.58, 35.54) in boys, and OR of 6.12 (95% CI: 2.80, 13.37; p < 0.001) and PAR of 12.75% (95% CI: 4.29, 21.02) in girls. Returning from obese to normal weight was associated with lowered HBP risk, with ORs of 1.07 (95% CI: 0.69, 1.66; p = 0.771) in boys and 0.73 (95% CI: 0.25, 2.12; p = 0.566) in girls. Conclusion Weight loss program could be effective to reduce HBP risk during school age, while the underlying mechanism needs further exploration.
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Affiliation(s)
- Xijie Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Sizhe Huang
- Zhongshan Health Care Center for Primary and Secondary Schools, Zhongshan, China
| | - Bin Dong
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China,*Correspondence: Bin Dong
| | - Jun Ma
- Institute of Child and Adolescent Health & School of Public Health, Peking University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China,Institute for Healthy China, Tsinghua University, Beijing, China,Wannian Liang
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