中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2013年
8期
726-730
,共5页
邹志勇%马军%王海俊%付连国%董彬%阳益德
鄒誌勇%馬軍%王海俊%付連國%董彬%暘益德
추지용%마군%왕해준%부련국%동빈%양익덕
青春期%月经初潮%血压%模型,统计学
青春期%月經初潮%血壓%模型,統計學
청춘기%월경초조%혈압%모형,통계학
Puberty%Menarche%Blood pressure%Models,statistical
目的 分析中国7～17岁女生青春期月经初潮较早与血压水平的关系.方法 从2010年全国学生体质与健康调研资料中,选择体测项目(身高、体重、血压等)、月经初潮史等资料记录完整的7～17岁女生作为研究对象,共76 869名.采用概率单位回归法计算女生月经初潮年龄的第10百分位数(P10)概率界值,月经初潮出现年龄小于其对应的界值定义为初潮时间较早,按城乡、年龄进行1∶2匹配未来初潮者,初潮较早者和未来潮者分别作为初潮较早组和未来潮组,收缩压或舒张压大于其对应的同年龄第95百分位数(P95)值定义为“收缩压或舒张压偏高”,收缩压和(或)舒张压大于其对应的同年龄P95值定义为“血压偏高”.采用x2检验分析已来潮和未来潮女生血压偏高检出率的差异,并用多水平模型分析初潮较早与血压水平的关系.结果 76 869名女生身高为(152.2±10.4)cm,BMI为(18.7±3.1) kg/m2,收缩压和舒张压值分别为(103.4±11.0) mm Hg(1 mm Hg =0.133 kPa)和(65.0±9.1) mm Hg,已来潮女生有47 942名(62.4％),未来潮女生有28 927名(37.6％).女生9岁开始出现月经初潮,13岁时有81.5％(7123/8736)的女生已出现月经来潮.11岁组、12岁组、13岁组已来潮女生血压偏高的检出率分别为6.71％ (100/1490)、5.99％(265/4423) 、5.38％(383/7123),明显高于同龄未来潮女生的3.78％ (265/7005)、3.33％ (144/4328)、4.09％(66/1613),差异有统计学意义(x2值分别为25.62、32.36、4.46,P值均＜0.05).初潮较早者年龄在9～11岁,其中11岁组血压偏高、收缩压偏高、舒张压偏高的检出率分别为6.08％ (49/806)、4.84％(39/806)、3.35％ (27/806),明显高于同年龄未来潮组的3.11％ (50/1607)、2.30％(37/1607)、1.43％ (23/1607),差异有统计学意义(x2值分别为12.02、11.32、9.74,P值均＜0.01).多水平模型分析显示,在控制了不同省(自治区、直辖市)和年龄后,初潮较早者血压偏高的检出率仍然高于同龄未来潮者[OR =2.188(95％ CI:1.254～3.818)],其中初潮较早者收缩压和舒张压偏高的检出率均高于同龄未来潮者[OR(95％ CI)值分别为1.925(1.097～3.379)、2.088(1.072 ～4.065)].结论 月经初潮较早可能与血压升高有关联,可能会导致我国儿童青少年血压升高的年龄进一步提前.
目的 分析中國7～17歲女生青春期月經初潮較早與血壓水平的關繫.方法 從2010年全國學生體質與健康調研資料中,選擇體測項目(身高、體重、血壓等)、月經初潮史等資料記錄完整的7～17歲女生作為研究對象,共76 869名.採用概率單位迴歸法計算女生月經初潮年齡的第10百分位數(P10)概率界值,月經初潮齣現年齡小于其對應的界值定義為初潮時間較早,按城鄉、年齡進行1∶2匹配未來初潮者,初潮較早者和未來潮者分彆作為初潮較早組和未來潮組,收縮壓或舒張壓大于其對應的同年齡第95百分位數(P95)值定義為“收縮壓或舒張壓偏高”,收縮壓和(或)舒張壓大于其對應的同年齡P95值定義為“血壓偏高”.採用x2檢驗分析已來潮和未來潮女生血壓偏高檢齣率的差異,併用多水平模型分析初潮較早與血壓水平的關繫.結果 76 869名女生身高為(152.2±10.4)cm,BMI為(18.7±3.1) kg/m2,收縮壓和舒張壓值分彆為(103.4±11.0) mm Hg(1 mm Hg =0.133 kPa)和(65.0±9.1) mm Hg,已來潮女生有47 942名(62.4％),未來潮女生有28 927名(37.6％).女生9歲開始齣現月經初潮,13歲時有81.5％(7123/8736)的女生已齣現月經來潮.11歲組、12歲組、13歲組已來潮女生血壓偏高的檢齣率分彆為6.71％ (100/1490)、5.99％(265/4423) 、5.38％(383/7123),明顯高于同齡未來潮女生的3.78％ (265/7005)、3.33％ (144/4328)、4.09％(66/1613),差異有統計學意義(x2值分彆為25.62、32.36、4.46,P值均＜0.05).初潮較早者年齡在9～11歲,其中11歲組血壓偏高、收縮壓偏高、舒張壓偏高的檢齣率分彆為6.08％ (49/806)、4.84％(39/806)、3.35％ (27/806),明顯高于同年齡未來潮組的3.11％ (50/1607)、2.30％(37/1607)、1.43％ (23/1607),差異有統計學意義(x2值分彆為12.02、11.32、9.74,P值均＜0.01).多水平模型分析顯示,在控製瞭不同省(自治區、直轄市)和年齡後,初潮較早者血壓偏高的檢齣率仍然高于同齡未來潮者[OR =2.188(95％ CI:1.254～3.818)],其中初潮較早者收縮壓和舒張壓偏高的檢齣率均高于同齡未來潮者[OR(95％ CI)值分彆為1.925(1.097～3.379)、2.088(1.072 ～4.065)].結論 月經初潮較早可能與血壓升高有關聯,可能會導緻我國兒童青少年血壓升高的年齡進一步提前.
목적 분석중국7～17세녀생청춘기월경초조교조여혈압수평적관계.방법 종2010년전국학생체질여건강조연자료중,선택체측항목(신고、체중、혈압등)、월경초조사등자료기록완정적7～17세녀생작위연구대상,공76 869명.채용개솔단위회귀법계산녀생월경초조년령적제10백분위수(P10)개솔계치,월경초조출현년령소우기대응적계치정의위초조시간교조,안성향、년령진행1∶2필배미래초조자,초조교조자화미래조자분별작위초조교조조화미래조조,수축압혹서장압대우기대응적동년령제95백분위수(P95)치정의위“수축압혹서장압편고”,수축압화(혹)서장압대우기대응적동년령P95치정의위“혈압편고”.채용x2검험분석이래조화미래조녀생혈압편고검출솔적차이,병용다수평모형분석초조교조여혈압수평적관계.결과 76 869명녀생신고위(152.2±10.4)cm,BMI위(18.7±3.1) kg/m2,수축압화서장압치분별위(103.4±11.0) mm Hg(1 mm Hg =0.133 kPa)화(65.0±9.1) mm Hg,이래조녀생유47 942명(62.4％),미래조녀생유28 927명(37.6％).녀생9세개시출현월경초조,13세시유81.5％(7123/8736)적녀생이출현월경래조.11세조、12세조、13세조이래조녀생혈압편고적검출솔분별위6.71％ (100/1490)、5.99％(265/4423) 、5.38％(383/7123),명현고우동령미래조녀생적3.78％ (265/7005)、3.33％ (144/4328)、4.09％(66/1613),차이유통계학의의(x2치분별위25.62、32.36、4.46,P치균＜0.05).초조교조자년령재9～11세,기중11세조혈압편고、수축압편고、서장압편고적검출솔분별위6.08％ (49/806)、4.84％(39/806)、3.35％ (27/806),명현고우동년령미래조조적3.11％ (50/1607)、2.30％(37/1607)、1.43％ (23/1607),차이유통계학의의(x2치분별위12.02、11.32、9.74,P치균＜0.01).다수평모형분석현시,재공제료불동성(자치구、직할시)화년령후,초조교조자혈압편고적검출솔잉연고우동령미래조자[OR =2.188(95％ CI:1.254～3.818)],기중초조교조자수축압화서장압편고적검출솔균고우동령미래조자[OR(95％ CI)치분별위1.925(1.097～3.379)、2.088(1.072 ～4.065)].결론 월경초조교조가능여혈압승고유관련,가능회도치아국인동청소년혈압승고적년령진일보제전.
Objective To investigate the association between early age at menarche and blood pressure in Chinese girls aged 7 to 17 years.Methods A total of 76 869 girls aged 7 to 17 years old were selected from the national physical fitness and health research in 2010,and probit analyses were used to calculate the average age of menarche for each province.Girls whose age were lower than the P10 of age at menarche were judged as early age at menarche,and matched with two selected participant without menarche based on the age and the same urban or rural areas.High blood pressure was defined as whose systolic pressure and/or diastolic pressure was higher than P95 of systolic pressure or diastolic pressure at the same age group.The difference of the rate of high blood pressure in girls with and without menarche by Chi-square test,and multilevel model was used to analyze the relationship between early age at menarche and blood pressure.Results In 76 869 grils,the values of hight and BMI were separately (152.2 ± 10.4) cm and (18.7 ± 3.1) kg/m2,while the systolic pressure and diastolic pressure were (103.4 ± 11.0) mm Hg (1 mm Hg =0.133 kPa)and (65.0 ±9.1) mm Hg respectively.In 47 942 girls (62.4％) had occurred menstruation while 28 927 girls (37.6％) without menstruation.The girls began to report menstruation at the age of 9,and 81.5％ (7123/8736) girls had already reported menstruation at the age of 13.The rate of high blood pressure in menstruation group from 11 to 13 years were separately 6.71％ (100/1490),5.99％(265/4423) and 5.38％ (383/7123),which was significant higher than 3.78％ (265/7005),3.33％(144/4328) and 4.09％ (66/1613) in the same age group of non-menstruation(the values of Chi-square were separately 25.62,32.36,4.46,and all P values ＜0.05).The mean age of early age at menarche was 9 to 11 years old,and the rate of high blood pressure,high systolic pressure,and high diastolic pressure at 11 years group was separately 6.08％ (49/806),4.84％ (39/806)and 3.35％ (27/806),which was significant higher than that in non-menstruation group (separately 3.11％ (50/1607),2.30％ (37/1607)and 1.43％ (23/1607),and the values of Chi-square were separately 12.02,11.32 and 9.74,while all P values ＜0.01).After adjusted by region and age,early age at menarche were separately associated with the rate of high blood pressure (OR =2.188 ; 95％ CI:1.254-3.818),high systolic pressure (OR =1.925 ;95 ％ CI:1.097-3.379) and high diastolic pressure (OR =2.088 ; 95 ％ CI:1.072-4.065).Conclusion Early age at menarche may be one of the influence factors of high blood pressure,which may contribute to early age of high blood pressure in Chinese children and adolescents.
