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Article(id=1241522847282156186, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522846384583426, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202304360, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1681747200000, receivedDateStr=2023-04-18, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773931713170, onlineDateStr=2026-03-19, pubDate=1707494400000, pubDateStr=2024-02-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773931713170, onlineIssueDateStr=2026-03-19, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773931713170, creator=13701087609, updateTime=1773931713170, updator=13701087609, issue=Issue{id=1241522846384583426, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='3', pageStart='385', pageEnd='576', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773931712956, creator=13701087609, updateTime=1773931842201, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241523388544504301, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522846384583426, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241523388544504302, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241522846384583426, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=452, endPage=459, ext={EN=ArticleExt(id=1241522847642866331, articleId=1241522847282156186, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Study on cardiovascular health status and influencing factors of children and adolescents aged 7 to 17 years in five provinces of China in 2022, columnId=1228016568949474136, journalTitle=Modern Preventive Medicine, columnName=Child and Adolescent Health, Maternal and Child Health, runingTitle=null, highlight=null, articleAbstract=
Objective

To investigate the cardiovascular health status and influencing factors of children and adolescents aged 7 to 17 in five provinces and cities of China.

Methods

From April to November 2022, 9 schools (including 4 primary schools and 5 middle schools) were selected from Beijing, Hebei, Shandong, Jiangxi, and Hunan provinces. In total 2 166 students from the third grade of primary school to the third grade of senior high school were enrolled in the study. The methods of data collection included questionnaire, physical measurement, and laboratory test. According to the revised American Heart Association standard, cardiovascular health was evaluated by four health behavior indicators (smoking, BMI, physical exercise, and dietary evaluation) and three health factors (total cholesterol, blood pressure, and fasting blood glucose). The indicators were divided into ideal, moderate, and poor levels. The total average score of 7 indexes was calculated and divided into low, medium, and high-risk grades according to the score. Multiple logistic regression model was used to analyze the influencing factors of cardiovascular health status of children and adolescents.

Results

Students with 7 ideal cardiovascular health behaviors and factors accounted for 1.8%, and those with more than 5 ideal cardiovascular health behaviors and factors accounted for 48.7%. The proportion of girls with 2 or 4 cardiovascular health behaviors was significantly higher than that of boys (P=0.025). The proportion of children and adolescents from township and rural areas with 2 to 4 cardiovascular health behaviors, 2 to 3 cardiovascular health factors, and 4 to 7 cardiovascular health behaviors and factors were significantly higher than those from urban areas (P< 0.05). There were significant differences in the total average scores of cardiovascular health indexes among age, sex, sleep duration, urban and rural areas, regions, and income levels (P<0.05). Multiple logistic regression analysis showed that long sleep time, female, rural area, and family income were positively correlated with the decrease of cardiovascular risk of children and adolescents, while the increase of age and the decrease of cardiovascular risk of children and adolescents in the south were negatively correlated.

Conclusion

The cardiovascular health of children and adolescents aged 7 to 17 in five provinces and cities of China is generally at the middle level, and the proportion of 7 ideal cardiovascular health behaviors and factors is low. In the future, attention should be paid to the prevention and control of children and adolescents aged 12 to 17 years with short sleep time, urban, southern, and low family income, so as to improve cardiovascular health.

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目的

了解中国五省市7～17岁儿童青少年心血管健康状况及影响因素。

方法

2022年4—11月在北京、河北、山东、江西、湖南五省市选择9所学校(包括4所小学和5所中学)，将小学三年级至高中三年级的2 166名7～17岁学生纳入研究。资料收集方法包括调查问卷、体格测量和实验室检测。依据修正后美国心脏协会标准，通过4个健康行为指标(吸烟、BMI、体育锻炼和膳食评价)和3个健康因素指标(总胆固醇、血压和空腹血糖)评估心血管健康情况，指标分为理想、中、差3个水平。计算7个指标的总平均分，根据评分分为低、中和高3个风险等级，并使用多元logistic回归模型分析儿童青少年心血管健康状况的影响因素。

结果

具有7个理想心血管健康行为和因素的人群占比1.8%，具有5个以上理想心血管健康行为和因素的人群占比48.7%。女生具有2～4个心血管健康行为的比例显著高于男生(P=0.025)。来自于乡镇农村的儿童青少年具有2～4个心血管健康行为、2～3个心血管健康因素、4～7个心血管健康行为和因素的比例均显著高于来自于城市的儿童青少年(P<0.05)。心血管健康指标总平均分在年龄、性别、睡眠时长、城乡、地域和收入水平变量中存在显著的组间差异(P<0.05)。多元logistic回归分析显示睡眠时间长、女性、农村、家庭收入高与儿童青少年心血管风险降低呈正相关，而年龄增加和南方与儿童青少年心血管风险降低呈负相关。

结论

中国五省市7～17岁儿童青少年的心血管健康总体居于中等水平，具有7个理想心血管健康行为与因素比例较低。未来应对男性、年龄12～17岁、睡眠时间短、城市、南方和家庭收入低的儿童青少年进行重点防控，改善心血管健康。

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张霞，E-mail:
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高璨（1985—），女，硕士，副主任医师，研究方向：运动员医务监督、运动促进健康相关工作

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高璨（1985—），女，硕士，副主任医师，研究方向：运动员医务监督、运动促进健康相关工作

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Evaluation criteria for cardiovascular health assessment projects

, figureFileSmall=null, figureFileBig=null, tableContent=
指标较差水平中等水平理想水平
健康行为
吸烟情况过去1月内吸烟—从不吸烟或仅偶尔尝试过
BMI肥胖超重正常体重
体育锻炼(min/d)从不锻炼0～60≥60
健康膳食0～1个健康膳食行为2～3个健康膳食行为4～5个健康膳食行为
健康因素
总胆固醇(mmol/L)≥5.184.40～5.18<4.4
血压血压偏高正常高值正常血压
空腹血糖(mmol/L)≥7.05.60～7.00<5.6
), ArticleFig(id=1241680453875323494, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=CN, label=表1, caption=

CVH评估项目的评价标准

, figureFileSmall=null, figureFileBig=null, tableContent=
指标较差水平中等水平理想水平
健康行为
吸烟情况过去1月内吸烟—从不吸烟或仅偶尔尝试过
BMI肥胖超重正常体重
体育锻炼(min/d)从不锻炼0～60≥60
健康膳食0～1个健康膳食行为2～3个健康膳食行为4～5个健康膳食行为
健康因素
总胆固醇(mmol/L)≥5.184.40～5.18<4.4
血压血压偏高正常高值正常血压
空腹血糖(mmol/L)≥7.05.60～7.00<5.6
), ArticleFig(id=1241680453967598188, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=EN, label=Table 2, caption=

Baseline of children and adolescents of different genders aged 7 to 17 years ［n=2 166，（），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群性别居住区域
男生女生P值城市乡镇农村P值
人数2 1661 1561 0101 233933
年龄(周岁)12.38±1.8512.50±1.9112.24±1.76<0.00112.11±1.7612.73±1.90<0.001
民族0.9030.364
汉族2 065(95.34)1 101(95.24)964(95.45)669(54.26)487(52.20)
其他101(4.66)55(4.76)46(4.55)564(45.74)446(47.80)
性别—0.364
男生———669(54.26)487(52.20)
女生———564(45.74)446(47.80)
身高(cm)157.16±12.52159.53 ± 13.81154.46±10.21<0.001157.83±12.86156.27±12.010.004
体重(kg)50.12±16.3653.20 ± 18.2446.60 ± 13.05<0.00151.18 ± 16.7748.72 ± 15.71<0.001
BMI(kg/m2)19.95 ± 4.7620.49 ± 5.0319.33 ± 4.36<0.00120.20 ± 4.8519.62 ± 4.620.005
居住地0.364—
城市1 233(56.93)669(57.87)564(55.84)——
乡镇农村933(43.07)487(42.13)446(44.16)———
家族史
高血压209(9.65)109(9.43)100(9.90)0.766159(12.90)50(5.36)<0.001
糖尿病96(4.43)49(4.24)47(4.65)0.71779(6.41)17(1.82)<0.001
高血脂128(5.91)66(5.71)62(6.14)0.740108(8.76)20(2.14)<0.001
心脏病42(1.94)18(1.56)24(2.38)0.22129(2.35)13(1.39)0.149
脑血管疾病21(0.97)14(1.21)7(0.69)0.31415(1.22)6(0.64)0.260
食物摄入
蔬菜/水果≥1次/d1 235(57.02)651(56.31)584(57.82)0.507831(67.40)404(43.30)<0.001
水产品≥1次/周2 002(92.43)1 066(92.21)936(92.67)0.7481 187(96.27)815(87.35)<0.001
全谷物≥1次/d366(16.90)196(16.96)170(16.83)0.985241(19.55)125(13.40)<0.001
豆/奶制品≥1次/d1 266(58.45)707(61.16)559(55.35)0.007800(64.88)466(49.95)<0.001
含糖饮料<1次/周304(14.04)145(12.54)159(15.74)0.038155(12.57)149(15.97)0.028
血压(mm Hg#)
收缩压113.05±13.66115.41±14.06110.28±12.62<0.001115.61±13.33110.04±13.43<0.001
舒张压69.23 ± 9.4768.75±8.2369.63 ± 10.400.13869.91 ± 9.7068.43 ± 9.130.014
总胆固醇(mmol/L*)4.12 ± 0.714.08±0.714.17 ± 0.710.0084.18 ± 0.704.00 ± 0.71<0.001
空腹血糖(mmol/L*)4.79 ± 0.624.84±0.464.73 ± 0.75<0.0014.87 ± 0.574.60 ± 0.67<0.001
), ArticleFig(id=1241680454185702011, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=CN, label=表2, caption=

7～17岁不同性别儿童青少年的基本情况［n=2 166，（），n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人群性别居住区域
男生女生P值城市乡镇农村P值
人数2 1661 1561 0101 233933
年龄(周岁)12.38±1.8512.50±1.9112.24±1.76<0.00112.11±1.7612.73±1.90<0.001
民族0.9030.364
汉族2 065(95.34)1 101(95.24)964(95.45)669(54.26)487(52.20)
其他101(4.66)55(4.76)46(4.55)564(45.74)446(47.80)
性别—0.364
男生———669(54.26)487(52.20)
女生———564(45.74)446(47.80)
身高(cm)157.16±12.52159.53 ± 13.81154.46±10.21<0.001157.83±12.86156.27±12.010.004
体重(kg)50.12±16.3653.20 ± 18.2446.60 ± 13.05<0.00151.18 ± 16.7748.72 ± 15.71<0.001
BMI(kg/m2)19.95 ± 4.7620.49 ± 5.0319.33 ± 4.36<0.00120.20 ± 4.8519.62 ± 4.620.005
居住地0.364—
城市1 233(56.93)669(57.87)564(55.84)——
乡镇农村933(43.07)487(42.13)446(44.16)———
家族史
高血压209(9.65)109(9.43)100(9.90)0.766159(12.90)50(5.36)<0.001
糖尿病96(4.43)49(4.24)47(4.65)0.71779(6.41)17(1.82)<0.001
高血脂128(5.91)66(5.71)62(6.14)0.740108(8.76)20(2.14)<0.001
心脏病42(1.94)18(1.56)24(2.38)0.22129(2.35)13(1.39)0.149
脑血管疾病21(0.97)14(1.21)7(0.69)0.31415(1.22)6(0.64)0.260
食物摄入
蔬菜/水果≥1次/d1 235(57.02)651(56.31)584(57.82)0.507831(67.40)404(43.30)<0.001
水产品≥1次/周2 002(92.43)1 066(92.21)936(92.67)0.7481 187(96.27)815(87.35)<0.001
全谷物≥1次/d366(16.90)196(16.96)170(16.83)0.985241(19.55)125(13.40)<0.001
豆/奶制品≥1次/d1 266(58.45)707(61.16)559(55.35)0.007800(64.88)466(49.95)<0.001
含糖饮料<1次/周304(14.04)145(12.54)159(15.74)0.038155(12.57)149(15.97)0.028
血压(mm Hg#)
收缩压113.05±13.66115.41±14.06110.28±12.62<0.001115.61±13.33110.04±13.43<0.001
舒张压69.23 ± 9.4768.75±8.2369.63 ± 10.400.13869.91 ± 9.7068.43 ± 9.130.014
总胆固醇(mmol/L*)4.12 ± 0.714.08±0.714.17 ± 0.710.0084.18 ± 0.704.00 ± 0.71<0.001
空腹血糖(mmol/L*)4.79 ± 0.624.84±0.464.73 ± 0.75<0.0014.87 ± 0.574.60 ± 0.67<0.001
), ArticleFig(id=1241680454269588097, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=EN, label=Table 3, caption=

Cardiovascular health assessment indicators for children and adolescents of different genders aged 7 to 17 years ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
指标水平总人群(n=2 166)男生（n=1 156）女生（n=1 010）χ2值P值
体质指数48.4<0.001
理想情况1 500(69.25)726(62.8)774(76.6)
超重309(14.27)200(17.3)109(10.8)
肥胖357(16.48)230(19.9)127(12.6)
体育锻炼36.0<0.001
从不锻炼150(6.93)77(6.7)73(7.2)
<60min/d1 779(82.13)909(78.6)870(86.1)
≥60min/d237(10.94)170(14.7)67(6.6)
膳食情况0.1580.924
理想情况375(17.31)203(17.6)172(17.1)
中等情况1 237(57.11)656(56.7)581(57.5)
较差情况554(25.58)297(25.7)257(25.4)
吸烟4.80.028
理想情况2 155(99.49)1 146(99.1)1 009(99.9)
较差情况11(0.51)10(0.9)1 (0.1)
被动吸烟5.50.019
理想情况1 838(84.86)961(83.1)877(86.8)
较差情况328(15.14)195(16.9)133(13.2)
血压*0.70.696
正常范围641(65.01)348(65.3)293(64.7)
正常高值130(13.18)66(12.4)64(14.1)
血压偏高215(21.81)119(22.3)96(21.2)
总胆固醇#8.00.018
理想水平1 083(66.69)601(69.6)482(63.4)
中等水平414(25.49)196(22.7)218(28.7)
较差水平127(7.82)67(7.7)60(7.9)
空腹血糖#8.50.007
理想水平1 568(96.55)824(95.4)744(97.9)
中等水平52(3.20)38(4.4)14(1.8)
较差水平4(0.25)2(0.2)2(0.3)
总分
), ArticleFig(id=1241680454387028619, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=CN, label=表3, caption=

7～17岁不同性别儿童青少年CVH评估指标情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
指标水平总人群(n=2 166)男生（n=1 156）女生（n=1 010）χ2值P值
体质指数48.4<0.001
理想情况1 500(69.25)726(62.8)774(76.6)
超重309(14.27)200(17.3)109(10.8)
肥胖357(16.48)230(19.9)127(12.6)
体育锻炼36.0<0.001
从不锻炼150(6.93)77(6.7)73(7.2)
<60min/d1 779(82.13)909(78.6)870(86.1)
≥60min/d237(10.94)170(14.7)67(6.6)
膳食情况0.1580.924
理想情况375(17.31)203(17.6)172(17.1)
中等情况1 237(57.11)656(56.7)581(57.5)
较差情况554(25.58)297(25.7)257(25.4)
吸烟4.80.028
理想情况2 155(99.49)1 146(99.1)1 009(99.9)
较差情况11(0.51)10(0.9)1 (0.1)
被动吸烟5.50.019
理想情况1 838(84.86)961(83.1)877(86.8)
较差情况328(15.14)195(16.9)133(13.2)
血压*0.70.696
正常范围641(65.01)348(65.3)293(64.7)
正常高值130(13.18)66(12.4)64(14.1)
血压偏高215(21.81)119(22.3)96(21.2)
总胆固醇#8.00.018
理想水平1 083(66.69)601(69.6)482(63.4)
中等水平414(25.49)196(22.7)218(28.7)
较差水平127(7.82)67(7.7)60(7.9)
空腹血糖#8.50.007
理想水平1 568(96.55)824(95.4)744(97.9)
中等水平52(3.20)38(4.4)14(1.8)
较差水平4(0.25)2(0.2)2(0.3)
总分
), ArticleFig(id=1241680454496080532, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=EN, label=Table 4, caption=

Cardiovascular health assessment indicators for children and adolescents from different residences ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
指标水平城市
（n=1 233）		乡镇农村
（n=933）		χ2值P值
体质指数28.2<0.001
理想情况798(64.7)702(75.2)
超重197(16.0)1 122(12.0)
肥胖238(19.3)119(12.8)
体育锻炼55.8<0.001
从不锻炼47(3.8)103(11.1)
<60min/d1 021(82.8)758(81.2)
≥60min/d165(13.4)72(7.7)
膳食情况90.73<0.001
理想情况261(21.2)114(12.2)
中等情况747(60.6)490(52.5)
较差情况225(18.2)329(35.3)
吸烟1.20.224
理想情况1 229(99.7)926(99.2)
较差情况4(0.3)7(0.8)
被动吸烟0.30.562
理想情况1 041(84.4)797(85.4)
较差情况192(15.6)136(14.6)
血压*8.40.015
正常范围331(62.1)310(68.4)
正常高值67(12.6)63(13.9)
血压偏高135(25.3)80(17.7)
总胆固醇#10.50.005
理想水平716(64.2)367(72.2)
中等水平304(27.2)110(21.7)
较差水平96(8.6)31(6.1)
空腹血糖#5.50.039
理想水平1 071(96.0)497(97.8)
中等水平43(3.9)9(1.8)
较差水平2(0.1)2(0.4)
), ArticleFig(id=1241680454579966625, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=CN, label=表4, caption=

不同居住地儿童青少年CVH评估指标情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
指标水平城市
（n=1 233）		乡镇农村
（n=933）		χ2值P值
体质指数28.2<0.001
理想情况798(64.7)702(75.2)
超重197(16.0)1 122(12.0)
肥胖238(19.3)119(12.8)
体育锻炼55.8<0.001
从不锻炼47(3.8)103(11.1)
<60min/d1 021(82.8)758(81.2)
≥60min/d165(13.4)72(7.7)
膳食情况90.73<0.001
理想情况261(21.2)114(12.2)
中等情况747(60.6)490(52.5)
较差情况225(18.2)329(35.3)
吸烟1.20.224
理想情况1 229(99.7)926(99.2)
较差情况4(0.3)7(0.8)
被动吸烟0.30.562
理想情况1 041(84.4)797(85.4)
较差情况192(15.6)136(14.6)
血压*8.40.015
正常范围331(62.1)310(68.4)
正常高值67(12.6)63(13.9)
血压偏高135(25.3)80(17.7)
总胆固醇#10.50.005
理想水平716(64.2)367(72.2)
中等水平304(27.2)110(21.7)
较差水平96(8.6)31(6.1)
空腹血糖#5.50.039
理想水平1 071(96.0)497(97.8)
中等水平43(3.9)9(1.8)
较差水平2(0.1)2(0.4)
), ArticleFig(id=1241680454676435625, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=EN, label=Table 5, caption=

Distribution of ideal cardiovascular health indicators among children and adolescents aged 7 to 17 years ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
理想指标数性别居住区域合计(n=979)
男生
(n=530)		女生
(n=449)		χ2值P值城市
(n=526)		乡镇农村
(n=453)		χ2值P值
理想CVH行为（个）
00(0.0)0(0.0)——0(0.0)0(0.0)——0(0.0)
1120(22.6)75(16.7)5.3730.020116(22.1)79(17.4)3.2480.071195(19.9)
2265(50.0)259(57.6)1.7400.187244(46.4)283(62.5)36.5880.001527(53.8)
3121(22.8)105(24.1)0.0420.837135(28.1)81(17.9)8.5780.003226(23.1)
424(4.6)10(1.6)3.1840.07421(4.0)13(2.2)0.9150.33934(3.5)
2～4410(77.3)374(83.3)5.0070.025403(76.6)377(83.2)6.5600.010780(79.7)
理想CVH因素（个）
07(1.3)3(0.7)1.0240.3128(1.5)2(0.4)2.8050.09410(1.0)
158(10.9)62(13.8)1.8550.17377(14.6)43(9.5)5.9940.014120(12.3)
2220(41.5)201(44.8)1.0520.305238(45.2)183(40.4)2.3360.126421(43.0)
3245(46.3)183(40.8)2.9550.086203(38.6)225(49.7)12.1340.001428(43.7)
2～3465(87.8)384(85.6)1.0330.309441(83.8)408(90.1)8.1930.004849(86.7)
理想CVH行为和因素（个）
00(0.0)0(0.0)——0(0.0)0(0.0)——0(0.0)
11(0.2)2(0.4)0.5250.4693(0.6)0(0.0)2.5920.1073(0.3)
232(6.0)17(3.8)2.5920.10730(5.7)19(4.2)1.1660.28049(5.0)
372(13.6)66(14.7)0.2490.61886(16.3)52(11.5)4.7690.029138(14.1)
4159(30.0)153(34.1)1.8600.173162(30.8)150(33.1)0.6000.438312(31.9)
5184(34.7)159(35.4)0.0520.820161(30.6)182(40.2)9.7900.002343(35.0)
669(13.0)47(10.5)1.5150.21874(14.1)42(9.2)5.3620.021116(11.9)
713(2.5)5(1.1)2.4160.12010(1.9)8(1.8)0.0250.87518(1.8)
4～7425(80.2)364(81.1)0.1200.729407(77.4)382(84.3)7.5170.006789(80.6)
), ArticleFig(id=1241680454856790712, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=CN, label=表5, caption=

7～17岁儿童青少年具有不同CVH理想指标数的分布情况［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
理想指标数性别居住区域合计(n=979)
男生
(n=530)		女生
(n=449)		χ2值P值城市
(n=526)		乡镇农村
(n=453)		χ2值P值
理想CVH行为（个）
00(0.0)0(0.0)——0(0.0)0(0.0)——0(0.0)
1120(22.6)75(16.7)5.3730.020116(22.1)79(17.4)3.2480.071195(19.9)
2265(50.0)259(57.6)1.7400.187244(46.4)283(62.5)36.5880.001527(53.8)
3121(22.8)105(24.1)0.0420.837135(28.1)81(17.9)8.5780.003226(23.1)
424(4.6)10(1.6)3.1840.07421(4.0)13(2.2)0.9150.33934(3.5)
2～4410(77.3)374(83.3)5.0070.025403(76.6)377(83.2)6.5600.010780(79.7)
理想CVH因素（个）
07(1.3)3(0.7)1.0240.3128(1.5)2(0.4)2.8050.09410(1.0)
158(10.9)62(13.8)1.8550.17377(14.6)43(9.5)5.9940.014120(12.3)
2220(41.5)201(44.8)1.0520.305238(45.2)183(40.4)2.3360.126421(43.0)
3245(46.3)183(40.8)2.9550.086203(38.6)225(49.7)12.1340.001428(43.7)
2～3465(87.8)384(85.6)1.0330.309441(83.8)408(90.1)8.1930.004849(86.7)
理想CVH行为和因素（个）
00(0.0)0(0.0)——0(0.0)0(0.0)——0(0.0)
11(0.2)2(0.4)0.5250.4693(0.6)0(0.0)2.5920.1073(0.3)
232(6.0)17(3.8)2.5920.10730(5.7)19(4.2)1.1660.28049(5.0)
372(13.6)66(14.7)0.2490.61886(16.3)52(11.5)4.7690.029138(14.1)
4159(30.0)153(34.1)1.8600.173162(30.8)150(33.1)0.6000.438312(31.9)
5184(34.7)159(35.4)0.0520.820161(30.6)182(40.2)9.7900.002343(35.0)
669(13.0)47(10.5)1.5150.21874(14.1)42(9.2)5.3620.021116(11.9)
713(2.5)5(1.1)2.4160.12010(1.9)8(1.8)0.0250.87518(1.8)
4～7425(80.2)364(81.1)0.1200.729407(77.4)382(84.3)7.5170.006789(80.6)
), ArticleFig(id=1241680454995202751, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=EN, label=Table 6, caption=

Scores of cardiovascular health indicators in children and adolescents aged 7 to 17 years （）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量CVH行为分数CVH因素分数总分
分数t值或F值P值
年龄（岁）
7～1178.45±3.5471.69±4.7775.07±4.52-4.0520.035
12～1772.51±5.3770.11±5.8771.31±5.23
性别
男73.65±4.2272.87±3.2473.26±3.983.2370.041
女77.63±3.2775.34±3.0176.49±3.34
睡觉时长（h）
<773.35±4.2172.93±4.6673.14±3.865.8640.038
7.0～9.977.81±3.5876.18±4.0276.99±3.63
≥10.075.41±5.8374.92±4.0574.81±4.25
午休
不午休75.23±5.7173.19±3.6474.21±4.41-1.1250.682
午休74.16±4.5273.81±3.8273.99±4.11
城乡
城市72.25±3.4175.49±4.2373.87±4.052.9810.042
农村76.88±3.1975.92±3.9476.40±4.28
地域
北方75.26±3.9176.18±4.0275.72±3.55-4.2370.002
南方72.44±4.0773.15±3.4672.80±4.32
收入水平
低73.57±4.4372.64±3.7673.11±4.058.2150.028
中76.83±3.7176.19±4.1476.51±3.62
高75.79±2.9973.52±3.6674.66±4.22
), ArticleFig(id=1241680455133614799, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=CN, label=表6, caption=

7～17岁儿童青少年CVH指标得分情况（）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量CVH行为分数CVH因素分数总分
分数t值或F值P值
年龄（岁）
7～1178.45±3.5471.69±4.7775.07±4.52-4.0520.035
12～1772.51±5.3770.11±5.8771.31±5.23
性别
男73.65±4.2272.87±3.2473.26±3.983.2370.041
女77.63±3.2775.34±3.0176.49±3.34
睡觉时长（h）
<773.35±4.2172.93±4.6673.14±3.865.8640.038
7.0～9.977.81±3.5876.18±4.0276.99±3.63
≥10.075.41±5.8374.92±4.0574.81±4.25
午休
不午休75.23±5.7173.19±3.6474.21±4.41-1.1250.682
午休74.16±4.5273.81±3.8273.99±4.11
城乡
城市72.25±3.4175.49±4.2373.87±4.052.9810.042
农村76.88±3.1975.92±3.9476.40±4.28
地域
北方75.26±3.9176.18±4.0275.72±3.55-4.2370.002
南方72.44±4.0773.15±3.4672.80±4.32
收入水平
低73.57±4.4372.64±3.7673.11±4.058.2150.028
中76.83±3.7176.19±4.1476.51±3.62
高75.79±2.9973.52±3.6674.66±4.22
), ArticleFig(id=1241680455238472412, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=EN, label=Table 7, caption=

Analysis of influencing factors on cardiovascular health status of children and adolescents aged 7 to 17 years

, figureFileSmall=null, figureFileBig=null, tableContent=
变量较差水平中等水平理想水平
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
年龄（岁）
7～111.001.001.00
12～171.000.89(0.71～1.17)0.2860.72(0.58～0.87)0.013
性别
男1.001.001.00
女1.002.89(1.44～4.38)0.0313.21(2.57～4.01)0.017
睡觉时长（h）
<71.001.001.00
7.0～9.91.002.74(1.17～4.65)0.0023.18(1.36～7.61)0.004
≥10.01.001.96(0.77～3.87)0.3491.79(0.98～2.72)0.571
午休
不午休1.001.001.00
午休1.001.23(0.89～1.82)0.5141.08(0.76～1.67)0.391
城乡
城市1.001.001.00
农村1.002.05(1.32～2.67)0.0352.48(1.49～3.68)0.027
地域
北方1.001.001.00
南方1.000.62(0.46～0.84)0.0010.68(0.52～0.88)0.002
收入水平
低1.001.001.00
中1.001.67(1.27～2.21)0.0021.23(0.86～1.75)0.392
高1.001.13(0.82～1.57)0.4311.19(0.85～1.66)0.618
), ArticleFig(id=1241680455343330023, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241522847282156186, language=CN, label=表7, caption=

7～17岁儿童青少年CVH状况影响因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量较差水平中等水平理想水平
OR值(95%CI)P值OR值(95%CI)P值OR值(95%CI)P值
年龄（岁）
7～111.001.001.00
12～171.000.89(0.71～1.17)0.2860.72(0.58～0.87)0.013
性别
男1.001.001.00
女1.002.89(1.44～4.38)0.0313.21(2.57～4.01)0.017
睡觉时长（h）
<71.001.001.00
7.0～9.91.002.74(1.17～4.65)0.0023.18(1.36～7.61)0.004
≥10.01.001.96(0.77～3.87)0.3491.79(0.98～2.72)0.571
午休
不午休1.001.001.00
午休1.001.23(0.89～1.82)0.5141.08(0.76～1.67)0.391
城乡
城市1.001.001.00
农村1.002.05(1.32～2.67)0.0352.48(1.49～3.68)0.027
地域
北方1.001.001.00
南方1.000.62(0.46～0.84)0.0010.68(0.52～0.88)0.002
收入水平
低1.001.001.00
中1.001.67(1.27～2.21)0.0021.23(0.86～1.75)0.392
高1.001.13(0.82～1.57)0.4311.19(0.85～1.66)0.618
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2022年中国五省市7～17岁儿童青少年心血管健康状况及影响因素研究
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高璨 1 , 张剑梅 1 , 韩历丽 2 , 邵晶 1 , 张霞 1
现代预防医学 | 儿少卫生与妇幼保健 2024,51(3): 452-459
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现代预防医学 | 儿少卫生与妇幼保健 2024, 51(3): 452-459
2022年中国五省市7～17岁儿童青少年心血管健康状况及影响因素研究
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高璨1, 张剑梅1, 韩历丽2, 邵晶1, 张霞1
作者信息
  • 1.国家体育总局运动医学研究所，北京 100061
  • 2.首都医科大学附属北京妇产医院/北京妇幼保健院

    • 高璨（1985—），女，硕士，副主任医师，研究方向：运动员医务监督、运动促进健康相关工作

通讯作者:

张霞，E-mail:
Study on cardiovascular health status and influencing factors of children and adolescents aged 7 to 17 years in five provinces of China in 2022
Can GAO1, Jian-mei ZHANG1, Li-li HAN2, Jing SHAO1, Xia ZHANG1
Affiliations
  • Institute of Sports Medicine, General Administration of Sports, Beijing 100061, China
出版时间: 2024-02-10 doi: 10.20043/j.cnki.MPM.202304360
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摘要
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目的

了解中国五省市7～17岁儿童青少年心血管健康状况及影响因素。

方法

2022年4—11月在北京、河北、山东、江西、湖南五省市选择9所学校(包括4所小学和5所中学)，将小学三年级至高中三年级的2 166名7～17岁学生纳入研究。资料收集方法包括调查问卷、体格测量和实验室检测。依据修正后美国心脏协会标准，通过4个健康行为指标(吸烟、BMI、体育锻炼和膳食评价)和3个健康因素指标(总胆固醇、血压和空腹血糖)评估心血管健康情况，指标分为理想、中、差3个水平。计算7个指标的总平均分，根据评分分为低、中和高3个风险等级，并使用多元logistic回归模型分析儿童青少年心血管健康状况的影响因素。

结果

具有7个理想心血管健康行为和因素的人群占比1.8%，具有5个以上理想心血管健康行为和因素的人群占比48.7%。女生具有2～4个心血管健康行为的比例显著高于男生(P=0.025)。来自于乡镇农村的儿童青少年具有2～4个心血管健康行为、2～3个心血管健康因素、4～7个心血管健康行为和因素的比例均显著高于来自于城市的儿童青少年(P<0.05)。心血管健康指标总平均分在年龄、性别、睡眠时长、城乡、地域和收入水平变量中存在显著的组间差异(P<0.05)。多元logistic回归分析显示睡眠时间长、女性、农村、家庭收入高与儿童青少年心血管风险降低呈正相关，而年龄增加和南方与儿童青少年心血管风险降低呈负相关。

结论

中国五省市7～17岁儿童青少年的心血管健康总体居于中等水平，具有7个理想心血管健康行为与因素比例较低。未来应对男性、年龄12～17岁、睡眠时间短、城市、南方和家庭收入低的儿童青少年进行重点防控，改善心血管健康。

儿童青少年  /  横断面研究  /  心血管健康  /  膳食结构
Objective

To investigate the cardiovascular health status and influencing factors of children and adolescents aged 7 to 17 in five provinces and cities of China.

Methods

From April to November 2022, 9 schools (including 4 primary schools and 5 middle schools) were selected from Beijing, Hebei, Shandong, Jiangxi, and Hunan provinces. In total 2 166 students from the third grade of primary school to the third grade of senior high school were enrolled in the study. The methods of data collection included questionnaire, physical measurement, and laboratory test. According to the revised American Heart Association standard, cardiovascular health was evaluated by four health behavior indicators (smoking, BMI, physical exercise, and dietary evaluation) and three health factors (total cholesterol, blood pressure, and fasting blood glucose). The indicators were divided into ideal, moderate, and poor levels. The total average score of 7 indexes was calculated and divided into low, medium, and high-risk grades according to the score. Multiple logistic regression model was used to analyze the influencing factors of cardiovascular health status of children and adolescents.

Results

Students with 7 ideal cardiovascular health behaviors and factors accounted for 1.8%, and those with more than 5 ideal cardiovascular health behaviors and factors accounted for 48.7%. The proportion of girls with 2 or 4 cardiovascular health behaviors was significantly higher than that of boys (P=0.025). The proportion of children and adolescents from township and rural areas with 2 to 4 cardiovascular health behaviors, 2 to 3 cardiovascular health factors, and 4 to 7 cardiovascular health behaviors and factors were significantly higher than those from urban areas (P< 0.05). There were significant differences in the total average scores of cardiovascular health indexes among age, sex, sleep duration, urban and rural areas, regions, and income levels (P<0.05). Multiple logistic regression analysis showed that long sleep time, female, rural area, and family income were positively correlated with the decrease of cardiovascular risk of children and adolescents, while the increase of age and the decrease of cardiovascular risk of children and adolescents in the south were negatively correlated.

Conclusion

The cardiovascular health of children and adolescents aged 7 to 17 in five provinces and cities of China is generally at the middle level, and the proportion of 7 ideal cardiovascular health behaviors and factors is low. In the future, attention should be paid to the prevention and control of children and adolescents aged 12 to 17 years with short sleep time, urban, southern, and low family income, so as to improve cardiovascular health.

Children and adolescents  /  Cross-sectional study  /  Cardiovascular health  /  Dietary structure
高璨, 张剑梅, 韩历丽, 邵晶, 张霞. 2022年中国五省市7～17岁儿童青少年心血管健康状况及影响因素研究. 现代预防医学, 2024 , 51 (3) : 452 -459 . DOI: 10.20043/j.cnki.MPM.202304360
Can GAO, Jian-mei ZHANG, Li-li HAN, Jing SHAO, Xia ZHANG. Study on cardiovascular health status and influencing factors of children and adolescents aged 7 to 17 years in five provinces of China in 2022[J]. Modern Preventive Medicine, 2024 , 51 (3) : 452 -459 . DOI: 10.20043/j.cnki.MPM.202304360
正文
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根据世界卫生组织报道[1]，每年约有1 790万人死因与心血管疾病（cardiovascular disease,CVD）直接相关，占全体死亡总数的约31%，且约75%以上的死亡发生在中低收入国家。根据《中国心血管健康与疾病报告2021》[2]，我国2019年农村与城镇CVD占其总体死亡率的46.74%与44.26%。CVD仍是我国居民的首要死因。报告也指出，我国CVD发病人数的不断增加与CVD危险因素（高血压、肥胖与不良生活方式）的流行密切相关。2010年，美国心脏学会提出了“理想心血管健康（cardiovascular health, CVH）”的概念[3]，CVH指数与未来的全因死亡率与CVD死亡率负相关[4]。研究显示儿童青少年时期的CVH分数可预测其成年的CVH分数与患CVD的风险[5]，因此了解儿童青少年时期的CVH现状有助于CVD的防治。本研究对北京、河北、山东、江西、湖南五省市学龄儿童青少年进行CVH及相关健康行为现状的调查，为后续我国制订CVD防治策略提供理论基础。
1　对象与方法
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1.1　研究对象
先进行样本量估算，参考刘炜[6]论文中关于横断面研究的样本量估算公式及相关参数，公式如下：
其中K为分位数，取1.96；d为容许误差，取值为0.006。根据陈芳芳[7]等研究可知，2017—2018年北京市儿童青少年具有7个理想心血管指标的比例为1.7%，故将7个理想心血管指标占比P值设置为1.7%。将以上参数代入公式，最后得到的最下可信样本量N值为1 783。考虑到70%的问卷有效回收，则应发放的最小问卷量为2 547份。通过整群抽样的方法，于2022年4月2日—11月20日在北京、河北、山东、江西、湖南五省市内共选择了9所学校(包括4所小学、5所中学)进行调查研究。研究对象的纳入标准为：7～17岁的儿童青少年。排除标准为：患有先天性心脏病、1型糖尿病、慢性肾病、处于急性感染期正服用抗生素、有急性损伤不适合参与体测的儿童青少年。发放2 547份问卷，共收回问卷2 268份，根据纳入与排除标准最终纳入2 166名研究对象，年级覆盖范围为小学三年级至高中三年级。本研究方案经过国家体育总局运动医学研究所伦理委员会批准(批准号:202204)，所有研究对象签署知情同意书。
1.2　调查方法
1.2.1　调查问卷
接受统一培训的调查员对每名研究对象及其监护人进行事先填写讲解，再由研究对象及其监护人通过填写电子问卷的形式提交调查表。调查问卷内容包含以下内容：个人基本信息(性别、年龄、民族等)、城乡、午休(是、否)、疾病家族史(糖尿病、高血压、高血脂等)、个人近一周内的饮食情况(吃水果、蔬菜、水产品等食物的频率)、睡眠时长、体育锻炼情况(每天进行中、高强度运动的时长)、吸烟情况(过去1个月是否吸烟)、家庭收入水平(低:<12 373.97元;中:12 373.97～30 418.25元;高:>30 418.25元)[8]、地域(南方:北京、河北、山东;北方:江西、湖南)。
1.2.2　体格测量
主要包括身高、体重、血压的测量。由专业人员严格按照“2010年中国学生体质与健康调研报告”对儿童青少年进行体格检查，研究对象穿轻薄衣物，赤脚测量身高及体重，身高测量仪精度0.1 cm，体重测量仪精度50 g。血压测量时，采用电子血压计(日本欧姆龙株式会社，HBP-1300)对每位受试者重复测量血压3次，每次测量时均松开袖带，间隔1 min，每次均记录收缩压和舒张压读数，数据分析时取其平均值作为最终的血压值。
1.2.3　血液指标检测
主要包括总胆固醇和空腹血糖的测量，单位为mmol/L。由专业护士采集受试者晨起空腹血3 ml，静置半小时后1 500×g离心10 min，采用全自动生化检测仪检测总胆固醇和空腹血糖。
1.3　指标定义
1.3.1　肥胖类型
体质指数(body mass index, BMI)=体重(kg)/身高的二次方(m)2。根据《学龄儿童青少年超重与肥胖筛查界值[9]，凡 BMI大于或等于相应性别、年龄组“超重”界值点且小于“肥胖”界值点者定义为超重，凡 BMI 大于或等于相应性别、年龄组“肥胖”界值点者定义为肥胖。
1.3.2　血压类型
根据7～18岁儿童青少年血压偏高筛查界值[10]，我们将收缩压和(或)舒张压≥同性别、同身高百分位人群P95血压判断为血压偏高；将收缩压和(或)舒张压≥同性别、同年龄、同身高百分位人群P90血压，且<P95血压判断为正常高值血压。
1.3.3　CVH指标
参考“美国心脏协会（American Heart Association,AHA）标准”，CVH指标包含4个健康行为指标(吸烟情况、BMI、体育锻炼、膳食)和3个健康因素指标(血压、总胆固醇、空腹血糖)。所有CVH指标均分为理想水平、中等水平和较差水平三个层次，划分依据参考陈芳芳等[7]对AHA标准校正修改后的版本，具体如表1所示。
另外，CVH指标总分的计算方法是将7项指标分数进行求和并计算其总平均分，其中指标单项满分均100分，赋分原则详见参考文献[11]。随后根据平均分将心血管状况分为低风险(≥80分)、中等风险(50～79分)和高风险(<50分)三个层次。
1.4　质量控制
对所有项目组工作人员和体检人员均进行问卷采集和体格检测相关培训，并介绍仪器的使用方法以及测量和调研的注意事项等。由问卷质控人员对问卷进行逻辑纠错。
1.5　统计学分析
采用R语言4.0软件进行分析。连续性变量采用（均值±标准差）的形式表示，分类变量采用频数(%)的形式表示。独立样本t检验分析满足正态分布的两组连续型变量之间的组间差异，而两组以上连续型变量之间的组间差异则通过单因素方差分析完成。通过χ2检验或Fisher精确检验分析分类变量之间的组间差异。采用多元logistic回归模型分析儿童青少年CVH状况(不同风险)的影响因素。检验水准α=0.05。
2　结果
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2.1　研究对象基本情况
如表2所示，本次研究连续性变量均符合正态分布要求，故采用（均值±标准差）的形式表达。共纳入2 166名儿童青少年，56.93%(1 233名)来自于城市，年龄范围为9.2～17.99周岁，平均年龄为12.38周岁，其中男性占53.37%，95.34%为汉族。本次纳入研究的女生相较于男生年龄偏小，身高偏低，体重更轻，体质指数BMI更低(P均<0. 001)。男生中每天至少食用1次豆/奶制品和每周饮用含糖饮料1次及以上的人群占比明显高于女性(P=0. 007)。相较于女生，男生的收缩压更高，总胆固醇水平更低，空腹血糖水平更高(P<0.05)。另外，城市和农村乡镇的两组青少年在年龄、民族、体重、BMI、高血压、家族史(糖尿病、高血压、高血脂)、食物摄入、血压、总胆固醇和空腹血糖方面的组间差异有统计学差异(P<0.05)。其他指标组间差异无统计学意义。
2.2　CVH评估指标分布情况
2 166名儿童青少年的CVH评估指标分布情况如表3所示。在不同性别中，除健康膳食指标外，男女生间其他健康行为（BMI、体育锻炼、吸烟）均具有统计学差异(P<0.05)。在健康因素指标中，男女生间总胆固醇和空腹血糖的构成比差异具有统计学意义(P<0.05)，男生总胆固醇达理想水平的人群占比高于女生，而空腹血糖达理想水平的人群占比低于女生。但两者之间的血压水平构成比差异未见显著统计学差异(P=0.696)。
不同居住地儿童青少年CVH评估指标情况如表4所示，体质指数、体育锻炼、健康膳食行为的构成比具有统计学差异(P<0.001)，但吸烟与被动吸烟情况的构成比未见显著统计学差异(P>0.05)。相较于城市青少年，乡镇农村的儿童青少年超重和肥胖人群占比更低、保持中高等强度运动的人群占比更少。在健康因素指标中，城市和乡镇农村儿童青少年间血压、总胆固醇、空腹血糖的构成比差异均具有显著统计学差异(P<0.05)，乡镇农村的儿童青少年的血压、总胆固醇、空腹血糖达理想水平的人群占比均高于城市青少年。
2.3　CVH理想指标数分布
本研究分析了该979名研究对象CVH指标数的分布情况，见表5。
共有66.9%的7～17岁儿童青少年具有4～5个理想指标，具有6～7个理想指标的儿童青少年所占比例仅为13.7%。女生具有2～4个CVH行为的比例显著高于男生(χ2=5. 007，P=0. 025)。来自于乡镇农村的儿童青少年具有2～4个CVH行为、2～3个CVH因素、4～7个CVH行为和因素的比例均显著高于来自于城市的儿童青少年(P<0.05)。
2.4　CVH指标得分情况
7～17岁儿童青少年CVH指标得分情况如表6所示。其中CVH指标总分在年龄、性别、睡觉时长、城乡、地域和收入水平变量中存在显著的组间差异(P<0.05)。
2.5　儿童青少年CVH状况的影响因素分析
回归分析如表7所示。以CVH高风险为参考组，12～17岁儿童青少年为低风险的可能性较7～11岁儿童青少年降低了28%；女性为中等风险和低风险分别是男性的2.89和3.21倍；睡眠时长7～9.9 h为中等风险和低风险分别是<7 h的2.74和3.18倍；农村为中等风险和低风险分别是城市的2.05和2.48倍；南方为中等风险和低风险较北方降低了38%和32%的可能性；中等水平收入为中等风险较低等水平收入提高了1.67倍。
3　讨论
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本研究发现，中国北京、河北、山东、江西、湖南五省市7～17儿童青少年具有7个CVH指标占比约1.8%，具有5个以上CVH指标占比约48.7%。各个指标均是吸烟作为理想情况最高（99.49%），具有理想体育锻炼水平(10.94%)和健康膳食水平(17.31%)的CVH指标人群占比较低。根据2018年WHO报告[12]，全球约五分之四的儿童青少年体育锻炼时间不足，这与本研究的结论相一致。由于新冠大流行期间，各地的学校普遍实行线上教学，这可能会对儿童青少年的身体活动以及锻炼时间产生较大影响。而儿童青少年时期非理想的饮食结构与不充足体育锻炼时间会导致其成年后CVD的风险大大增加。根据一项从婴幼儿时期到20岁的生活方式干预研究[13]，试验组的CVH知识水平显著优于对照组，且CVD风险明显降低，证明如对儿童青少年实施早期的CVH观念教育、膳食情况干预以及增加体育锻炼时间可以显著改善儿童及其成年后的CVH水平，并因此终身受益。
在性别差异方面，女生除体育锻炼外，在体质指数，吸烟与血压情况，空腹血糖方面具有较高的CVH评分，且比例也优于男生。在城乡差异方面，相较于城镇儿童青少年，乡镇的儿童青少年具有更好的体质指数、体育锻炼、总胆固醇以及血压情况，但在膳食情况方面不如城镇儿童青少年。根据Wang等人[14]的估计，中国现在约有50%的成年人和25%的儿童青少年超重和肥胖，使得中国成为肥胖人数最多的国家。此外，相关调查[15]也显示超重和肥胖引起的高血压逐年上升，这表明肥胖是高血压儿童的主要因素，这与本研究的结论相一致。
另外，本研究还对7～17岁儿童青少年CVH状况(不同风险)的影响因素进行了分析。回归分析结果显示7～17岁儿童青少年心血管风险与年龄、性别、城乡、睡觉时长密切相关。以往研究[16-17]指出年龄增长、男性、城市和睡眠缺乏是心血管风险提高的危险因素，与本研究结果相似。还值得注意的是，本研究发现在地域和收入水平相关因素中，南方和家庭收入低是儿童青少年心血管风险增高的因素，其原因可能是：一是南方地区对于肉类食物需求高，特别是饱和脂肪含量的摄入[18]；二是低收入家庭拥有更多的不良生活习惯和较低的就医依从性，故加剧了心血管风险[19]。
本研究存在一些局限性，美国AHA的CVH标准是否完全适用于中国人群还需要进一步验证，考虑到不同种族、血压水平对标准判断的影响，均采用了中国标准。本研究的研究对象地域覆盖广泛，但也无法完全代表中国儿童青少年，且乡镇儿童青少年的样本相对较少。
综上，中国北京、河北、山东、江西、湖南五省市7～17岁儿童青少年CVH整体水平并不乐观。因此，建议从健康生活干预的方向出发，进行早期筛查与健康风险评估，出现心血管风险因素后进行早期干预，这对预防中国人整体CVD的发生具有潜在益处，同时需要在非城市地区开展健康宣教。
基金
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  • 国家重点研发计划(2020YFC2006705)
文献
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参考文献 引证文献
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2024年第51卷第3期
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doi: 10.20043/j.cnki.MPM.202304360
  • 接收时间：2023-04-18
  • 首发时间：2026-03-19
  • 出版时间：2024-02-10
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  • 收稿日期：2023-04-18
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国家重点研发计划(2020YFC2006705)
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    1.国家体育总局运动医学研究所，北京 100061
    2.首都医科大学附属北京妇产医院/北京妇幼保健院

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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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