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目的 描绘儿童自出生至7～9岁阶段的年龄别体质指数Z评分(body mass index for age Z score, BAZ)的轨迹，并分析其与血压偏高的关联。方法 依托中国母婴营养与健康队列中的太仓队列，于2013—2024年测量儿童1、3、6、8月龄及1、1.5、2、2.5、3、4、5、6、7～9岁时的身长/身高和体重数据；于2024年测量7～9岁儿童血压，依据《7岁～18岁儿童青少年血压偏高筛查界值》判定血压偏高。依据《世界卫生组织儿童生长发育标准》计算BAZ评分，采用基于组的轨迹模型(group-based trajectory modeling, GBTM)识别BAZ轨迹。采用多因素Logistic回归模型分析BAZ轨迹与血压偏高之间的关联，并调整混杂因素。结果 共纳入1274名儿童，血压偏高检出率为20.6%。GBTM识别出3种BAZ轨迹：低BAZ下降组(34.5%)、中等BAZ稳定组(48.3%)和高BAZ上升组(17.2%)。在调整儿童性别、首次BAZ和末次随访年龄等潜在混杂因素后，与中等BAZ稳定组相比，高BAZ上升组儿童血压偏高的风险升高(OR=1.55,95%CI 1.07～2.23,P=0.02),低BAZ下降组儿童血压偏高的风险无统计学意义(OR=0.77,95%CI 0.55～1.06,P=0.11)。自2.5岁，血压偏高组儿童BAZ均高于血压正常组儿童(P<0.05)。结论 0～9岁儿童“高BAZ上升”生长轨迹与儿童在7～9岁的血压偏高风险相关；2.5岁是控制BAZ和降低血压偏高风险的关键起始时间。
Abstract：OBJECTIVE To characterize the longitudinal trajectories of body-mass-index-for-age Z-score(BAZ) from birth to 7-9 years and to explore their association with elevated blood pressure(EBP) in childhood.METHODS Based on the TAWS prospective cohort study in China, children living in Taicang were followed from 2013 to 2024. Length/height and weight of children were measured at 1, 3, 6, 8 months, and 1, 1.5, 2, 2.5, 3, 4, 5, 6, 7-9 years of age. Blood pressure was measured in 2024 when children were 7-9 years old, and EBP was defined according to Chinese reference of screening for EBP among children. BAZ was calculated based on the World Health Organization child growth standards. Group-based trajectory modeling(GBTM) was applied to identify BAZ trajectories. Multivariate logistic regression was used to assess the association between BAZ trajectories groups and EBP, adjusting for potential confounders.RESULTS Among the 1,274 children included in this study, the prevalence of EBP was 20.6%. GBTM identified three distinct BAZ trajectories: low-decreasing(34.5%), moderate-stable(48.3%), and high-increasing(17.2%). After adjustment for child's gender, initial BAZ, and age at the last follow-up, children in the high-increasing BAZ group had an increased risk of EBP(OR=1.55, 95%CI 1.07-2.23, P=0.02) compared to those in the moderate-stable BAZ group, while the low-decreasing BAZ group showed no statistically significant association with EBP(OR=0.77, 95%CI 0.55-1.06, P=0.11). From 2.5 years old onwards, BAZ values in children with EBP were consistently higher than those with normal blood pressure(P<0.05).CONCLUSION The high-increasing BAZ trajectory from birth to nine years is associated with an increased risk of EBP in children aged 7-9 years. The age of 2.5 years may represent a critical starting point for interventions aimed at controlling BAZ rise to mitigate future EBP.
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基本信息:
DOI：10.19813/j.cnki.weishengyanjiu.2026.03.008
中图分类号:R179
引用信息:
[1]孔亚男,郭尧政,郝靖文,等.2013—2024年儿童体质指数变化轨迹与血压偏高关联的队列研究[J].卫生研究,2026,55(03):414-422.DOI:10.19813/j.cnki.weishengyanjiu.2026.03.008.
基金信息:
国家财政项目(No.102393260020070000001); 国家重点研发计划(No.2023YFC2506701)
2026-05-21
2026-05-21