Objective: This study aimed to explore the association between malnutrition and the level of blood pressure (BP) as well as elevated BP (EBP) in Han students aged 7 to 18 years in China. Methods: 170 037 subjects with normal nutritional status and malnutrition were enrolled in this study from 2014 Chinese National Surveys on Students' Constitution and Health with a multi-stage stratified cluster random sampling framework covering 31 provinces, autonomous regions and municipalities after the exclusion of 44 317 overweight and obese students. According to the standard of "Screening Standard for Malnutrition of School-age Children and Adolescents" (WS/T456-2014), the nutritional status of children were classified into two categories, normal nutritional status and malnutrition containing stunting, mild wasting and moderate severe wasting. The level of BP and prevalence of EBP were compared between students with normal nutritional status and malnutrition. The multivariate logistic regression model was used to analyze the association between malnutrition and EBP. Results: The levels of systolic BP (SBP) and diastolic BP (DBP) in Chinese Han students aged 7-18 years who were non-overweight and non-obesity status were (103.4±12.3) and (64.7±9.5) mmHg (1 mmHg=0.133 kPa), respectively. The prevalence of EBP, systolic EBP and diastolic EBP in Chinese Han malnourished students (N=21 012) were 3.1% (n=649), 1.5% (n=324) and 2.1% (n=445), respectively, which was significantly lower than those (N=148 320) with normal nutritional status (4.5% (n=6 707), 2.6% (n=3 872) and 2.7% (n=3 959)), and the corresponding differences were statistically significant (P<0.05). The OR (95%CI) between malnutrition and EBP was 0.68 (0.62-0.73), which were 0.65 (0.58-0.72) and 0.68 (0.60-0.77) for boys and girls. The OR (95%CI) between EBP and stunting as well as mild wasting and moderate severe wasting were 0.69 (0.62-0.77), 0.63 (0.55-0.72) and 0.79 (0.60-1.05), respectively. Conclusion: The level of BP and prevalence of EBP in Chinese Han students with malnutrition were lower than those with normal nutritional status. The negative correlation existed between malnutrition and EBP in Chinese Han students aged 7 to 18 years.
目的： 探讨中国7~18岁汉族学生营养不良与血压水平以及血压偏高之间的关联。 方法： 2014年全国学生体质与健康调研采用了多阶段分层整群随机抽样，涵盖中国31个省、自治区和直辖市。排除超重和肥胖7~18岁汉族学生（44 317名）后，本研究最终共纳入营养状况正常和营养不良的7~18岁汉族学生170 037名。按照《学龄儿童青少年营养不良筛查标准》（WS/T456-2014）将研究对象划分为营养状况正常和营养不良（包括生长迟缓、中重度消瘦和轻度消瘦）。比较营养不良和营养状况正常的7~18岁汉族学生的血压水平和血压偏高的检出率差异；利用多因素logistics回归模型分析营养不良与血压偏高的关联。 结果： 2014年中国7~18岁非超重肥胖营养状态的汉族学生的收缩压和舒张压分别为（103.4±12.3）和（64.7±9.5）mmHg（1 mmHg=0.133 kPa）；21 012名营养不良汉族学生血压偏高、收缩压偏高和舒张压偏高的检出率分别为3.1%（649例）、1.5%（324例）和2.1%（445例），均低于148 320名正常营养状态汉族学生的检出率[4.5%（6 707名）、2.6%（3 872名）和2.7%（3 959名）]，差异均有统计学意义（P<0.05）。与正常营养状态汉族学生相比，营养不良者发生血压偏高的OR（95%CI）值为0.68（0.62~0.73），男女生分别为0.65（0.58~0.72）和0.68（0.60~0.77）；生长迟缓、中重度消瘦和轻度消瘦者血压偏高的OR（95%CI）值分别为0.69（0.62~0.77）、0.63（0.55~0.72）和0.79（0.60~1.05）。 结论： 营养不良汉族学生的血压水平和血压偏高检出率均低于营养状况正常的汉族学生，中国汉族学生营养不良与血压偏高呈负相关。.
Keywords: Blood pressure; Cross-sectional studies; Han students; Malnutrition.