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严卫丽:重新评估中国儿童青少年高血压流行趋势:中国居民健康与营养调查1991-2011年 PPT讲座视频 中华医学会第二十一次全国儿科学术大会
标题: 重新评估中国儿童青少年高血压流行趋势:中国居民健康与营养调查1991-2011年
讲者: 严卫丽
单位: 复旦大学附属儿科医院
播放: 2396
论文摘要: 目的  正常儿童青少年血压水平主要与年龄、性别和身高相关。本研究基于全国居民健康营养调查数据1991-2011,通过校正体格发育测量(身高)逐年发展趋势的影响,重新评估了儿童青少年过去20年肥胖和高血压流行的长期趋势。
方法  数据来自中国居民健康与营养调查(CHNs)1991-2011年数据,分8个调查年完成,共纳入8-17岁之间7358个男生,6881个女生。依据全国参考值,体质质数、身高、腰围、收缩压和舒张压水平转换为Z-score后观察8个调查年的变化趋势。采用线性回归、调查年为自变量,以观察年的斜率间接反应年龄标准化后的体质质数、身高、腰围、血压的年平均增长量。为了校正身高逐年变化趋势的影响,分别依据全国性别、年龄别和身高别血压参考曲线和美国第四次血压检测报告(the 4th report)推荐的分性别、年龄和身高百分位的血压参考值分别评估各年度高血压患病率,并计算患病率年平均增长率(average annual increase%, AAI%),用以评估儿童肥胖和高血压患病率近20年的变化趋势。
结果  收缩压和舒张压平均每年增长0.07SD和0.09SD;BMI、腰围、身高的增长幅度分别为每年0.14SD, 0.11SD 和 0.29SD。 肥胖患病率从1.5%增长到8.1%,城市和农村男童的增长幅度分别为每年0.36%和0.42%,城市和农村女童的增长幅度分别为0.33% 和0.22%。高血压的患病率从6.9%增长到10.7%,在过去的20年里,平均每年增长0.19%。整体来说男孩高血压患病率每年的增长幅度是女孩的3倍(0.29% vs 0.09%),城市男孩女孩高血压的患病率增长趋势相似(0.11%-0.13%),而农村男孩高血压的患病率增长趋势是女孩的3倍(0.36% vs. 0.07%)。通过校正身高逐年增长趋势,儿童高血压患病率的增长趋势显现出性别和城乡差异,表现为男生高于女生,农村高于城市。无论用中国标准和国际标准(美国The 4th report), 年增长均远低于以往的报道。
结论  校正身高逐年变化趋势后, 对我国儿童高血压近20年流行趋势的评估更加客观。增长趋势显现出性别和城乡差异,表现为男生高于女生,农村高于城市。高血压患病率年增长率0.19%, 远低于之前报道的6%。

临床流行病学研究室

复旦大学附属儿科医院



1b.   Academic qualifications

1992  MD in Public Health, Xinjiang Medical University, Urumqi, China

1995  MS in Public Health, Xinjiang Medical University, Urumqi, China

2003  PhD in Genetic Epidemiology, Peking Union Medical College, Beijing, China

 

1c.   Professional positions held

2011.01-now   Professor, Director, Department of clinical epidemiology&Clinical Trial UnitChildrens Hospital of Fudan University, Shanghai, China.

1995-2000     Assistant professor

2003-2007     Associate Professor

2007-2010     Professor,

School of Public Health, Xinjiang Medical University, Xinjiang, China

2006-2008     Postdoctoral fellow in Cardiovascular Genetic Epidemiology, Georgia Prevention Institute, Medical College of Georgia

1d.   Present research/professional speciality

Contributing methodological part of the population-based study, I have gained extensive training and research experience in study on genetic and environmental interactions in etiology of obesity and related diseases. My research focused on clinical and epidemiologic characteristics of metabolic syndrome in Chinese ethnic children and adult populations. During my PhD training and postdoctoral training at Georgia Prevention Institute, Medical College of Georgia (renamed Georgia Health Sciences University), my role as statistician, I worked with large longitudinal cohorts and national nutrition survey databases, conduct data analysis and interpret results. Our achievements include establishment of ethnic references of age-specific BMI, waist circumference, waist-to-height ratio, and age- and height-specific blood pressure for children and adolescent population, provided tools for early prevention of childhood obesity and hypertension. Based on the national nutrition survey data CHNs, my team established the first age- and height-specific blood pressure percentile references for children and adolescents. Based on these studies, we developed practical APPs for improving practice in prevention of obesity, including gestational weight management, birth weight classification for gestational ages, obesity-related cardiometabolic risk assessment for children and adolescents. I have 10-year experience of served as epidemiological and statistical consultant.  I lead the department of clinical epidemiology of the hospital to provide methodology support to large clinical studies. I am involved in the national congenital heart disease screening projects, and successfully assisted with the publication of the paper in The Lancet (see publication Zhao et al. below; doi: 10.1016/S0140-6736(14)60198-7). I also designed the first national autism spectrum disorder survey, prepared the budget, and successfully obtained the grant from the National Ministry of Health. Currently, I lead a team to support SPCC cohort study and multi-center clinical registry studies that sponsored by our hospital.

 

1e.   Total years research experience

15 years post Ph.D

 

1f.   Professional distinctions and memberships (including honours, prizes, scholarships, boards or governance roles, etc)

2011 - now Committee member, Shanghai Pharmaceutical Association

 

1g.   Total number of peer reviewed publications and patents

Journal articles

Books

Book chapters, books edited

Conference proceedings

Patents

45

1

2

 

2

 


PART 2

2a.   Research publications and dissemination

 

Peer-reviewed journal articles

 

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· 

· 

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1. Siyuan JiangXiangyuan Huang , Lan Zhang , Junyan Han , Yi Yang , Weiping Wang , Shoo K Lee Weili Yan* , Yun Cao.Estimated Survival and Major Comorbidities of Very Preterm Infants Discharged Against Medical Advice vs Treated With Intensive Care in China.JAMA Netw Open.2021 Jun 1;4(6):e2113197. doi: 10.1001/jamanetworkopen.2021.13197

2. J Han, L Zhang, S Li, Y Zhang, YJiang, X Chen, Y Wang, YDou, P Dong, Y Lv, YCao*, W Yan*. Associations of early nutrition with growth and body composition in very preterm infants: a prospective cohort study. European journal of clinical nutrition. 2021.DOI: 10.1038/s41430-021-00901-w

3. J Han; Y Jiang; JHuang; YZhang; Y Zhang; Y Zhang; X Chen; Y Li*,W Yan*. Postnatal growth of preterm infants during the first two years of life: catch-up growth accompanied by risk of overweight.Italian Journal of Pediatric. 2021.DOI: 10.1186/s13052-021-01019-2

4. Chen X, Zhang Y, Chen H, Jiang Y, Wang Y, Wang D, Li M, Dou Y, Sun X, Huang G*, Yan W*. Association of Maternal Folate and Vitamin B 12 in Early Pregnancy With Gestational Diabetes Mellitus: A Prospective Cohort Study. X Chen, Y Zhang, H Chen, Y Jiang, Y Wang, D Wang, M Li, Y Dou, X Sun, ...G Huang*, W Yan *. Diabetes care 44 (1), 217-22

5. Ye Y, Dou LM, Zhang Y, Dou YL, Zhao PP, Jiang Y, Gao W, Ji M, He LF, Niu DY, Zhang L, Gao XH, Li Y, Xiao LP, Huang J, Zhang XH, Wang LH*, Yan WL*. Maternal periconceptional folate status and infant atopic dermatitis: a prospective cohort study,Pediatric Allergy and Immunology 32 (1), 137-145

6. Dou Y#, Jiang Y#, Yan Y#, Chen H, Zhang Y, Chen X, Wang Y, Cheng H, Zhao X, Hou D, Mi J*, Yan W*. Waist-to-height ratio as a screening tool for cardiometabolic risk in children and adolescents: a nationwide cross-sectional study in China. BMJ Open. 2020 Jun 21;10(6):e037040

7. Li M, Zhang Y, Chen X, Wang D, Ji M, Jiang Y, Dou Y, Ma X, Sheng W, Yan W*, Huang G*.Effectiveness of community-based folate-oriented tertiary interventions on incidence of fetus and birth defects: a protocol for a single-blind cluster randomized controlled trial. BMC pregnancy and childbirth 20 (1), 1-10

8. Zhou H#, Xu X#Yan W#, Zou X, Wu L, Luo X, Li T, Huang Y, Guan H, Chen X, Mao M, Xia K, Zhang L, Li E, Ge X, Zhang L, Li C, Zhang X, Zhou Y, Ding D, Shih A, Fombonne E, Zheng Y, Han J, Sun Z, Jiang YH, Wang Y*; LATENT-NHC Study Team.Prevalence of Autism Spectrum Disorder in China: A Nationwide Multi-center Population-based Study Among Children Aged 6 to 12 Years. Neurosci Bull. 2020 Sep;36(9):961-971. doi: 10.1007/s12264-020-00530-6.

9. He L, Liu F, Yan W, Huang M, Huang M, Xie L, Guo Y, Xu X, Chu C, Wu L, Liang X, Sun S, Wang F, Zhao L, Zhao Q, Ma X, Xie L, Huang G*. Randomized Trial of Different initial IVIG Regimens in Kawasaki Disease. Pediatr Int. 2021 Feb 18. doi: 10.1111/ped.14656. 

10. J Wang, W Shi, D Khiati, B Shi, X Shi, D Luo, Y Wang, R Deng, H Huang, H Yang*, W Yan*. Acupuncture treatment on the motor area of the scalp for motor dysfunction in children with cerebral palsy: study protocol for a multicenter randomized controlled trial.Trials 21 (1), 1-11

11. Zhang Z, Huang X, Wang Y, Li Y, Miao H, Zhang C, Pan G, Zhang Y, Zhu X, Chen W, Li J, Su D, Bi Y, Chen Z, Jin B, Miao H, Kong X, Cheng Y, Chen Y, Yan G, Yan W*, Lu G*. Performance of Three Mortality Prediction Scores and Evaluation of Important Determinants in Eight Pediatric Intensive Care Units in China. Frontiers in pediatrics 8, 522

12. Huang X#, Ye Y#, Li Y, Zhang Y, Zhang Y, Jiang Y, Chen X, Wang L, Yan W*. Maternal folate levels during pregnancy and children's neuropsychological development at 2 years of age. European journal of clinical nutrition 74 (11), 1585-1593

13. Hu XJ, Ding JX, Wang Y, Niu C, Zhang Y, Zhao QM, Yan WL, Cao Y, Huang GY.Peripheral perfusion index percentiles for healthy newborns by gestational age and sex in China. Sci Rep. 2020 Mar 6;10(1):4213. doi: 10.1038/s41598-020-60741-9

14. Jiang S, Yan W, Li S, Zhang L, Zhang Y, Shah PS, Shah V, Lee SK, Yang Y, Cao Y.Mortality and Morbidity in Infants <34 Weeks' Gestation in 25 NICUs in China: A Prospective Cohort Study. Front Pediatr. 2020 Feb 13;8:33. doi: 10.3389/fped.2020.00033.

15. Wang D, Zhang Y, Jiang Y, Ye Y, Ji M, Dou Y, Chen X, Li M, Ma X, Sheng W, Huang G*, Yan W*; SPCC group. Shanghai Preconception Cohort (SPCC) for the association of periconceptional parental key nutritional factors with health outcomes of children with congenital heart disease: a cohort profile. BMJ Open.2019 Nov 24;9(11):e031076. doi: 10.1136/bmjopen-2019-031076.

16. Yan W*, Zhang Y, Wang L, Yang W, Li C, Wang L, Gu P, Xia Y, Yan J, Shen Y, Zhao Q, Niu D, Mu K, Jiang Y. Maternal dietary glycaemic change during gestation influences insulin-related gene methylation in the placental tissue: a genome-wide methylation analysis. Genes Nutr. 2019 May 9;14:17. doi: 10.1186/s12263-019-0634-x.

17. Zhang Y, Wang L, Yang W, Niu D, Li C, Wang L, Gu P, Xia Y, Shen Y, Yan J, ZhaoQ, Mu K, Yan W*. Effectiveness of Low Glycemic Index Diet Consultations Through a Diet Glycemic Assessment App Tool on Maternal and Neonatal Insulin Resistance: A Randomized Controlled Trial. JMIR Mhealth Uhealth. 2019 Apr 18;7(4):e12081. doi: 10.2196/12081.

18. Li C, Zhu G, Feng J, Xu Q, Zhou Z, Zhou B, Hu C, Liu C, Li H, Wang Y, Yan W, Ge X, Xu X. Improving the early screening procedure for autism spectrum disorder in young children: Experience from a community-based model in shanghai. Autism Res. 2018 Sep;11(9):1206-1217. doi: 10.1002/aur.1984.

19. Zhou H, Li C, Luo X, Wu L, Huang Y, Zhang L, Zou X, Xu X, Jiang YH, Yan W*, Wang Y*. Cross-Cultural Revision and Psychometric Properties of the Chinese Version of the Autism Spectrum Rating Scale (2-5 Years). Front Neurol. 2018 Jun 27; 9:460. doi: 10.3389/fneur.2018.00460.

20. Yi Zhang, Liping Wang, Chuanmin Yin, Yuan Jiang, Dayan Niu, Weili Yan*. Development and evaluation of percentile distribution of body weight by gestational week as a tool for gestational weight management: a retrospective study based on hospital routine data. BMJ Open. 2018 Jun 28;8(6):e019645.

21. Li FL, Liu JP, Bao RX, Yan G, Feng X, Xu YP, Sun YP, Yan W, Ling ZQ, Xiong Y, Guan KL, Yuan HX.Acetylation accumulates PFKFB3 in cytoplasm to promote glycolysis and protects cells from cisplatin-induced apoptosis. Nat Commun. 2018 Feb 6;9(1):508. doi: 10.1038/s41467-018-02950-5.

22. Li C, Zhou H, Wang T, Long S, Du X, Xu X, Yan W, Wang Y. Performance of the Autism Spectrum Rating Scale and Social Responsiveness Scale in Identifying Autism Spectrum Disorder Among Cases of Intellectual Disability. Neurosci Bull. 2018 May 28. doi: 10.1007/s12264-018-0237-3. [Epub ahead of print]

23. Muyumba EK, Nkulu DN, Mukeng CK, Musung JM, Kakoma PK, Kakisingi CN, Luboya ON, Malonga FK, Kizonde JK, Mukuku O, Yan W. Oscillometric blood pressure by age and height for non overweight children and adolescents in Lubumbashi, Democratic Republic of Congo. BMC Cardiovasc Disord. 2018 Jan 19;18(1):9. doi: 10.1186/s12872-018-0741-4.

24. Junting Liu,1 Liang Wang,2 Jinghui Sun,3 Gongshu Liu,4 Weili Yan*, Bo Xi,
Feng Xiong,7 Wenqing Ding,8 Guimin Huang,1 Steven Heymsfeld,9 Jie Mi1. Bone mineral density reference tandards for Chinese children aged 3–18: cross-sectional results of the 2013–2015 China Child and Adolescent Cardiovascular Health (CCACH) Study BMJ Open 2017;7:e014542.

25. Jiang Y, Dou YL, Xiong F, Zhang L, Zhu GH, Wu T, Zhang Y, Yan WL(*); Waist-to-height ratio remains an accurate and practical way of identifying cardiometabolic risks in children and adolescents. Acta Paediatr. 2018 Mar 22. 2018.5.22

26. Bingrui ZhouHao ZhouLijie Wu..., Weili Yan*, Xiu Xu*.Assessing the Accuracy of the Modified Chinese Autism Spectrum Rating Scale and Social Responsiveness Scale for Screening Autism Spectrum Disorder in Chinese children. Neuroscience Bulletin. Neuroscience Bulletin 2017, DOI: 10.1007/s12264-017-0105-6

27. Hao ZhouLili ZhangXuerong Luo..Weili Yan*, Yi Wang*. Modifying the Autism Spectrum Rating Scale (6–18 years) to a Chinese Context: An Exploratory Factor Analysis.Neuroscience Bulletin 2017, DOI: 10.1007/s12264-017-0104-7

28. Hao ZhouLili ZhangXiaobing Zou.., Weili Yan*,Yi Wang*. Chinese Norms for the Autism Spectrum Rating Scale.Neuroscience Bulletin 2017, DOI: 10.1007/s12264-017-0104-7.

29. Nong Li,Weili YanXiaojuan Hu, Kehong Sun. Effects of oral α-lipoic acid administration on body weight in overweight or obese subjects: A cross-over randomized, double-blind, placebo-controlled trial. Clinical Endocrinology.2017, DOI: 10.1111/cen.13303

30. Bin ZhouJames BenthamMariachiara Di Cesare..Weili Yan.]Julio Zu?iga Cisneros. Worldwide trends in blood pressure from 1975 to 2015 : a pooled analysis of 1479 population-based measurement studies with 19.1 million participants. The Lancet 389(10064):37-55.January 2017 DOI: 10.1016/S0140-6736(16)31919-5

31. Weili Yan*, Xuesong Li, Yi Zhang; Dayan Niu,Kai Mu,Ying Ye,Fang Liu. Re-evaluate secular trends of body size measurements and prevalence of hypertension among Chinese children and adolescents in past two decades. J Hypertens. 2016 Dec;34 (12): 2337-2343

32. Yan WL#*, Wang CC, Huang YD, Yimiti D, Wang Q, Upur H#*. Parental factors affecting the circumcision of non-Muslim Chinese boys include education and family history.Acta Paediatr. 2015 Dec;104(12):e569-76

33. Ngee Lek, Weili Yan*, Yi Zhang, Qian Wang & Yin Bun Cheung. Indices of central and general obesity and cardiometabolic risk among adolescents in three ethnic groups in north-west China. Annals of Human Biology, 2016, DOI: 10.3109/03014460.2015.1014418  -

34.  Wei-Li Yan (yanwl@fudan.edu.cn) *, Chen-Chen Wang, Yong-Di Huang, Deliciati Yimiti, Qian Wang, Halmurat Upur (halmurat@263.net) *.Parental factors affecting the circumcision of non-Muslim Chinese boys include education and family history. Acta P?diatrica. 2016,  DOI:10.1111/apa.13142  

35.  Hao ZhouaLili ZhangaLijie WubXiaobing ZoucXuerong LuodKun XiaeYimin WangaXiu Xuf,Xiaoling Geg,Caihong Sunb, Hongzhu Dengc, Eric Fombonneh, Yong-Hui Jiangi,Weili Yan,* Yi Wang*. Validity and reliability analysis of the Chinese parent version of the Autism Spectrum Rating Scale (6–18 years). Psychiatry Research. (2015)  http://dx.doi.org/10.1016/j.psychres.2015.09.003 

36. Youtao Lu, Yi Cheng, Weili Yan*and Christine Nardini*. Exploring the molecular causes of hepatitis B virus vaccination response: an approach with epigenomic and transcriptomic data. BMC Medical Genomics 2014, 7:12.http://www.biomedcentral.com/1755-8794/7/12

37. W.L. Yan*, X.S. Li, Q. Wang, Y.D. Huang, W.G. Zhang, X.H. Zhai, C.C. Wang &J.H. Lee (2014).Overweight, high blood pressure and impaired fasting glucose in Uyghur, Han, and Kazakh Chinese children and adolescents. Ethnicity & Health, DOI: 10.1080/13557858.2014.921894

38. Ying Xu, Weili Yan, Yin Bun Cheung. Body shape indices and cardiometabolic risk in adolescents. Ann Hum Biol, Early Online: 1–6. 2014 Informa UK Ltd. DOI: 10.3109/03014460.2014.903998

39. Qu-ming Zhao , Xiao-jing Ma , Xiao-ling Ge, Fang Liu, Wei-li Yan, Lin Wu, Ming Ye, Xue-cun Liang, Jing Zhang, Yan Gao, Bing Jia *, Guo-ying Huang *, and the Neonatal Congenital Heart Disease Screening Group. Using Pulse Oximetry Combined with Clinical Evaluation to Screen Congenital Heart Disease in Early Neonatal Stage: a Chinese prospective screening study in 122,738 newborns. THE LANCET, Early Online Publication, 23 April 2014 doi:10.1016/S0140-6736(14)60198-7

40. Yan WL*, Liu F, Wu L, Li XS, Zhou WH, Huang GY. Blood pressure percentiles for Non-overweight Chinese Children and Adolescents aged 7-17 years. BMC Pediatrics 2013.13:195

41. Shi P, Yang WH, Yu Q, Zhao Q, … Yan WL*. Overweight,gestational weight gain and elevated fasting plasma glucose and theirassociation with macrosomia in Chinese pregnant women. Maternal and Child Health Journal 2013 Jun 20.

42. Kai Yan, Wenping Cai, Fang Cao, He Sun, Shaoke Chen, Ruiwei Xu, Xin Wei, Xiaoxiang Shi and Weili Yan*. Genetic Effects Play Dominant Role on Poor Responses to Infant Vaccination to Hepatitis B Virus. Journal of Human Genetics.  (14 March 2013) | doi:10.1038/jhg.2013.18

43. Weili Yan*, Nong Li, Xiaojuan Hu, Yongdi Huang, Weiguo Zhang, Qian Wang, Fugang Wang, Chenchen Wang, Xiaohu Zhai, Ruiwei Xu, Kai Yan, Xiuhua Ding, Xiaoling Wang. Effect of oral ALA supplementation on oxidative stress and insulin sensitivity among overweight/obese adults: A double-blinded, randomized, controlled, cross-over intervention trial. International journal of cardiology. 10/2012

44. Yan W*, Tagging SNPs in REN, AGTR1 and AGTR2 Gene and Response of Renin Activity, Angiotensin II and Aldosterone Concentrations to Antihypertensive Treatment in Kazakans. J RENIN-ANGIO-ALDO S 2011;12(4):581-587

45. Huang YD, Li N, Zhang WG, Hu XJ, Wang Q, Wang CC, Xu RW, Yan K, Hou XY, Naer K, Wang XL, Yan WL*. The effect of oral alpha-lipoic acid in overweight/obese individuals on brachial-ankle pulse wave velocity and supine blood pressure: a randomized, crossover, double-blind, placebo-controlled trial. Chinese J Epidemiol.2011;32(3):278-284

 

Peer reviewed books

Book in Chinese: Genetic Study Methods to Complex Diseases (editor) 2010

Patents

2 Chinese patents (patent numbers): ZL201310038845.5; 0661769

 


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