Association between the pubertal timing and high blood pressure in children and adolescents in Suzhou City
Objective To investigate the association of the timing of pubertal onset with blood pressure levels and hypertension risk in children and adolescents,in order to provide scientific evidence for hypertension prevention and control.Methods A multi-stage stratified cluster random sampling method was used to select 1 992 children and adolescents aged 9-16 years from four primary schools and four junior high schools in Suzhou between October and November 2022.Basic information including height,weight,and blood pressure was collected on-site.Questionnaires were used to gather data on students'dietary habits,screen time,academic performance,and physical activity.The Pubertal Development Scale(PDS)was employed to categorize pubertal timing into early group(>P75),timely group(P25-P75),and delayed groups(<P25).Linear regression analysis was conducted to examine the association between different pubertal timing and blood pressure levels.Logistic regression analysis was performed to assess the relationship between pubertal timing and the risk of elevated blood pressure.Results A total of 999 males(50.2%)and 993 females(49.8%)were enrolled in this study.The average age of males and females was(12.76±1.76)years and(12.31±1.77)years,respectively,and the systolic blood pressure(SBP)of males and females were(114.40±12.70)and(110.34±11.74)mmHg(x2=7.412,P<0.001),respectively,and diastolic blood pressure(DBP)was(65.05±7.36)and(65.44±7.41)mmHg(P>0.05).The detection rates of high blood pressure in male and female students were 26.3%and 16.3%,respectively(x2=29.744,P<0.001).After adjusting for the relevant covariates,linear regression analysis revealed a negative correlation between delayed pubertal timing and SBP Z-score in boys(β=-0.340,95%CI:-0.340--0.140),while the results of the girls were not statistically significant(P>0.05),and the early and delayed puberty initiation groups and the DBP Z-score were not statistically significant(P>0.05).No significant correlations were observed between early or delayed pubertal timing and DBP Z-score in either gender(P>0.05).Logistic regression analysis indicated a negative association between delayed pubertal timing and the risk of elevated blood pressure in boys(OR=0.545,95%CI:0.314-0.944),whereas no statistical significance was found in girls(P>0.05).Conclusions The association of pubertal timing with blood pressure levels and hypertension risk varies by gender in children and adolescents.Early intervention measures should be taken to improve pubertal development,particularly in boys.