[The combined effect of spermarche, menarche and obesity on elevated blood pressure among Chinese students].

Objective: To investigate the association between the combined effect of spermarche/menarche and obesity with elevated blood pressure among Chinese students. Methods: A total of 106 009 primary and secondary school students (55 614 boys and 50 395 girls) were selected from " 2014 National Physical Fitness and Health Surveillance" (including 31 provinces, with the exception of Hong Kong, Macao, and Taiwan) with full record of height, weight, blood pressure, puberty development data of spermarche/menarche. The level of blood pressure, as well as the prevalence of high blood pressure(HBP), were compared between different subgroups (pre-spermarche/menarche and non-obesity group, pre-spermarche/menarche and obesity group, pro-spermarche/menarche and non-obesity group, pro-spermarche/menarche and obesity group), and mulilevel logistic model was used to investigate the relationship between puberty development, obesity and blood pressure. Results: Among 55 614 boys aged 11 to 17 years old, the prevalence of spermarche was 62.1% (34 512/55 614), the prevalence of obesity was 7.5% (4 166/55 614), and the mean values of systolic pressure and diastolic pressure were 110.7/68.2 mmHg (1 mmHg=0.133 kPa). While among 50 395 girls aged 9-14 years, the prevalence of menarche was 48.2% (24 301/50 395), the prevalence of obesity was 5.8% (2 942/50 395), and the mean values of systolic pressure and diastolic pressure was 102.9/64.8 mmHg. The prevalence of high blood pressure was 5.2% (1 003/19 274), 17.9% (328/1 828), 6.6% (2 132/32 174), and 23.9% (558/2 338) in pre-spermarche and non-obesity boys, pre-spermarche and obesity boys, pro-spermarche and non-obesity boys and pro-spermarche and obesity boys, respectively. The prevalence of high blood pressure was 5.9% (1 439/24 570), 17.2% (262/1 524), 5.0% (1 147/22 883), and 17.0% (241/1 418) in pre-menarche and non-obesity girls, pre-menarche and obesity girls, pro-menarche and non-obesity girls and pro-menarche and obesity girls, respectively. After adjustment of region, age, height and urban/rural area by multilevel model, the students in pro-spermarche/menarche and obesity group were more likely to have high blood pressure (boys: OR(95% CI)=4.93 (4.30-5.66); girls: OR(95% CI) =3.77(3.16-4.50)) Conclusion: Puberty development and obesity were closed associated with blood pressure. Both boys and girls who enter puberty earlier and were in obesity status were more likely to have high blood pressure. Therefore, interventions focused on obesity prevetion and intervention among prepuberty students may be beneficial to reduce their prevalence of high blood pressure in the future.