中国7~18岁汉族学生2010-2014年腹型肥胖变化及其影响因素分析

doi:10.11852/zgetbjzz2018-26-09-10

摘要/Abstract

摘要： 目的分析我国7~18岁汉族学生2010-2014年的腹型肥胖变化情况,探索学生腹型肥胖的影响因素。方法选取2010年和2014年中国学生体质与健康调研库中7~18岁汉族学生作为研究对象,筛出腰围、身高信息不完整以及腰围和腰围身高比异常样本,纳入分析共计228 562名。采用国内制定的腰围界值点和国际常用腰围身高比≥0.5判定腹型肥胖;采用问卷调查收集影响因素的信息。采用t检验、χ²检验比较腹型肥胖年份差异,多因素Logistic回归模型分析腹型肥胖的影响因素。结果 2010年7~18岁中国汉族学生的腰围和腰围身高比均值分别为(64.96±9.79)cm 和0.428±0.048,2014年分别为(65.90±10.07)cm 和0.434±0.051,2014年显著高于2010年(P＜0.001)。2010-2014年7~18岁中国汉族学生的腹型肥胖检出率显著上升(腰围界值:13.84%＜17.13%;腰围身高比界值:8.91%＜11.23%,P均＜0.001)。2014年腹型肥胖检出率男生高于女生,城市高于乡村,东中部高于西部,低年龄段高于高年龄段(P均＜0.001)。多因素Logistic回归结果显示,男生(OR=2.37,95%CI: 2.26~2.48)、城市(OR=1.25,95%CI: 1.20~1.31),东部和中部(东部:OR=1.29,95%CI: 1.22~1.37;中部:OR=1.08,95%CI: 1.02~1.15),7~9岁和10~12岁(7~9岁:OR=1.89,95%CI: 1.77~2.03;10~12岁:OR=2.07,95%CI: 1.89~2.26)、早餐＜3~5次/周(OR=1.17,95%CI: 1.07~1.28)、不愿意长跑锻炼(OR=1.72,95%CI: 1.64~1.80)、每天电视时间≥1 h(OR=1.06,95%CI: 1.01~1.13)可能是腹型肥胖的危险因素(P<0.05或<0.01)。睡眠时间、每天锻炼时间、每天做作业时间可能与腹型肥胖无关(P＞0.05)。结论 2010-2014年7~18岁中国汉族学生的腹型肥胖检出率显著上升,学生腹型肥胖可能具有多种影响因素,应开展有针对性的综合干预。

关键词: 汉族学生, 腹型肥胖, 影响因素, 腰围, 腰围身高比

Abstract: Objective To analyze the prevalence of abdominal obesity in Chinese Han students aged 7~18 in 2010 and 2014,and to explore the influencing factors of abdominal obesity. Methods Han students aged 7~18 years from Chinese National Survey on Students' Constitution and Health in 2010 and 2014 were included. After screening students lacking waist or height information and students with abnormal waist or waist-to-height ratio,finally 228 562 students were analyzed. Waist cut-off standards in China and waist-to-height ratio cut-off (≥0.5) were used to classify abdominal obesity. Questionnaires were used to collect information about influencing factors. t-test and χ² test were used to analyze the difference of abdominal obesity in 2010 and 2014,and Logistic regressive model was used to analyze the influencing factors. Results The average waist and waist-to-height ratio of Chinese Han students aged 7~18 years in 2010 were (64.96±9.79)cm and 0.428±0.048. The average waist and waist-to-height ratio in 2014 were (65.90±10.07)cm and 0.434±0.051, which were higher than those in 2010 (P<0.001). The prevalence of abdominal obesity of Chinese Han students significantly increased from 2010 to 2014 (by waist cut-off: 13.84%<17.13%,by waist-to-height ratio: 8.91%<11.23%,both P<0.001). In 2014,the prevalence of abdominal obesity among boys was higher than that of girls,urban students higher than rural students,students from middle and eastern China was higher than those from western China,students in low age higher than the older ones (P<0.001). Logistic regression analysis showed that boys (OR=2.37,95%CI: 2.26~2.48),urban area (OR=1.25,95%CI: 1.20~1.31),eastern and middle regions (east: OR=1.29,95%CI: 1.22~1.37; middle: OR=1.08,95%CI: 1.02~1.15),7~9 and 10~12 years (7~9: OR=1.89,95%CI: 1.77~2.03; 10~12: OR=2.07,95%CI: 1.89~2.26),having breakfast less than 3~5 times/per week (OR=1.17,95%CI: 1.07~1.28),unwillingness for long-distance running (OR=1.72,95%CI: 1.64~1.80),TV time ≥1 hour/per day (OR=1.06,95%CI: 1.01~1.13) were the risk factors of abdominal obesity(all P<0.05 or<0.01). Sleep duration,exercise duration/per day,homework duration/per day were not related to the prevalence of abdominal obesity (all P>0.05). Conclusions The prevalence of abdominal obesity of Chinese Han students aged 7~18 years significantly increased from 2010 to 2014.Abdominal obesity in studerts can be affected by multiple influencing factors, and thus comprehensive intervention for obesity should be factor-targeted.

Key words: Chinese Han students, abdominal obesity, influencing factors, waist, waist-to-height ratio

中图分类号:

R179

杨忠平,杨招庚,邹志勇,马军. 中国7~18岁汉族学生2010-2014年腹型肥胖变化及其影响因素分析[J]. 中国儿童保健杂志, 2018, 26(9): 964-968.

YANG Zhong-ping,YANG Zhao-geng,ZOU Zhi-yong,MA Jun. Analysis of prevalence of abdominal obesity in Chinese Han students aged 7~18 from 2010 to 2014 and related factors of abdominal obesity[J]. journal1, 2018, 26(9): 964-968.

参考文献

[1] Yi Song,Jun Ma,Hai-Jun Wang,et al.Secular trends of obesity prevalence in chinese children from 1985 to 2010: urban-rural disparity[J].Obesity,2015,23(2):448-453.
[2] 王烁,董彦会,王政和,等.1985—2014年中国7~18岁学生超重与肥胖流行趋势[J].中华预防医学杂志,2017,51(4):300-305.
[3] Liang Y,Hou D,Zhao X,et al.Childhood obesity affects adult metabolic syndrome and diabetes[J].Endocrine,2015,50(1):87-92.
[4] 马军.高度关注学生肥胖流行新趋势有效落实慢性病防控关口前移[J].中华预防医学杂志,2017,51(4):281-284.
[5] Ashwell M,Gunn P,Gibson S.Waist-to-height ratio is a better screening tool than waist circumference and BMI for adult cardiometabolic risk factors: systematic review and meta-analysis[J].Obes Rev,2012,13(3):275-286.
[6] Lam BC,Koh GC,Chen C,et al,Comparison of body mass index (BMI),body adiposity index (BAI),waist circumference (WC),waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) as predictors of cardiovascular disease risk factors in an adult population in Singapore[J].PLoS One,2015,10(4):e0122985.
[7] Keihani S,Hosseinpanah F,Barzin M,et al.Abdominal obesity phenotypes and risk of cardiovascular disease in a decade of follow-up: the Tehran lipid and glucose study[J].Atherosclerosis,2015,238(2):256-263.
[8] He F,Rodriguez-Colon S,Fernandez-Mendoza J,et al.Abdominal obesity and metabolic syndrome burden in adolescents--Penn State Children Cohort study[J].J Clin Densitom,2015,18(1):30-36.
[9] 吴丽晶,马军,付连国,等.中国7～10岁儿童腹型肥胖与血压的关系[J].中华预防医学杂志,2013,47(8):689-694.
[10] Liang YJ,Xi B,Song AQ,et al.Trends in general and abdominal obesity among Chinese children and adolescents 1993-2009[J].Pediatr Obes,2012,7(5):355-364.
[11] 马军,蔡赐河,王海俊,等.1985-2010年中国学生超重与肥胖流行趋势[J].中华预防医学杂志,2012,46(9):776-780.
[12] 中华人民共和国国家统计局.东西中部和东北地区划分方法[EB/OL].(2011-06-13) [2014-08-11].http://www.stats.gov.cn/ztjc/zthd/sjtjr/dejtjkfr/tjkp/201106/t20110 613_71947.htm.
[13] 中国学生体质与健康研究组.2014年中国学生体质与健康调研报告[M].北京:高等教育出版社,2016:10-12,24-41.
[14] Ma GS,Ji CY,Ma J,et al.Waist circumference reference values for screening cardiovascular risk factors in Chinese children and adolescents[J].Biomed Environ Sci,2010,23(1):21-31.
[15] Schwandt P,Haas GM.Is the ratio waist circumference to height (WHtR) of 0.5 a universal measure for abdominal adiposity in children and adolescents？[J].Int J Obes (Lond),2016,40(7):1141-1142.
[16] Xi B,Mi J,Zhao M,et al.Trends in abdominal obesity among U.S.children and adolescents[J].Pediatrics,2014,134(2):e334-339.
[17] 马军.中国儿童青少年主要健康问题及应对策略[J].中国学校卫生,2015,36(6):801-804.
[18] Fatima Y,Doi SA,Mamun AA.Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis[J].Obes Rev,2015,16(2):137-149.
[19] Roberts RE,Duong HT.Is there an association between adolescent sleep restriction and obesity[J].J Psychosom Res,2015,79(6):651-656.
[20] Carrillolarco RM,Bernabéortiz A,Miranda JJ.Short sleep duration and childhood obesity: cross-sectional analysis in Peru and Patterns in four developing countries[J].Plos One,2014,9(11):e112433.
[21] 中国民族教育.中共中央国务院关于加强青少年体育增强青少年体质的意见[J].体育教学,2007,28(6):4-5.
[22] 王政和,董彦会,宋逸,等.中国2014年9～22岁学生体育锻炼时间不足1小时的流行现状与相关因素分析[J].中华流行病学杂志,2017,38(3):341-345.