Abstract: Objective To investigate the prevalence of abdominal obesity among primary and secondary school students in Zhengzhou, so as to provide reference for the prevention and control of overweight and obesity in urban students. Methods A stratified cluster sampling method was performed to select 6 859 students aged 7 - 15 years in Zhengzhou in 2019. Questionnaire survey and physical examination were conducted among these children. Body mass index(BMI), waist circumference(WC) and waist-to-height ratio(WHtR) were used to analyze the prevalence of overweight, obesity and abdominal obesity among primary and secondary school students. The t test, completely random design χ² test, paired χ² test and weighted Kappa consistency tests were performed with the R 4.0.3 software. Results The overall detection rate of overweight and obesity based on the BMI standard was 14.4% and 10.3%, respectively. The detection rate of abdominal obesity based on WC and WHtR standards was 19.4% and 14.3%, respectively. The detection rates of obesity and abdominal obesity in boys were higher than that in girls under the three criteria(P<0.01). The detection rate of abdominal obesity in students aged 10 - 15 years were significantly higher than that in students aged 7 - 9 years(P<0.01). For the screening of abdominal obesity in primary and middle school students, the Kappa value of WC standard vs. WHtR standard was 0.73, among which, the Kappa values of boys aged 7 - 9 years, 10 - 12 years and 13 - 15 years was 0.84, 0.85 and 0.76, respectively, showing a high degree of consistency. Conclusions The prevalence of overweight, obesity and abdominal obesity among 7- to 15-year-old students in Zhengzhou is not optimistic, especially for boys and primary school students. Comprehensive intervention should be carried out as soon as possible.

Key words: primary and secondary school students, abdominal obesity, screening standard, overweight, obesity

摘要： 目的 了解郑州市城区中小学生超重肥胖和中心性肥胖的流行现况,为城区学生的超重肥胖防控提供参考。方法 采用分层整群抽样方法,于2019年选取郑州市城区小学和初中学校的6 859名7~15岁学生进行问卷调查和体格检查,采用体重指数(BMI)、腰围(WC)和腰围身高比(WHtR)3种指标标准分析中小学生的超重肥胖和中心型肥胖流行现况。用R 4.0.3软件进行t检验、完全随机设计χ²检验、配对χ²检验和加权Kappa一致性检验。结果 以BMI标准筛查郑州市城区中小学生的总体超重和肥胖率分别为14.4%和10.3%,以WC标准和WHtR标准筛查的中心型肥胖率分别为19.4%和14.3%。3种筛查标准对各年龄段男生的肥胖和中心型肥胖检出率均高于女生,差异有统计学意义(P<0.01);10~15岁学生的中心型肥胖检出率均高于7~9岁学生,差异有统计学意义(P< 0.01)。在筛查中小学生中心型肥胖上,WC标准 vs. WHtR标准的Kappa值为0.73,其中7~9岁、10~12岁和13~15岁男生的Kappa值分别为0.84、0.85和0.76,一致性程度较高。结论 郑州市城区7~15岁学生超重肥胖和中心型肥胖状况不容乐观,尤其是男生和小学生应重点关注,应及早开展综合干预进行防控。

关键词: 中小学生, 中心型肥胖, 筛查标准, 超重, 肥胖