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内蒙古地区学生超重肥胖与血压偏高及其共病状况的生活方式影响因素分析

蒋家诺 杨田 袁雯 秦阳 宋欣俐 张奕 陈力 王若琳 张秀红 宋逸 马军 董彦会

蒋家诺, 杨田, 袁雯, 秦阳, 宋欣俐, 张奕, 陈力, 王若琳, 张秀红, 宋逸, 马军, 董彦会. 内蒙古地区学生超重肥胖与血压偏高及其共病状况的生活方式影响因素分析[J]. 中国学校卫生, 2023, 44(9): 1313-1318. doi: 10.16835/j.cnki.1000-9817.2023.09.008
引用本文: 蒋家诺, 杨田, 袁雯, 秦阳, 宋欣俐, 张奕, 陈力, 王若琳, 张秀红, 宋逸, 马军, 董彦会. 内蒙古地区学生超重肥胖与血压偏高及其共病状况的生活方式影响因素分析[J]. 中国学校卫生, 2023, 44(9): 1313-1318. doi: 10.16835/j.cnki.1000-9817.2023.09.008
JIANG Jianuo, YANG Tian, YUAN Wen, QIN Yang, SONG Xinli, ZHANG Yi, CHEN Li, WANG Ruolin, ZHANG Xiuhong, SONG Yi, MA Jun, DONG Yanhui. Co-occurrence trend of overweight, obesity and elevated blood pressure and its association with lifestyle factors among students in Inner Mongolia Autonomous Region[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2023, 44(9): 1313-1318. doi: 10.16835/j.cnki.1000-9817.2023.09.008
Citation: JIANG Jianuo, YANG Tian, YUAN Wen, QIN Yang, SONG Xinli, ZHANG Yi, CHEN Li, WANG Ruolin, ZHANG Xiuhong, SONG Yi, MA Jun, DONG Yanhui. Co-occurrence trend of overweight, obesity and elevated blood pressure and its association with lifestyle factors among students in Inner Mongolia Autonomous Region[J]. CHINESE JOURNAL OF SCHOOL HEALTH, 2023, 44(9): 1313-1318. doi: 10.16835/j.cnki.1000-9817.2023.09.008

内蒙古地区学生超重肥胖与血压偏高及其共病状况的生活方式影响因素分析

doi: 10.16835/j.cnki.1000-9817.2023.09.008
基金项目: 

北京教育科学规划课题 AECA22126

北京教育科学规划课题 AHCA23107

详细信息
    作者简介:

    蒋家诺(1999-),女,陕西省人,在读硕士,主要研究方向为儿童青少年慢性病及其影响因素

    通讯作者:

    董彦会,E-mail:dongyanhui@bjmu.edu.cn

  • 利益冲突声明  所有作者声明无利益冲突。
  • 中图分类号: R723.14  R544  R179

Co-occurrence trend of overweight, obesity and elevated blood pressure and its association with lifestyle factors among students in Inner Mongolia Autonomous Region

  • 摘要:   目的  探究2016—2021年学生超重肥胖、血压偏高及其共病的流行趋势,分析其生活方式影响因素,为制定区域性常见病共病的学校防控策略提供参考。  方法  采用分层随机整群抽样方法于2016—2021年每年9月选取内蒙古8 908,8 222,9 448,127 068,100 778,138 540名10~18岁学生为研究对象,对其进行体格检查和问卷调查,分析超重肥胖、血压偏高及其共病的流行趋势,采用Logistic回归分析不同体质量指数(BMI)分组的血压偏高检出情况。排除2021年生活方式信息缺失者后,采用Logistic回归分析136 374名研究对象超重肥胖、血压偏高及其共病的生活方式影响因素。  结果  2016—2021年学生超重肥胖与血压偏高共病的检出率分别为5.04%,5.14%,4.99%,7.51%,7.60%,9.45%;超重肥胖的检出率分别为26.94%,28.07%,29.62%,34.19%,36.71%,37.53%;血压偏高检出率分别为16.05%,11.54%,13.12%,14.85%,14.12%,18.40%。除2016年外,其余年份均呈现超重肥胖者发生血压偏高的风险较BMI正常组升高,分性别、城乡后也呈现出超重肥胖与血压偏高正性相关(P值均 < 0.05)。2021年城区儿童青少年超重肥胖与血压偏高共病的检出率高于郊县,健康生活方式的报告率低于郊县(P值均 < 0.05)。非每天吃早餐(OR=1.11,95%CI=1.07~1.16)和非每天中高强度身体活动≥60 min(OR=1.27,95%CI=1.20~1.34)与儿童青少年超重肥胖与血压偏高共病的发生呈正相关,非每天中高强度身体活动≥60 min与血压偏高的发生呈正相关(OR=1.11,95%CI=1.07~1.16),睡眠时间不达标与超重肥胖的发生呈正相关(OR=1.04,95%CI=1.01~1.06)(P值均 < 0.05)。  结论  内蒙古儿童青少年超重肥胖、血压偏高及其共病的检出率较高,超重肥胖是血压偏高发生的重要风险因素,不健康生活方式是其共发的风险因素。因地制宜的生活方式干预是实现区域性常见病共病共防不可缺少的措施,城区可能是生活方式干预的重点区域。
    1)  利益冲突声明  所有作者声明无利益冲突。
  • 表  1  2016—2021年内蒙古不同性别和城乡儿童青少年超重肥胖、血压偏高及其共病检出率比较/%

    Table  1.   Comparison of detection rates of overweight, obesity, elevated blood pressure and co-occurrence among children and adolescents of different gender and area in Inner Mongolia Autonomous Region from 2016 to 2021/%

    组别 选项 统计值 2016年 2017年 2018年
    人数 超重肥胖 血压偏高 共病 人数 超重肥胖 血压偏高 共病 人数 超重肥胖 血压偏高 共病
    性别 4 491 31.17 16.08 5.39 3 914 33.80 10.66 5.55 4 462 34.92 11.25 5.05
    4 417 22.64 16.03 4.69 4 308 22.86 12.33 4.76 4 986 24.87 14.79 4.94
    χ2 81.96 0.00 2.15 120.96 5.40 2.44 113.20 25.45 0.04
    P < 0.01 0.97 0.14 < 0.01 0.02 0.12 < 0.01 < 0.01 0.84
    城乡 城区 5 006 29.44 8.87 3.14 5 110 30.00 14.24 6.62 5 346 32.65 12.05 5.16
    郊县 3 902 23.73 25.27 7.48 3 112 24.90 7.12 2.70 4 102 25.67 14.52 4.78
    χ2 36.07 436.42 85.67 24.63 95.00 60.19 53.80 12.19 0.61
    P < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 0.43
    总体 8 908 26.94 16.05 5.04 8 222 28.07 11.54 5.14 9 448 29.62 13.12 4.99
    组别 选项 统计值 2019年 2020年 2021年
    人数 超重肥胖 血压偏高 共病 人数 超重肥胖 血压偏高 共病 人数 超重肥胖 血压偏高 共病
    性别 64 202 39.05 13.95 7.96 50 377 42.22 13.32 8.13 69 868 42.70 17.49 10.13
    62 866 29.23 15.78 7.06 50 401 31.21 14.92 7.07 68 672 32.26 19.32 8.75
    χ2 1 360.00 84.16 36.89 1 314.30 53.26 40.24 1 610.00 76.61 76.33
    P < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01
    城乡 城区 39 389 36.69 13.18 7.35 32 171 39.50 13.83 8.06 37 529 40.34 20.01 10.44
    郊县 87 679 33.07 15.61 7.59 68 607 35.41 14.26 7.38 101 011 36.48 17.80 9.08
    χ2 157.93 126.54 2.11 157.30 3.36 14.15 173.73 89.00 59.22
    P < 0.01 < 0.01 0.15 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01 < 0.01
    总体 127 068 34.19 14.85 7.51 100 778 36.71 14.12 7.60 138 540 37.53 18.40 9.45
    下载: 导出CSV

    表  2  2016—2021年内蒙古不同BMI分组儿童青少年血压偏高检出情况Logistic回归分析[OR值(95%CI)]

    Table  2.   Logistic regression analysis of elevated blood pressure prevalence in different BMI groups among children and adolescent in Inner Mongolia Autonomous Region from 2016 to 2021[OR(95%CI)]

    年份 BMI分组 整体 性别 城乡
    男生 女生 城区 郊县
    2016 消瘦 0.60(0.44~0.82)** 0.67(0.46~0.99)* 0.46(0.27~0.81)** 0.48(0.27~0.87)* 0.66(0.45~0.95)*
    (n=8 908) 超重 1.14(0.97~1.35) 1.09(0.87~1.37) 1.19(0.93~1.52) 1.06(0.81~1.39) 1.19(0.96~1.46)
    肥胖 1.80(1.52~2.13)** 1.55(1.23~1.96)** 2.17(1.69~2.78)** 1.62(1.25~2.10)** 1.95(1.56~2.43)**
    2017 消瘦 0.64(0.43~0.96)* 0.49(0.27~0.90)* 0.84(0.48~1.47) 0.56(0.34~0.92)* 0.96(0.46~2.01)
    (n=8 222) 超重 1.99(1.66~2.37)** 1.73(1.33~2.26)** 2.22(1.75~2.82)** 2.05(1.67~2.51)** 1.75(1.20~2.56)**
    肥胖 2.62(2.19~3.14)** 2.55(1.98~3.28)** 2.60(2.01~3.37)** 2.58(2.10~3.18)** 2.67(1.85~3.85)**
    2018 消瘦 0.92(0.69~1.22) 1.07(0.73~1.56) 0.76(0.49~1.18) 0.74(0.49~1.14) 1.14(0.77~1.68)
    (n=9 448) 超重 1.42(1.21~1.68)** 1.52(1.19~1.95)** 1.34(1.07~1.67)* 1.36(1.09~1.70)** 1.51(1.17~1.93)**
    肥胖 1.95(1.66~2.29)** 1.81(1.43~2.29)** 2.10(1.69~2.62)** 2.10(1.70~2.60)** 1.74(1.36~2.23)**
    2019 消瘦 0.61(0.55~0.68)** 0.66(0.57~0.75)** 0.56(0.47~0.66)** 0.64(0.52~0.79)** 0.60(0.53~0.68)**
    (n=127 068) 超重 1.67(1.60~1.74)** 1.67(1.57~1.77)** 1.68(1.58~1.78)** 1.78(1.65~1.93)** 1.63(1.55~1.71)**
    肥胖 2.95(2.85~3.07)** 2.94(2.79~3.10)** 2.97(2.81~3.14)** 3.25(3.03~3.49)** 2.84(2.72~2.97)**
    2020 消瘦 0.67(0.59~0.76)** 0.72(0.61~0.84)** 0.62(0.51~0.75)** 0.61(0.47~0.79)** 0.69(0.60~0.80)**
    (n=100 778) 超重 1.69(1.61~1.77)** 1.72(1.61~1.85)** 1.66(1.55~1.77)** 1.74(1.60~1.90)** 1.67(1.57~1.77)**
    肥胖 2.95(2.82~3.07)** 2.96(2.79~3.15)** 2.94(2.77~3.12)** 3.20(2.97~3.45)** 2.83(2.69~2.98)**
    2021 消瘦 0.78(0.71~0.85)** 0.79(0.70~0.89)** 0.77(0.67~0.88)** 0.92(0.79~1.08) 0.73(0.65~0.81)**
    (n=138 540) 超重 1.50(1.45~1.56)** 1.48(1.40~1.56)** 1.53(1.45~1.61)** 1.39(1.30~1.49)** 1.55(1.48~1.62)**
    肥胖 2.58(2.49~2.66)** 2.61(2.50~2.74)** 2.53(2.41~2.65)** 2.37(2.23~2.52)** 2.67(2.56~2.77)**
    :模型调整了性别、城乡和学段;**P < 0.01,*P < 0.05;趋势检验P值均 < 0.01。
    下载: 导出CSV

    表  3  2021年内蒙古不同性别城乡儿童青少年生活方式报告率比较

    Table  3.   Comparison of lifestyle reporting rate of children and adolescents of different gender and area from Inner Mongolia Autonomous Region in 2021

    组别 选项 人数 统计值 每天吃早餐 每天中高强度身体活动≥60 min 户外活动时间达标 视屏时间 睡眠时间达标
    性别 68 698 52 082(75.91) 13 990(20.40) 51 118(79.47) 30 769(45.24) 21 653(32.31)
    67 676 50 493(74.72) 8 972(13.29) 46 124(73.39) 31 702(47.27) 19 463(29.20)
    χ2 25.96 1 227.00 652.06 55.85 151.63
    P < 0.01 < 0.01 < 0.01 < 0.01 < 0.01
    城乡 城区 36 295 27 000(73.20) 6 269(17.00) 26 477(76.06) 16 773(45.85) 9 884(27.14)
    效县 99 449 75 575(76.11) 16 693(16.82) 70 765(76.62) 45 698(46.39) 31 232(32.12)
    χ2 122.56 0.61 4.37 3.11 309.08
    P < 0.01 0.44 0.04 0.08 < 0.01
    合计 136 374 102 575(75.32) 22 962(16.87) 97 242(76.46) 62 471(46.25) 41 116(30.76)
    :()内数字为报告率/%;所有变量均有信息缺失值。
    下载: 导出CSV

    表  4  2021年内蒙古儿童青少年超重肥胖、血压偏高及其共病生活方式影响因素Logistic回归分析(n=136 374)

    Table  4.   Logistic regression analysis of lifestyle factors associated with overweight/obesity, elevated blood pressure and co-occurrence among children and adolescent from Inner Mongolia Autonomous Region in 2021 (n=136 374)

    自变量 选项 共病 超重肥胖 血压偏高
    OR值(95%CI) P OR值(95%CI) P OR值(95%CI) P
    每天吃早餐
    1.11(1.07~1.16) < 0.01 1.11(1.09~1.14) < 0.01 1.07(1.03~1.10) < 0.01
    每天中高强度身体活动≥60 min
    1.27(1.20~1.34) < 0.01 1.24(1.20~1.28) < 0.01 1.11(1.07~1.16) < 0.01
    户外活动时间达标
    1.04(0.99~1.09) 0.08 1.02(0.99~1.05) 0.21 1.04(1.01~1.08) 0.02
    视屏时间达标
    1.03(0.99~1.07) 0.17 1.01(0.98~1.03) 0.61 1.01(0.99~1.04) 0.32
    睡眠时间达标
    1.00(0.96~1.05) 0.84 1.04(1.01~1.06) < 0.01 0.99(0.96~1.02) 0.39
    :模型调整了性别、城乡和学段。
    下载: 导出CSV
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出版历程
  • 收稿日期:  2023-08-16
  • 修回日期:  2023-09-02
  • 网络出版日期:  2023-09-28
  • 刊出日期:  2023-09-25

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