中国13~18岁青少年心理健康及其与肌肉力量的关联

杨若澜; 蔡珊; 马宁; 党佳佳; 刘云飞; 张依航; 陈子玥; 李佳欣; 黄天彧; 芦利利; 孙子曰; 杨旸; 胡佩瑾; 马军; 宋逸

doi:10.16835/j.cnki.1000-9817.2025285

中国13~18岁青少年心理健康及其与肌肉力量的关联

doi: 10.16835/j.cnki.1000-9817.2025285

1.
北京大学公共卫生学院/北京大学儿童青少年卫生研究所，北京 100191
2.
清华大学万科公共卫生与健康学院

基金项目:

科技部重点研发计划项目 2024YFC2707901

详细信息

作者简介:
杨若澜(2002-)，女，北京市人，在读硕士，主要研究方向为儿童青少年肌肉力量指数

通讯作者:
宋逸，E-mail：songyi@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: R179 B844.2 R337
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- 被引次数: 0
出版历程
- 收稿日期: 2025-04-23
- 修回日期: 2025-06-10
- 网络出版日期: 2025-10-10
- 刊出日期: 2025-09-25

Association between mental health and muscle strength among Chinese adolescents aged 13-18

1.
School of Public Health/Institute of Child and Adolescent Health, Peking University, Beijing 100191, China

摘要

摘要: 目的探讨中国13~18岁青少年心理健康与肌肉力量水平的关联，为青少年心理健康促进提供理论依据和干预方向。方法采用2019年全国学生体质与健康调研数据，研究对象为98 631名13~18岁青少年。使用凯斯勒心理困扰量表(K10)评估青少年的心理困扰，使用沃里克-爱丁堡积极心理健康量表(WEMWBS)评估青少年的心理幸福感；根据各测试项目握力、立定跳远、引体向上(男生)、仰卧起坐(女生)的性别、年龄别Z评分构建肌肉力量指数(MSI)，以评价青少年肌肉力量的综合水平。根据心理健康双因素模型，将心理健康状态分为完全病态、部分病态、部分心理健康和完全心理健康4类。使用χ²检验比较性别差异，采用Cochran-Armitage检验进行趋势检验，建立无序多分类Logistic回归模型分析青少年心理健康与肌肉力量的关联。结果 2019年中国13~18岁青少年高心理困扰报告率为37.4%，低主观幸福感报告率为59.9%。男生高心理困扰报告率(35.3%)和低主观幸福感报告率(55.6%)均低于女生(39.4%，64.3%)，差异均有统计学意义(χ²值分别为176.13，780.42，P值均 < 0.05)。2019年青少年完全心理健康率随年龄的增加呈现下降趋势(χ_趋势²=258.47)，且随肌肉力量水平的提升呈现逐渐上升趋势(χ_趋势²=123.14)，男、女生中均有类似趋势(χ_趋势²值分别为103.83，168.46；57.00，67.34)(P值均 < 0.05)。无序多分类Logistic回归模型结果显示，控制年龄、性别等混杂因素后，以完全病态组为参照时，青少年MSI每升高1个单位，处于完全心理健康状态的可能性增加29%(OR=1.29)；在男生中，引体向上Z评分每升高1个单位，处于完全心理健康状态的可能性增加6%(OR=1.06)；在女生中，仰卧起坐Z评分每升高1个单位，处于完全心理健康状态的可能性增加19%(OR=1.19)(P值均 < 0.05)。结论中国青少年心理健康状况欠佳，肌肉力量水平与心理健康状态呈正相关。
- 精神卫生 /
- 肌力 /
- 回归分析 /
- 青少年
Abstract: Objective To explore the association between mental health and muscle strength among Chinese adolescents aged 13-18, providing a theoretical foundation and intervention strategies for mental health promotion. Methods Data were obtained from the 2019 Chinese National Survey on Students' Constitution and Health, including 98 631 Chinese adolescents aged 13-18. Psychological distress was assessed by using the Kessler Psychological Distress Scale (K10), and mental well-being was measured with the Warwick-Edinburgh Mental Well-being Scale (WEMWBS). Based on the gender- and age-specific Z-scores of various test items [grip strength, standing long jump, pull-ups (for males), and sit-ups (for females)], muscle strength index (MSI) was constructed to evaluate the comprehensive level of muscle strength in adolescents. According to the Dual-factor Model (DFM) of mental health, participants were categorized into four groups: troubled, symptomatic but content, vulnerable, and complete mental health. Gender differences were analyzed by using Chi-square tests, trends were tested with Cochran-Armitage tests, and multinomial Logistic regression models were applied to assess associations between muscle strength and mental health among adolescents. Results In 2019, 37.4% of Chinese adolescents aged 13-18 were reported of high mental distress, and 59.9% were reported of low mental well-being. Boys had significantly lower rates of high mental distress (35.3%) and low mental well-being (55.6%) compared to girls (39.4%, 64.3%), and the differences were of statistical significance (χ²=176.13, 780.42, both P < 0.05). In 2019, the rate of complete mental health among adolescents showed a downward trend with increasing age (χ_trend²=258.47) and a gradual upward trend with increasing muscle strength levels (χ_trend²=123.14), and both boys and girls exhibited similar trends (χ_trend²=103.83, 168.46; 57.00, 67.34) (all P < 0.05). The results of the unordered multiclass Logistic regression model showed that after controlling for confounding factors such as age and gender, when the completely pathological group as a reference, for every 1 unit increase in MSI in adolescents, the likelihood of being in a completely mental health state increased by 29% (OR=1.29); for every unit increase in the Z-score for pull-ups, the likelihood of being in a completely mental health state increased by 6% (OR=1.06) among boys; for every 1 unit increase in sit-up Z-score, the likelihood of being in a completely mental health state increased by 19% (OR=1.19) among girls (all P < 0.05). Conclusions The mental health status of Chinese adolescents is not good enough. Muscle strength is positively associated with mental health.
- Mental health /
- Muscle strength /
- Regression analysis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 不同年龄和肌肉力量水平青少年完全心理健康率

Figure 1. Complete psychological health rates of adolescents by different ages and muscle strength levels

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表 1 不同性别青少年人口学特征、心理健康状态和肌肉力量水平分布比较

Table 1. Comparison of distribution of demographic characteristics, mental health status and muscle strength level among adolescents by sex

性别	人数	年龄段/岁		城乡		心理健康状态				肌肉力量水平
性别	人数	13~15	16~18	城市	乡村	完全病态	部分病态	部分心理健康	完全心理健康	差	中	良	优
男生	49 621	25 037(50.5)	24 584(49.5)	25 153(50.7)	24 468(49.3)	12 095(24.4)	5 435(11.0)	15 495(31.2)	16 596(33.4)	11 447(23.1)	13 656(27.5)	13 229(26.7)	11 289(22.8)
女生	49 010	25 151(51.3)	23 859(48.7)	24 569(50.1)	24 441(49.9)	15 136(30.9)	4 183(8.5)	16 388(33.4)	13 303(27.1)	12 890(26.3)	10 946(22.3)	11 529(23.5)	13 645(27.8)
χ²值		7.29		3.07		886.52				719.67
P值		0.01		0.08		< 0.01				< 0.01
注：()内数字为构成比/%。

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表 2 中国13~18岁青少年心理健康状态与肌肉力量水平关联[OR值(95%CI)]

Table 2. Association between mental health status and muscle strength levels among Chinese adolescents aged 13-18 years[OR(95%CI)]

心理健康状态	肌肉力量	总体(n=98 631)	男生(n=49 621)	女生(n=49 010)
部分病态	中	0.93(0.88~0.99)^*	0.97(0.89~1.05)	0.90(0.82~0.98)^*
	良	0.99(0.94~1.05)	1.04(0.96~1.13)	0.94(0.86~1.03)
	优	0.97(0.91~1.03)	1.02(0.94~1.11)	0.92(0.85~1.01)
部分心理健康	中	1.03(0.99~1.07)	1.00(0.95~1.05)	1.07(1.01~1.13)^*
	良	0.99(0.95~1.03)	0.95(0.90~1.00)	1.02(0.97~1.08)
	优	0.95(0.91~0.98)^**	0.93(0.88~0.98)^*	0.96(0.91~1.01)
完全心理健康	中	1.12(1.08~1.17)^**	1.12(1.06~1.19)^**	1.12(1.05~1.19)^**
	良	1.18(1.14~1.23)^**	1.17(1.11~1.23)^**	1.20(1.13~1.27)^**
	优	1.34(1.29~1.39)^**	1.30(1.23~1.38)^**	1.38(1.30~1.45)^**
注：^P < 0.05，^{ *}P < 0.01。

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表 3 中国13~18岁青少年心理健康状态与MSI和各肌肉力量组分Z评分的关联[OR值(95%CI)]

Table 3. Association of mental health status with MSI and Z-scores of muscle strength components among Chinese adolescents aged 13-18 [OR(95%CI)]

心理健康状态	自变量	总体(n=98 631)	男生(n=49 621)	女生(n=49 010)
部分病态	MSI	0.97(0.93~1.01)	1.01(0.95~1.08)	0.94(0.88~1.00)^*
	握力	1.01(0.99~1.03)	1.02(0.99~1.05)	1.00(0.97~1.03)
	立定跳远	1.00(0.98~1.02)	0.99(0.96~1.02)	1.01(0.98~1.04)
	引体向上	—	1.01(0.98~1.04)	—
	仰卧起坐	—	—	0.92(0.89~0.95)^**
部分心理	MSI	0.94(0.91~0.97)^**	0.92(0.88~0.96)^**	0.95(0.92~0.99)^**
健康	握力	0.98(0.97~0.99)^**	0.96(0.95~0.98)^**	1.00(0.98~1.02)
	立定跳远	0.99(0.98~1.00)	0.98(0.96~1.00)	1.00(0.98~1.02)
	引体向上	—	0.98(0.96~1.00)^*	—
	仰卧起坐	—	—	0.96(0.94~0.97)^**
完全心理	MSI	1.29(1.25~1.32)^**	1.26(1.20~1.31)^**	1.31(1.26~1.37)^**
健康	握力	1.03(1.02~1.05)^**	1.05(1.03~1.07)^**	1.02(1.00~1.04)^*
	立定跳远	1.10(1.09~1.12)^**	1.11(1.09~1.13)^**	1.09(1.07~1.11)^**
	引体向上	—	1.06(1.04~1.08)^**	—
	仰卧起坐	—	—	1.19(1.17~1.22)^**
注：^P < 0.05，^{ *}P < 0.01。

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