A follow-up study on the correlation between sleep duration and body mass index in primary and middle school students in Zhejiang Province from 2017 to 2019
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摘要:
目的 了解睡眠行为及其变化对中小学生体重变化的影响,为制定儿童青少年肥胖防控策略提供理论依据。 方法 选取来自“全国学生常见病和健康影响因素监测”浙江省3座城市中同时参与2017和2019年问卷调查和体格测量的中小学生,形成605人的追踪调查数据,分析睡眠时长与体质量指数(BMI)的关联。 结果 2017—2019年,男、女生BMI Z评分分别升高了0.24和0.13,9~12岁学生的BMI Z评分升高了0.29,城市和乡村学生BMI Z评分分别升高了0.11和0.25(P值均<0.05);同期睡眠不足总体检出率由37.0%增加到41.8%(χ2=3.68,P=0.06)。在调整混杂因素后,睡眠不足学生的BMI Z评分较睡眠充足学生高0.20(P < 0.01);与睡眠始终充足的学生相比,2017—2019年睡眠时长由充足变为不足、睡眠始终不足的学生BMI Z评分均增加了0.23(P值均<0.05)。 结论 睡眠不足是肥胖的危险因素,睡眠时长缩短的学生体重增长明显,增加睡眠时长可能降低学生远期肥胖风险。 Abstract:Objective To understand sleep behavior among primary and middle school students and its impact on overweight and obesity changes, to provide evidence for developing obesity prevention and controlling strategies in children and adolescents. Methods Primary and middle school students from three cities in Zhejiang Province who participated in questionnaire surveys and physical measurements in both 2017 and 2019 were selected. A follow-up dataset of 605 students was developed and the relationship between sleep duration and body mass index was analyzed. Results From 2017 to 2019, BMI-Z scores for male and female participants increased by 0.24 and 0.13, respectively. BMI-Z scores increased by 0.29 in students of 9-12 years old and increased by 0.11 and 0.25 in urban and rural students, respectively (P < 0.05). The prevalence of insufficient sleep duration increased from 37.0% to 41.8% simultaneously (χ2=3.68, P=0.06). After adjusting for confounding factors, the BMI-Z score of students with insufficient sleep was 0.20 higher than those with sufficient sleep duration (P < 0.01). Compared with participants who had sufficient sleep duration from 2017 to 2019, participants whose sleep duration changed from sufficient to insufficient, and those who always had insufficient sleep duration increased by 0.23, respectively (P < 0.05). Conclusion Insufficient sleep duration is a risk factor for obesity. Shortened sleep duration is related to weight gain, and maintaining sufficient sleep duration may reduce the risk of obesity in children and adolescents. -
Key words:
- Sleep /
- Time /
- Body mass index /
- Regression analysis /
- Students
1) 利益冲突声明 所有作者声明无利益冲突。 -
表 1 中学生一般资料构成在2017年和2019年间比较(n=605)
Table 1. Participants' demographic characteristics and behaviors(n=605)
组别 选项 2017年 2019年 χ2值 P值 BMI分组 正常 605(100.0) 560(92.5) 44.62 <0.01 超重肥胖 0 45(7.5) 睡眠时长 不足 225(37.0) 254(41.8) 5.18 0.02 充足 380 (63.0) 351(58.2) 每天摄入含糖饮料/次 ≥1 42(6.9) 38(6.2) 0.12 0.73 <1 563(93.1) 567(93.8) 每天摄入油炸食品/次 >0 497(82.1) 534(88.3) 8.50 <0.01 0 108(17.9) 71(11.7) 每天吃早餐/次 <1 64(10.5) 86(14.1) 3.36 0.07 1 541(89.5) 519(85.9) 每周1 h以上中高强度 0 291(53.1) 73(11.9) 222.24 <0.01 身体活动a/d ≥1 257(46.9) 532(88.1) 每天看电视/h ≥2 85(13.9) 71(11.6) 1.24 0.27 <2 520(86.1) 534(88.4) 每天刷牙频率/次 <2 174(29.5) 121(20.8) 12.12 <0.01 ≥2 431(70.5) 484(79.2) 注:a由于问卷漏填等原因存在少量缺失;()内数字为构成比/%。 表 2 2017和2019年中小学生BMI Z评分比较(n=605)
Table 2. Comparison of changes in BMI Z scores of elementary and middle school students from 2017 to 2019(n=605)
年份 性别 年龄/岁 城乡 合计 男 女 9~12 13~17 城市 乡村 2017 -0.40 -0.41 -0.39 -0.44 -0.39 -0.42 -0.40 2019 -0.16 -0.28 -0.10 -0.31 -0.28 -0.17 -0.22 差值 0.24 0.13 0.29 0.13 0.11 0.25 0.18 P值 <0.01 <0.01 <0.01 0.17 0.03 <0.01 <0.01 表 3 睡眠时长及其变化与中学生BMI Z评分变化值的关联(n=605)
Table 3. The relationship between sleep duration and the changes in the student's BMI Z score (n=605)
自变量 选项 模型1 模型2 β值 标准误 P值 β值 标准误 P值 睡眠时长c 充足 - - 不足 0.05 0.07 0.49 0.20 0.08 <0.01 睡眠时长变化 始终充足 - - 不足变化为充足 0.02 0.10 0.93 0.12 0.10 0.27 充足变化为不足 0.12 0.09 0.57 0.23 0.10 0.04 始终不足 -0.01 0.09 0.93 0.23 0.11 0.04 注:模型1无调整;模型2调整了年龄、性别、城乡以及当年的含糖饮料摄入、油炸食品摄入、看电视时间、身体活动、刷牙习惯。模型多重比较的P值已经过FDR校正。c使用2019年数据。 -
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