中小学生家长肥胖知信行与子女腹型肥胖发生风险的关联

黄闪; 桂曌环; 章舒心; 姜楠; 黄绍逸; 普雪娅; 陈亚军

doi:10.16835/j.cnki.1000-9817.2022.11.004

中小学生家长肥胖知信行与子女腹型肥胖发生风险的关联

doi: 10.16835/j.cnki.1000-9817.2022.11.004

中山大学公共卫生学院妇幼卫生学系, 广东广州 510080

基金项目:

2012年卫生公益性行业科研专项项目 201202010

详细信息

作者简介:
黄闪(1999-), 男, 河北邢台人, 在读硕士, 主要研究方向为儿童体质健康与慢性病

通讯作者:
陈亚军, E-mail: chenyj68@mail.sysu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G 478 R 723.14 R 179
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- 被引次数: 0
出版历程
- 收稿日期: 2022-01-07
- 修回日期: 2022-03-02
- 网络出版日期: 2022-11-30
- 刊出日期: 2022-11-25

Incidence of abdominal obesity among primary and middle school students and its association with parental weight-related knowledge, attitude and practice

Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou (510080), China

摘要

摘要: 目的了解中国7省市中小学生腹型肥胖与家长肥胖相关知识、信念、行为的关联性, 为制定儿童青少年腹型肥胖相关干预措施提供参考。方法采用多阶段整群随机抽样的方法, 于2013年9月从中国7省市抽取17 307名正常腰围学生, 进行9个月的随访, 最终14 118名6~18岁儿童青少年纳入分析。通过自制问卷调查收集家长肥胖相关知信行情况, 测量学生基线和随访腰围指标。采用多重线性回归和多因素Logistic回归分别分析家长知信行与子女腰围变化值以及腹型肥胖发生风险的关联性。结果 6~18岁儿童青少年腹型肥胖前期和腹型肥胖的9个月累积发病率分别为6.67%, 0.85%, 不同性别、年龄间差异均有统计学意义。家长的知识、信念、行为得分率分别为80.17%, 78.17%, 50.50%。校正混杂因素后, 家长信念得分与学生腰围变化值(β=-0.18, 95%CI=-0.26~-0.10)及腹型肥胖前期/腹型肥胖发生风险均呈负相关(OR=0.90, 95%CI=0.82~0.98)(P值均 < 0.05)。结论家长对子女肥胖持积极正确的信念与子女腹型肥胖发生风险呈负相关。家长建立正确的健康信念有利于预防儿童青少年腹型肥胖的发生。
- 肥胖症 /
- 健康知识, 态度, 实践 /
- 法定监护人 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the association of parental weight-related knowledge, attitude and practice (KAP) with abdominal obesity among primary and middle school students and to provide evidence for related intervention measures. Methods In September 2013, the multistage random sampling method was used to select 17 307 primary and secondary school students with normal waist circumference in seven provinces/municipalities in China. After nine-month follow-up, 14 118 students aged 6-18 years were included in the final analysis. Questionnaires were used to assess parental weight-related KAP, and students' waist circumference was measured objectively at baseline and follow-up. Multiple linear regression and multivariate Logistic regression were conducted to analyze the relationship between parents' KAP with the change of students' waist circumference and abdominal obesity, respectively. Results The nine-month cumulative incidence of pre-and abdominal obesity among students was 6.67% and 0.85%, respectively. The scoring rates of parents' knowledge, attitude and practice were 80.17%, 78.17%, 50.50%, respectively. The score of parents' weight-related attitude was inversely associated with the changes of waist circumference (β=-0.18, 95%CI=-0.26--0.10) and cumulative incidence of pre-and abdominal obesity (OR=0.90, 95%CI=0.82-0.98)(P < 0.05). Conclusion Parental positive and correct weight-related attitude is inversely associated with the incidence of abdominal obesity among children and adolescents. Interventions targeting establishing parents' correct beliefs may be an effective way to prevent abdominal obesity in children and adolescents.
- Obesity /
- Health knowledge, attitudes, practice /
- Legal guardians /
- Regression analysis /
- Students
注释:

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表 1 不同组别学生腹型肥胖9个月累积发病率比较

Table 1. Comparison of nine-month cumulative incidence of childhood abdominal obesity among different groups of students

组别	选项	人数	统计值	腹型肥胖前期	腹型肥胖
性别	男	7 453		370(4.96)	32(0.43)
	女	6 665		571(8.57)	88(1.32)
			χ²值	33.14	7.24
			P值	＜0.01	＜0.01
年龄/岁	6~11	8 871		528(5.95)	45(0.51)
	12~18	5 247		413(7.87)	75(1.43)
			χ²值	14.84	33.27
			P值	＜0.01	＜0.01
合计		14 118		941(6.67)	120(0.85)
注：()内数字为发病率/%。

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表 2 不同体型学生家长肥胖相关知信行得分比较(x±s)

Table 2. Comparison of KAP scores related to obesity among parents of students of different body types(x±s)

体型	人数	知识	信念	行为	总分
正常腰围	13 057	9.61±1.42	4.71±1.03	5.05±1.84	19.47±2.53
腹型肥胖前期	941	9.78±1.19	4.42±0.95	5.04±1.89	19.26±2.46
腹型肥胖	120	9.65±1.56	4.58±1.01	5.25±1.78	19.61±2.62
F值		6.17	36.50	0.52	2.33
P值		＜0.01	＜0.01	0.60	0.10

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表 3 家长肥胖相关知信行对中小学生腰围变化值影响的多重线性回归分析(n=14 118)

Table 3. Multiple linear regression of parents' weight-related KAP scores with changes of waist circumference among primary and middle school students(n=14 118)

家长肥胖KAP得分	模型	β值(β值95%CI)	P值
知识	1	0.02(-0.04~0.07)	0.52
	2	0.04(-0.01~0.10)	0.11
	3	0.03(-0.03~0.09)	0.35
信念	1	0.05(-0.02~0.12)	0.20
	2	-0.13(-0.20~-0.06)	＜0.01
	3	-0.18(-0.26~-0.10)	＜0.01
行为	1	-0.01(-0.05~0.03)	0.56
	2	-0.02(-0.06~0.01)	0.23
	3	-0.01(-0.06~0.03)	0.58
注：模型1调整基线年龄、性别；模型2在模型1基础上调整基线腰围；模型3在模型2基础上调整分娩方式、出生体重、是否独生子女、父母文化程度、家庭每月总收入、父母是否超重肥胖、城乡。

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表 4 中小学生腹型肥胖前期/腹型肥胖发生风险的多因素Logistic回归分析(n=14 118)

Table 4. Multivariate Logistic regression of the risk ratio of pre-and abdominal obesity among primary and middle school students(n=14 118)

自变量	选项	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
年龄		-0.55	0.04	246.04	＜0.01	0.58(0.54~0.62)
基线腰围		0.34	0.02	363.64	＜0.01	1.41(1.36~1.46)
家长知识得分		0.05	0.04	1.43	0.23	1.05(0.97~1.13)
家长信念得分		-0.11	0.05	5.44	0.02	0.90(0.82~0.98)
家长行为得分		0.01	0.03	0.28	0.59	1.01(0.96~1.07)
性别	男					1.00
	女	1.47	0.11	193.00	＜0.01	4.37(3.55~5.38)
父母文化程度	初中及以下					1.00
	高中	0.04	0.12	0.12	0.73	1.04(0.82~1.32)
	大专	0.04	0.15	0.08	0.77	1.04(0.78~1.40)
	大学及以上	-0.03	0.17	0.04	0.84	0.97(0.70~1.34)
家庭每月总收入/元	＜5 000					1.00
	5 000~7 999	-0.04	0.13	0.10	0.76	0.96(0.74~1.24)
	≥8 000	-0.18	0.15	1.47	0.23	0.84(0.63~1.12)
	拒绝回答	0.03	0.12	0.08	0.78	1.03(0.82~1.31)
分娩方式	顺产					1.00
	剖宫产	0.06	0.10	0.37	0.54	1.06(0.87~1.29)
出生体重	正常体重					1.00
	低出生体重	-0.40	0.21	3.84	0.05	0.67(0.45~1.00)
	高出生体重	0.45	0.14	10.22	＜0.01	1.56(1.19~2.05)
独生子女	是					1.00
	否	0.12	0.10	1.28	0.26	1.13(0.92~1.38)
城乡	农村					1.00
	城市	0.41	0.11	13.65	＜0.01	1.50(1.21~1.86)
母亲肥胖	消瘦/正常					1.00
	超重/肥胖	0.11	0.11	0.92	0.34	1.11(0.90~1.38)
父亲肥胖	消瘦/正常					1.00
	超重/肥胖	0.25	0.09	7.48	0.01	1.29(1.07~1.54)
注：父母文化程度指父亲和母亲两者中最高文化程度。

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