天津市中学生体力活动睡眠时间及超重肥胖与抑郁症状的关系

孙志颖; 刘忠慧; 冯宝佳; 张献伟; 徐渴; 陈璐

doi:10.16835/j.cnki.1000-9817.2023.04.003

天津市中学生体力活动睡眠时间及超重肥胖与抑郁症状的关系

doi: 10.16835/j.cnki.1000-9817.2023.04.003

天津市疾病预防控制中心环境与健康室，300011

基金项目:

天津市医学重点学科(专科)建设项目 TJYX2DXK-051A

详细信息

作者简介:
孙志颖(1992-)，女，河北邯郸人，硕士，医师，主要研究方向为儿童青少年健康与学校卫生

通讯作者:
陈璐，E-mail：chenlu6@tj.gov.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G804.49 R723.14 G444
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出版历程
- 收稿日期: 2022-09-09
- 修回日期: 2023-02-15
- 网络出版日期: 2023-04-26
- 刊出日期: 2023-04-25

Relationship between physical activity, sleep duration and overweight, obesity with depressive symptoms among middle school students in Tianjin

Institute of Environment and Health, Tianjin Center for Disease Control and Prevention, Tianjin(300011), China

摘要

摘要: 目的了解天津市中学生体力活动、睡眠时间、超重肥胖与抑郁症状的关系，为儿童青少年抑郁的干预提供理论依据。方法于2019—2021年每年9月采用分层整群抽样方法，从天津市16个区抽取52 747名中学生进行问卷调查，问卷内容包括学生基本信息、抑郁症状、睡眠时间和体力活动时间。采用χ²检验和Logistic回归对数据进行分析。结果天津市中学生抑郁症状检出率为19.07%，女生高于男生，城区高于农村，住校学生高于走读学生，留守学生高于非留守学生，差异均有统计学意义(χ²值分别为128.44，155.77，35.29，19.15，P值均 < 0.05)。天津市中学生超重检出率为20.64%，肥胖检出率为22.13%，一周体力活动时间合格率为49.54%，每天户外活动时间合格率为33.64%，睡眠时间合格率为25.77%。Logistic回归分析结果显示，一周体力活动时间合格、每天户外活动时间合格、睡眠时间合格、体质量指数(BMI)合格均与抑郁症状检出率呈负相关，其中睡眠时间合格抑郁症状检出风险最低(OR=0.60，95%CI=0.57~0.63)；与4项均不合格学生相比，4项均合格学生发生抑郁症状风险较低(OR=0.39，95%CI=0.34~0.46)(P值均 < 0.05)。结论天津市中学生抑郁症状水平居中，应从睡眠时间、体力活动、户外活动和超重肥胖方面进行综合干预，减少中学生抑郁症状的发生。
- 运动活动 /
- 睡眠 /
- 超重 /
- 肥胖症 /
- 抑郁 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the relationship between physical activity, sleep duration, overweight, obesity and depressive symptoms among middle school students in Tianjin, and to provide the evidence for targeted prevention of depression. Methods In September 2019 to 2021, the stratified cluster sampling method was used to select 52 747 middle school students from 16 districts in Tianjin for questionnaire survey, including demographics, depressive symptom, sleep status and physical activity. The χ² test and multivariate Logistic regression were used to analyze the data. Results The prevalence of depressive symptoms among middle school students in Tianjin was 19.07%, with higher prevalence in female, urban areas, resident students and left-behind students (χ²=128.44, 155.77, 35.29, 19.15, P < 0.05). The prevalence of overweight and obesity were 20.64% and 22.13%, the proportion of students who met physical activity, outdoor activity, sleep duration guideline were 49.54%, 33.64%, 25.77%, respectively. Logistic regression results showed that meeting the guidelines on physical activity, outdoor activity, sleep duration and BMI were negatively correlated with depression symptoms, with sleep duration showed the highest protective effects on depressive symptoms(OR=0.60, 95%CI=0.57-0.63, P < 0.05). Compared with students who did not meet any guidelines, students who met 4 guidelines had a lower risk of depression symptoms(OR=0.39, 95%CI=0.34-0.46, P < 0.05). Conclusion The prevalence of depressive symptoms of middle school students in Tianjin is in moderate level, and the intervention should be comprehensively administered in terms of sleep duration, physical activity, outdoor activities, as well as overweight and obesity to reduce the occurrence of depression symptoms among middle school students.
- Motor activity /
- Sleep /
- Overweight /
- Obesity /
- Depression /
- Regression analysis /
- Students
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表 1 天津市不同组别中学生抑郁症状检出率比较

Table 1. Comparison of depression symptoms rate among middle school students in different groups in Tianjin

组别	选项	人数	抑郁症状人数	χ²值	P值
性别	男	27 074	4 652(17.18)	128.44	< 0.01
	女	25 673	5 407(21.06)
学段	初中	27 903	4 543(16.28)	329.20	< 0.01
	高中	19 346	4 153(21.47)
	职高	5 498	1 363(24.79)
城乡	城区	29 196	6 147(21.05)	155.77	< 0.01
	郊区	23 551	3 912(16.61)
住校	是	5 934	1 301(21.92)	35.29	< 0.01
	否	46 813	8 758(18.71)
留守	是	1 290	303(23.49)	19.15	< 0.01
	否	51 457	9 752(18.95)
年份	2019	15 881	3 435(21.63)	127.63	< 0.01
	2020	15 991	3 082(19.27)
	2021	20 875	3 542(16.97)
注：()内数字为检出率/%。

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表 2 天津市不同组别中学生BMI、体力活动、睡眠时间及不同组合达标数合格率比较

Table 2. Comparison of qualified rate of BMI, physical activity, sleep duration and combination standards of different groups in middle school students in Tianjin

组别	选项	人数	统计值	一周体力活动时间合格	每天户外活动时间合格	睡眠时间合格	BMI合格	组合达标数/项
组别	选项	人数	统计值	一周体力活动时间合格	每天户外活动时间合格	睡眠时间合格	BMI合格	0	1	2	3	4
性别	男	27 074		15 050(55.59)	9 922(36.65)	7 594(28.05)	14 060(51.93)	3 271(12.08)	8 436(31.16)	9 056(33.45)	5 166(19.08)	1 145(4.23)
	女	25 673		11 081(43.16)	7 820(30.46)	6 000(23.37)	17 046(66.40)	2 933(11.42)	9 087(35.40)	8 785(34.22)	4 182(16.29)	686(2.67)
			χ²值	813.98	226.02	150.75	1 139.55	228.31
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
学段	初中	27 903		16 583(59.43)	10 148(36.37)	6 856(24.57)	16 118(57.76)	2 728(9.78)	8 415(30.16)	10 049(36.01)	5 652(20.26)	1 059(3.80)
	高中	19 346		7 459(38.56)	5 550(28.69)	3 967(20.51)	11 645(60.19)	2 980(15.40)	7 513(38.83)	5 887(30.43)	2 530(13.08)	436(2.25)
	职高	5 498		2 089(38.00)	2 044(37.18)	2 771(50.40)	3 343(60.80)	496(9.02)	1 595(29.01)	1 905(34.65)	1 166(21.21)	336(6.11)
			χ²值	2 318.85	336.42	2 044.75	36.37	1 320.67
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
城乡	城区	29 196		13 784(47.21)	9 552(32.72)	8 037(27.53)	17 099(58.57)	3 558(12.19)	9 789(33.53)	9 870(33.81)	4 973 (17.03)	1 006(3.45)
	郊区	23 551		12 347(52.43)	8 190(34.78)	5 557(23.60)	14 007(59.48)	2 646(11.24)	7 734(32.84)	7 971(33.85)	4 375(18.58)	825(3.50)
			χ²值	141.80	24.75	105.36	4.45	29.55
			P值	< 0.01	< 0.01	< 0.01	0.03	< 0.01
住校	是	5 934		2 102(35.42)	1 826(30.77)	1 623(27.35)	3 822(64.41)	764(12.87)	2 195(36.99)	1 927(32.47)	868(14.63)	180(3.03)
	否	46 813		24 029(51.33)	15 916(34.00)	11 971(25.57)	27 284(58.28)	5 440(11.62)	15 328(32.74)	15 914(34.00)	8 480(18.11)	1 651(3.53)
			χ²值	533.06	24.57	8.71	81.67	79.07
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	0.05
留守	是	1 290		581(45.04)	432(33.49)	358(27.75)	715(55.43)	167(12.95)	472(36.59)	390(30.23)	210(16.28)	51(3.96)
	否	51 457		25 550(49.65)	17 310(33.64)	13 236(25.72)	30 391(59.06)	6 037(11.73)	17 051(33.14)	17 451(33.91)	9 138(17.76)	1 780(3.46)
			χ²值	10.72	0.01	2.71	6.87	13.57
			P值	< 0.01	0.91	0.10	< 0.01	< 0.01
抑郁症状	是	10 059		4 229(42.04)	3 054(30.36)	1 936(19.25)	5 809(57.75)	1 544(15.35)	3 771(37.49)	3 182(31.63)	1 355(13.47)	207(2.06)
	否	42 688		21 902(51.31)	14 688(34.41)	11 658(27.31)	25 297(59.26)	4 660(10.92)	13 752(32.22)	14 659(34.34)	7 993(18.72)	1 624(3.80)
			χ²值	279.56	59.73	276.68	7.68	420.12
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
注：()内数字为合格率或构成比/%。

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表 3 天津市中学生体力活动、睡眠时间和BMI与抑郁症状的Logistic回归分析(n=52 747)

Table 3. Logistic regression analysis of physical activity, sleep duration, BMI and depression symptoms in middle school students in Tianjin(n=52 747)

自变量	选项	模型1		模型2		模型3
自变量	选项	OR值(OR值95%CI)	P值	OR值(OR值95%CI)	P值	OR值(OR值95%CI)	P值
一周体力活动合格		0.69(0.66~0.72)	< 0.01	0.75(0.72~0.79)	< 0.01	0.83(0.76~0.90)	< 0.01
每天户外活动时间合格		0.83(0.79~0.87)	< 0.01	0.86(0.82~0.90)	0.01	0.89(0.82~0.97)	0.01
睡眠时间合格		0.63(0.60~0.67)	< 0.01	0.60(0.57~0.63)	< 0.01	0.56(0.50~0.62)	< 0.01
BMI合格		0.94(0.90~0.98)	0.01	0.90(0.86~0.94)	< 0.01	0.86(0.80~0.94)	< 0.01
组合合格项数	1	0.83(0.77~0.89)	< 0.01	0.83(0.77~0.88)	< 0.01	0.76(0.68~0.86)	< 0.01
	2	0.66(0.61~0.70)	< 0.01	0.67(0.62~0.71)	< 0.01	0.65(0.57~0.73)	< 0.01
	3	0.51(0.47~0.56)	< 0.01	0.53(0.49~0.57)	< 0.01	0.50(0.43~0.58)	< 0.01
	4	0.39(0.33~0.45)	< 0.01	0.39(0.34~0.46)	< 0.01	0.52(0.39~0.67)	< 0.01

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参考文献(25)

[1]	WHO. Depression[EB/OL]. (2021-09-13)[2022-05-12]. https://www.who.int/news-room/fact-sheets/detail/depression.
[2]	VOS T, LIM S S, ABBAFATI C, et al. Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019[J]. Lancet, 2020, 396(10258): 1204-1222. doi: 10.1016/S0140-6736(20)30925-9
[3]	WHO. WHO calls for stronger focus on adolescent health[EB/OL]. (2014-05-14)[2022-05-12]. https://www.who.int/news/item/14-05-2014-who-calls-for-stronger-focus-on-adolescent-health.
[4]	JOHNSON D, DUPUIS G, PICHE J, et al. Adult mental health outcomes of adolescent depression: a systematic review[J]. Depres Anx, 2018, 35(8): 700-716. doi: 10.1002/da.22777
[5]	刘福荣, 宋晓琴, 尚小平, 等. 中学生抑郁症状检出率的Meta分析[J]. 中国心理卫生杂志, 2020, 34(2): 123-128. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202002009.htm LIU F R, SONG X Q, SHANG X P, et al. A Meta-analysis of detection rate of depression symptoms among middle school students[J]. Chin Ment Health J, 2020, 34(2): 123-128. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS202002009.htm
[6]	洪忻, 梁亚琼, 王志勇, 等. 南京中学生体力活动现状及其与抑郁症状的相关分析[J]. 中国学校卫生, 2007, 28(12): 1059-1061. doi: 10.3969/j.issn.1000-9817.2007.12.007 HONG X, LIANG Y Q, WANG Z Y, et al. Physical activity and its correlation with depression among high school students in Nanjing[J]. Chin J Sch Health, 2007, 28(12): 1059-1061. (in Chinese) doi: 10.3969/j.issn.1000-9817.2007.12.007
[7]	KANDOLA A, ASHDOWN-FRANKS G, HENDRIKSE J, et al. Physical activity and depression: towards understanding the antidepressant mechanisms of physical activity[J]. Neurosci Biobehav Rev, 2019, 107: 525-539. doi: 10.1016/j.neubiorev.2019.09.040
[8]	徐莹, 廖若男, 邱霜, 等. 中学生昼夜节律情绪调节与抑郁症状的相关性[J]. 中国学校卫生, 2022, 43(5): 722-726. doi: 10.16835/j.cnki.1000-9817.2022.05.019 XU Y, LIAO R N, QIU S, et al. Correlation between circadian rhythm, emotion regulation and depressive symptoms among adolescents[J]. Chin J Sch Health, 2022, 43(5): 722-726. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.05.019
[9]	MILANESCHI Y, IMMONS W K, VAN ROSSUM E, et al. Depression and obesity: evidence of shared biological mechanisms[J]. Mol Psychiatry, 2019, 24(1): 18-33. doi: 10.1038/s41380-018-0017-5
[10]	PASCOE M C, PARKER A G. Physical activity and exercise as a universal depression prevention in young people: a narrative review[J]. Early Interv Psychiatry, 2019, 13(4): 733-739. doi: 10.1111/eip.12737
[11]	李婷婷, 伍晓艳, 陶舒曼, 等. 大学生体力活动与身体健康及抑郁症状的关联[J]. 中国学校卫生, 2020, 41(6): 867-870. doi: 10.16835/j.cnki.1000-9817.2020.06.018 LI T T, WU X Y, TAO S M, et al. Study on the relationship between physical activity and physical, mental health of college students[J]. Chin J Sch Health, 2020, 41(6): 867-870. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.06.018
[12]	全国学生体质与健康调研组. 2019年全国学生体质与健康调研工作手册[M]. 北京: 高等教育出版社, 2019: 17-24, 41-48. National Student Physique and Health Research Group. 2019 national student physique and health research manual[M]. Beijing: Higher Education Press, 2019: 17-24, 41-48. (in Chinese)
[13]	何津, 陈祉妍, 郭菲, 等. 流调中心抑郁量表中文简版的编制[J]. 中华行为医学与脑科学杂志, 2013, 22(12): 1133-1136. doi: 10.3760/cma.j.issn.1674-6554.2013.12.023 HE J, CHEN Z Y, GUO F, et al. A short Chinese version of Center for Epidemiologic Studies Depression Scale[J]. Chin J Behav Med Brain Sci, 2013, 22(12): 1133-1136. (in Chinese) doi: 10.3760/cma.j.issn.1674-6554.2013.12.023
[14]	国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586—2018[S/OL]. (2018-08-01)[2022-05-12]. https://hbba.sacinfo.org.cn/stdDetail/a5078dab6fbfd5b6495cdcce69424bbdd128f380aa93c7dbe5c58c67d9d2075e. National Health and Family Planning Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018[S/OL]. (2018-08-01)[2022-05-12]. https://hbba.sacinfo.org.cn/stdDetail/a5078dab6fbfd5b6495cdcce69424bbdd128f380aa93c7dbe5c58c67d9d2075e. (in Chinese)
[15]	国家卫生和计划生育委员会. 学龄儿童青少年营养不良筛查: WS/T 456—2014[S/OL]. (2014-12-15)[2022-05-12]. https://hbba.sacinfo.org.cn/stdDetail/8dfa4f569546fee01d6148f9b3cb86d0. National Health and Family Planning Commission of the PRC. Screening for malnutrition among school-age children and adolescents: WS/T 456-2014[S/OL]. (2014-12-15)[2022-05-12]. https://hbba.sacinfo.org.cn/stdDetail/8dfa4f569546fee01d6148f9b3cb86d0. (in Chinese)
[16]	张云婷, 马生霞, 陈畅, 等. 中国儿童青少年身体活动指南[J]. 中国循证儿科杂志, 2017, 12(6): 401-409. doi: 10.3969/j.issn.1673-5501.2017.06.001 ZHANG Y T, MA S X, CHEN C, et al. Physical activity guidelines for children and adolescents in China[J]. Chin J Evid-Based Pediatr, 2017, 12(6): 401-409. (in Chinese) doi: 10.3969/j.issn.1673-5501.2017.06.001
[17]	教育部办公厅关于进一步加强中小学生体质健康管理工作的通知[J]. 中华人民共和国教育部公报, 2021(6): 36-37. Notice of the General Office of the Ministry of Education on further strengthening the physical health management of primary and secondary school students[J]. Bull Ministry Educ, PRC, 2021(6): 36-37. (in Chinese)
[18]	教育部办公厅关于进一步加强中小学生睡眠管理工作的通知[J]. 中华人民共和国教育部公报, 2021(5): 71-72. Notice of the General Office of the Ministry of Education on further strengthening sleep management of primary and secondary school students[J]. Bull Ministry Educ PRC, 2021(5): 71-72. (in Chinese)
[19]	SALK R H, HYDE J S, ABRAMSON L Y. Gender differences in depression in representative national samples: meta-analyses of diagnoses and symptoms[J]. Psychol Bull, 2017, 143(8): 783-822. doi: 10.1037/bul0000102
[20]	宋玲玲, 吴静, 苏普玉. 青少年抑郁的环境可控性因素[J]. 中国学校卫生, 2022, 43(2): 312-315. doi: 10.16835/j.cnki.1000-9817.2022.02.035 SONG L L, WU J, SU P Y. Environmental controllable factors of adolescents' depression[J]. Chin J Sch Health, 2022, 43(2): 312-315. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.02.035
[21]	KORCZAK D J, MADIGAN S, COLASANTO M. Children's physical activity and depression: a Meta-analysis[J]. Pediatrics, 2017, 139(4): e20162266.
[22]	MANNAN M, MAMUN A, DOIS, et al. Prospective associations between depression and obesity for adolescent males and females: a systematic review and Meta-analysis of longitudinal studies[J]. PLoS One, 2016, 11(6): e0157240.
[23]	CHAPUT J P, GRAY C E, POITRAS V J, et al. Systematic review of the relationships between sleep duration and health indicators inschool-aged children and youth[J]. Appl Physiol Nutr Metabol, 2016, 41(6): S266-S282.
[24]	刘洋, 张伟波, 蔡军. 初中生焦虑抑郁情绪与生活方式的关系[J]. 中国心理卫生杂志, 2017, 31(3): 235-240. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201703016.htm LIU Y, ZHANG W B, CAI J. Relation of anxiety and depression to lifestyle in junior high school students[J]. Chin Ment Health J, 2017, 31(3): 235-240. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201703016.htm
[25]	吴慧攀. 中国心理亚健康青少年体质健康及其影响因素的研究[D]. 上海: 华东师范大学, 2019. WU H P. Study on physical fitness and influencing factors of mental sub-health adolescents in China[D]. Shanghai: East China Normal University, 2019. (in Chinese)