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

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

蒋家诺¹,
杨田²,
袁雯¹,
秦阳¹,
宋欣俐¹,
张奕¹,
陈力¹,
王若琳¹,
张秀红²,
宋逸¹,
马军¹,
董彦会^1, ,

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.
内蒙古自治区综合疾病预防控制中心学校卫生科

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
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- 被引次数: 0
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

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

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

摘要

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。
- 超重 /
- 肥胖症 /
- 血压 /
- 生活方式 /
- 共病现象 /
- 学生 /
- 少数民族
Abstract: Objective To explore the epidemiological trend of overweight and obesity, elevated blood pressure and their comorbidities in children and adolescents from Inner Mongolia Autonomous Region during 2016-2021, and to analyze its association with lifestyle, so as to provide reference for formulating prevention and control strategies of regional common comorbidities in schools. Methods A total of 8 908, 8 222, 9 448, 127 068, 100 778, and 138 540 students aged 10-18 years in Inner Mongolia were selected by stratified random cluster sampling in September each year from 2016 to 2021. Physical examination and questionnaire survey were conducted on the included students. The prevalence trends of overweight, obesity, elevated blood pressure and their co-occurrence were analyzed. Logistic regression was used to compare the prevalence of elevated blood pressure in different body mass index (BMI) groups. After excluding individuals without lifestyle information in 2021, Logistic regression analysis was used on 136 374 subjects to analyze the association between overweight, obesity, elevated blood pressure and their co-occurrence and lifestyle factors. Results During 2016 to 2021, the prevalence of comorbidity of overweight, obesity with elevated blood pressure among students in Inner Mongolia Autonomous Region were 5.04%, 5.14%, 4.99%, 7.51%, 7.60% and 9.45%, respectively. The prevalence of overweight and obesity was 26.94%, 28.07%, 29.62%, 34.19%, 36.71% and 37.53%, respectively. The prevalence of elevated blood pressure were 16.05%, 11.54%, 13.12%, 14.85%, 14.12% and 18.40%, respectively. Except for 2016, the risk of elevated blood pressure in overweight and obese people was higher than that in normal BMI group in other years, and there was a positive correlation between overweight and obesity and elevated blood pressure after gender and urban and rural areas (P < 0.05). In 2021, the detection rate of comorbidity of overweight and obesity with elevated blood pressure among children and adolescents in urban areas was higher than that in suburban counties, and the reporting rate of healthy lifestyle was lower than that in suburban counties (P < 0.05).Skipping breakfast (OR=1.11, 95%CI=1.07-1.16) and non-daily moderate and high-intensity physical activity(OR=1.27, 95%CI=1.20-1.34) were positively correlated with the co-occurrence of overweight, obesity and elevated blood pressure among children and adolescents in Inner Mongolia Autonomous Region. Non-daily moderate and high-intensity physical activity ≥60 min was positively correlated with elevated blood pressure (OR=1.11, 95%CI=1.07-1.16), and insufficient sleep was positively correlated with overweight, obesity (OR=1.04, 95%CI=1.01-1.06)(P < 0.05). Conclusion The prevalence of overweight, obesity, elevated blood pressure and their co-occurrence among children and adolescents in Inner Mongolia Autonomous Region is relatively high. Overweight/obesity is an important risk factor for elevated blood pressure, and unhealthy lifestyles are risk factors for co-occurrence of overweight, obesity and elevated blood pressure. Region-specific lifestyle interventions are indispensable for the prevention and control of regional common comorbidities. Urban areas may be a key focus for lifestyle interventions.
- Overweight /
- Obesity /
- Blood pressure /
- Life style /
- Comorbidity /
- Students /
- Minority groups
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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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
组别	选项	统计值	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	男		4 491	31.17	16.08	5.39	3 914	33.80	10.66	5.55	4 462	34.92	11.25	5.05
	女		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值		81.96	0.00	2.15		120.96	5.40	2.44		113.20	25.45	0.04
		P值		< 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值		36.07	436.42	85.67		24.63	95.00	60.19		53.80	12.19	0.61
		P值		< 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
组别	选项	统计值	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	男		64 202	39.05	13.95	7.96	50 377	42.22	13.32	8.13	69 868	42.70	17.49	10.13
	女		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值		1 360.00	84.16	36.89		1 314.30	53.26	40.24		1 610.00	76.61	76.33
		P值		< 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值		157.93	126.54	2.11		157.30	3.36	14.15		173.73	89.00	59.22
		P值		< 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

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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
年份	BMI分组	整体	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)^**
注：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。

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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	男	68 698		52 082(75.91)	13 990(20.40)	51 118(79.47)	30 769(45.24)	21 653(32.31)
	女	67 676		50 493(74.72)	8 972(13.29)	46 124(73.39)	31 702(47.27)	19 463(29.20)
			χ²值	25.96	1 227.00	652.06	55.85	151.63
			P值	< 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值	122.56	0.61	4.37	3.11	309.08
			P值	< 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)
注：()内数字为报告率/%；所有变量均有信息缺失值。

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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
自变量	选项	OR值(95%CI)	P值	OR值(95%CI)	P值	OR值(95%CI)	P值
每天吃早餐	否	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	否	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	否	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	否	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	否	1.00(0.96~1.05)	0.84	1.04(1.01~1.06)	< 0.01	0.99(0.96~1.02)	0.39
注：模型调整了性别、城乡和学段。

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