苏州市中小学生不同类型肥胖与青春发动时相的关联

吕慧玲; 王希; 胡佳乐; 韩迪; 胡佳; 沈蕙

doi:10.16835/j.cnki.1000-9817.2023.12.019

苏州市中小学生不同类型肥胖与青春发动时相的关联

doi: 10.16835/j.cnki.1000-9817.2023.12.019

吕慧玲¹,
王希¹,
胡佳乐¹,
韩迪²,
胡佳^{1, 2, 3},
沈蕙^{1, 2, 3, ,}

1.
南京医科大学公共卫生学院，江苏 211166
2.
苏州市疾病预防控制中心学校卫生科
3.
南京医科大学姑苏学院苏州市公共卫生高等研究院

基金项目:

国家自然科学基金青年项目 82204070

苏州市姑苏卫生人才计划培养项目 GSWS2020100

详细信息

作者简介:
吕慧玲(1998-)，女，安徽巢湖人，在读硕士，主要研究方向为儿童青少年发育与健康

通讯作者:
沈蕙，E-mail：18962168733@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R723.14 R179 R193
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- 被引次数: 0
出版历程
- 收稿日期: 2023-09-13
- 修回日期: 2023-10-12
- 网络出版日期: 2023-12-26
- 刊出日期: 2023-12-25

Association between different types of obesity and puberty timing in primary and secondary school students in Suzhou City

LYU Huiling¹,
WANG Xi¹,
HU Jiale¹,
HAN Di²,
HU Jia^{1, 2, 3},
SHEN Hui^{1, 2, 3
, ,}

1.
School of Public Health, Nanjing Medical University, Nanjing (211166), Jiangsu Province, China

摘要

摘要: 目的探讨儿童青少年不同类型肥胖与青春发动时相的关联，为控制肥胖和改善青春期发育提供线索。方法于2022年10—11月，采用分层整群随机抽样方法从苏州市4所小学和4所初中共抽取2 009名学生，使用标准化问卷收集学生基本信息、饮食、运动行为、户外活动、睡眠、视屏情况和青春期发育状况等，测量学生身高、体重和腰围，利用Logistic回归分析不同类型肥胖与青春发动时相的关联。结果苏州市中小学女生月经初潮中位年龄为11.64岁，男生首次遗精中位年龄为14.43岁。调整协变量后，Logistic回归分析结果显示，在女生中，超重组和单纯性肥胖、中心型肥胖、混合型肥胖组与青春期启动均呈正相关[OR值(95%CI)分别为3.20(1.63~6.29)，4.15(2.18~7.91)，2.70(1.52~4.79)和2.42(1.23~4.76)]，与青春发动时相提前均呈正相关[OR值(95%CI)分别为2.41(1.54~3.75)，2.46(1.55~3.90)，1.59(1.05~2.40)和1.72(1.06~2.81)]，超重组和单纯性肥胖、中心型肥胖组与青春发动时相延迟呈负相关[OR值(95%CI)分别为0.45(0.24~0.85)，0.48(0.25~0.92)和0.44(0.24~0.80)](P值均 < 0.05)。在男生中，超重肥胖与青春期启动、青春发动时相的关联均无统计学意义(P值均>0.05)。结论儿童青少年不同类型肥胖与青春期启动和青春发动时相的关联存在性别差异。应采取干预措施控制儿童青少年肥胖，尤其是女童，进而改善其青春期发育。
- 肥胖症 /
- 青春期发育 /
- 生长和发育 /
- 回归分析 /
- 学生
Abstract: Objective To explore the association between obesity types and puberty timing, in order to provide clues for healthy development in children and adolescents. Methods From October to November 2022, a stratified cluster random sampling method was used to select a total of 2 009 students from 4 primary schools and 4 middle schools in Suzhou City. The basic information, diet, exercise behaviors, outdoor activities, sleep, view screen and pubertal development of students were collected through standardized questionnaires. Height, weight and waist circumference were measured. The association between different types of obesity and pubertal development was analyzed using Logistic regression model. Results The median age of menarche for girls in primary and middle schools in Suzhou was 11.64 years old, the median age of first spermatorrhea in boys was 14.43 years old. After adjusting the covariates, the Logistic regression analysis results showed that overweight and simple obesity, central obesity, and mixed obesity groups were positively correlated with puberty onset among girls [OR(95%CI)=3.20(1.63-6.29), 4.15(2.18-7.91), 2.70(1.52-4.79), 2.42(1.23-4.76)], as well as early puberty onset [OR(95%CI)=2.41(1.54-3.75), 2.46(1.55-3.90), 1.59(1.05-2.40), 1.72(1.06-2.81)] (P < 0.05). The overweight, simple obesity and central obesity group were negatively correlated with delayed onset of puberty [OR(95%CI)=0.45(0.24-0.85), 0.48(0.25-0.92), 0.44(0.24-0.80), respectively] (P < 0.05). There was no statistically significant association between overweight and obesity among boys and the onset and phase of puberty (P>0.05). Conclusions There are gender differences in the association between different types of obesity and the onset and timing of puberty among children and adolescents. Intervention measures should be taken to control obesity in children and adolescents, especially in girls, in order to improve their adolescent development.
- Obesity /
- Adolescent development /
- Growth and development /
- Regression analysis /
- Students
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 不同性别中小学生基本情况比较

Table 1. Comparison of basic information of primary and secondary school students in different gender

性别	人数	超重	单纯性肥胖	中心型肥胖	混合型肥胖	含糖饮料摄入频率≥1次/d	油炸食品摄入频率≥1次/d	水果摄入频率 < 1次/d	蔬菜摄入频率 < 1次/d	每天≥60 min中高强度运动 < 3 d/周	视屏时间≥2 h/d	户外活动时间 < 2 h/d	睡眠时间合格	青春期启动
男生	1 006	206(20.5)	274(27.2)	288(28.6)	228(22.7)	88(8.7)	63(6.3)	171(17.0)	109(10.8)	285(28.3)	158(15.7)	581(57.8)	254(25.2)	191(21.6)^*
女生	1 003	159(15.9)	144(14.4)	188(18.7)	114(11.4)	56(5.6)	39(3.9)	149(14.9)	60(6.0)	308(30.7)	124(12.4)	651(64.9)	239(23.8)	610(60.8)
χ²值		7.23	50.56	27.14	45.39	7.56	5.87	1.72	15.35	1.37	4.65	10.83	0.55	295.72
P值		< 0.01	< 0.01	< 0.01	< 0.01	0.01	0.02	0.19	< 0.01	0.24	0.03	< 0.01	0.46	< 0.01
注： ()内数字为检出率/%；*男生中有122人缺失首次遗精信息。

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表 2 中小学生不同类型肥胖与青春期启动关联的Logistic回归分析[OR值(95%CI)]

Table 2. Logistic regression analysis of association between different obesity types and onset of puberty of primary and secondary school students [OR(95%CI)]

自变量	选项	男生(n=884)		女生(n=1 003)
自变量	选项	调整前	调整后	调整前	调整后
基于BMI	正常	1.00	1.00	1.00	1.00
	超重	0.69(0.46~1.05)	0.92(0.55~1.52)	1.88(1.29~2.74)^**	3.20(1.63~6.29)^**
	单纯性肥胖	0.55(0.37~0.83)^**	0.68(0.41~1.11)	1.39(0.96~2.03)	4.15(2.18~7.91)^**
基于WC	正常	1.00	1.00	1.00	1.00
	中心型肥胖	0.68(0.47~0.99)^*	0.67(0.43~1.05)	1.17(0.84~1.63)	2.70(1.52~4.79)^**
基于BMI和WC	正常	1.00	1.00	1.00	1.00
	混合型肥胖	0.67(0.45~1.01)	0.71(0.44~1.16)	1.07(0.72~1.60)	2.42(1.23~4.76)^*
注：调整年龄、父亲受教育程度、母亲受教育程度、摄入含糖饮料频率、摄入油炸食品频率、摄入水果频率、视屏时间、户外活动时间和睡眠时间；男生中有122人缺失首次遗精信息；P < 0.05，*P < 0.01。

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表 3 中小学生不同类型肥胖与青春发动时相关联的Logistic回归分析[OR值(95%CI)]

Table 3. Logistic regression analysis of association between obesity types and puberty timing of primary and secondary school students[OR(95%CI)]

因变量	自变量	选项	男生(n=1 000)^a		女生(n=996)^a
因变量	自变量	选项	调整前	调整后	调整前	调整后
青春发动时相提前	基于BMI	正常	1.00	1.00	1.00	1.00
		超重	1.19(0.78~1.83)	1.24(0.80~1.91)	2.41(1.55~3.74)^**	2.41(1.54~3.75)^**
		单纯性肥胖	1.12(0.75~1.66)	1.15(0.77~1.73)	2.43(1.54~3.84)^**	2.46(1.55~3.90)^**
	基于WC	正常	1.00	1.00	1.00	1.00
		中心型肥胖	1.06(0.73~1.54)	1.04(0.71~1.51)	1.59(1.06~2.39)^*	1.59(1.05~2.40)^*
	基于BMI和WC	正常	1.00	1.00	1.00	1.00
		混合型肥胖	1.11(0.75~1.64)	1.11(0.74~1.65)	1.70(1.05~2.75)^*	1.72(1.06~2.81)^*
青春发动时相延迟	基于BMI	正常	1.00	1.00	1.00	1.00
		超重	0.78(0.43~1.40)	0.86(0.47~1.57)	0.46(0.25~0.87)^*	0.45(0.24~0.85)^*
		单纯性肥胖	0.88(0.53~1.47)	1.07(0.63~1.82)	0.48(0.25~0.92)^*	0.48(0.25~0.92)^*
	基于WC	正常	1.00	1.00	1.00	1.00
		中心型肥胖	1.10(0.69~1.77)	1.11(0.69~1.81)	0.43(0.24~0.79)^**	0.44(0.24~0.80)^**
	基于BMI和WC	正常	1.00	1.00	1.00	1.00
		混合型肥胖	1.02(0.61~1.72)	1.09(0.64~1.85)	0.48(0.22~1.01)	0.48(0.23~1.03)
注：调整年龄、摄入油炸食品频率、视屏时间和睡眠时间；P < 0.05，*P < 0.01；a数据有缺失。

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