云南省多民族初一年级学生饮食模式潜类别与抑郁症状的关联

徐洪吕; 王继学; 杨继宗; 杨婉娟; 张明; 付允; 段亚娟; 常利涛

doi:10.16835/j.cnki.1000-9817.2024049

云南省多民族初一年级学生饮食模式潜类别与抑郁症状的关联

doi: 10.16835/j.cnki.1000-9817.2024049

徐洪吕^{1, 2},
王继学³,
杨继宗⁴,
杨婉娟⁵,
张明⁶,
付允⁶,
段亚娟³,
常利涛^7, ,

1.
昆明学院医学院护理系，云南 650214
2.
昆明学院社区护理研究团队
3.
双江自治县第一完全中学
4.
南涧县第二中学
5.
南涧县疾病预防控制中心免疫规划科
6.
镇沅县民族中学
7.
云南省疾病预防控制中心学校卫生所

基金项目:

国家自然科学基金项目 82160622

云南省“兴滇英才支持计划”青年人才专项项目 XDYC-QNRC-2022-0289

详细信息

作者简介:
徐洪吕(1985-)，男，云南曲靖人，博士，副教授，主要研究方向为青少年心理行为健康

通讯作者:
常利涛，E-mail：78327135@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R155.1 G444 R179
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- 被引次数: 0
出版历程
- 收稿日期: 2023-12-25
- 修回日期: 2024-01-13
- 网络出版日期: 2024-03-02
- 刊出日期: 2024-02-25

Association between latent classes of dietary patterns and depressive symptoms among first-grade students from multi-ethnic middle schools in Yunnan Province

1.
Department of Nursing, School of Medicine, Kunming University, Kunming (650214), Yunnan Province, China

摘要

摘要: 目的探讨云南省多民族初一年级学生饮食模式潜类别及其与抑郁症状的关联，为边疆中学生心理健康促进提供参考依据。方法 2022年10—12月，采用整群随机抽样方法抽取云南省11个县8 500名初一年级学生进行问卷调查。使用儿童抑郁量表(CDI)评估学生抑郁症状，应用饮食频率调查表收集学生饮食行为数据。使用潜在剖面分析模型拟合学生饮食模式潜类别，应用Logistic回归分析饮食模式潜类别与抑郁症状的关联。结果初一年级学生抑郁症状检出率为28.3%，女生抑郁症状检出率(30.9%)高于男生(25.5%)，差异有统计学意义(χ²=29.83，P＜0.01)。初一年级学生饮食模式有4种潜类别：类别1(所有饮食低消费)，类别2(水果、奶及奶制品高消费)，类别3(蔬菜、畜肉高消费，加工食品低消费)，类别4(奶及奶制品和蛋类消费低，加工食品消费高)。以饮食模式类别1为参照，在控制混杂变量后，饮食模式类别3与初一年级学生抑郁症状呈负相关(OR=0.62，95%CI=0.52~0.74)；类别4与初一年级学生抑郁症状呈正相关(OR＝1.28，95%CI=1.05~1.57)(P值均＜0.05)。结论云南省多民族初一年级学生饮食模式多样，不健康饮食模式可能增加抑郁症状发生的风险。应调整云南省多民族中学生饮食模式，促进其健康饮食模式的建立，降低中学生抑郁症状发生的风险。
- 饮食习惯 /
- 抑郁 /
- 精神卫生 /
- 回归分析 /
- 学生 /
- 少数民族
Abstract: Objective To determine the latent class of dietary patterns and their association with depressive symptoms among first-grade students from multi-ethnic middle schools in Yunnan Province, so as to provide a reference basis for promoting mental health among border middle school students. Methods A cluster random sampling involving 8 500 first-grade middle school students from 11 counties in Yunnan Province was conducted by a questionnaire survey between October to December 2022. The Children's Depression Inventory (CDI) was used to assess the depressive symptoms and the Food Frequency Questionnaire was used to collect eating behavior data. The latent profile analysis model was used to fit the latent class of dietary patterns among students. The association between the dietary pattern latent class and depressive symptoms was analyzed by Logistic regression. Results The depressive symptom detection rate among first-grade middle school students was 28.3%. Prevalence of depressive symptom in girls (30.9%) was higher than boys (25.5%) with a statistically significant difference (χ²=29.83, P<0.01). The dietary patterns among first-grade middle school students were classified into four latent classes, as follows: class 1 (low consumption of all dietary components), class 2 (high consumption of fruit, milk and dairy products), class 3 (high consumption of vegetables and meat, and low consumption of processed foods) and class 4 (low consumption of milk, dairy products and eggs, and high consumption of processed foods). After adjusting for confounding variables, the class 3 dietary pattern was negatively correlated with depressive symptoms (OR=0.62, 95%CI=0.52-0.74) and the class 4 dietary pattern was positively correlated with depressive symptoms (OR=1.28, 95%CI=1.05-1.57) (P<0.05), compared with the class 1 dietary pattern. Conclusions Multi-ethnic first-grade middle school students in Yunnan Province follow various dietary patterns. Unhealthy dietary patterns increase the risk of depressive symptoms. The dietary patterns of multi-ethnic middle school students in Yunnan Province should be adjusted to promote the establishment of healthy dietary patterns and reduce the risk of depression symptoms in middle school students.
- Food habits /
- Depression /
- Mental health /
- Regression analysis /
- 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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图 1 初一年级学生饮食模式潜类别的条件概率分布

Figure 1. Conditional probability distribution of latent classes of dietary patterns in first-grade middle school students

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表 1 不同人口学特征男女初一年级学生抑郁症状检出率比较

Table 1. Comparison of detection rates of depressive symptoms in first-grade middle school students for boys and girls with different demographic characteristics

人口学指标	选项	男生				女生
人口学指标	选项	人数	抑郁症状	χ²值	P值	人数	抑郁症状	χ²值	P值
年龄/岁	12	1 668	388(23.3)	7.64	＜0.01	2 030	599(29.5)	3.41	0.07
	13~15	2 516	681(27.1)			2 286	734(32.1)
民族	汉族	1 916	420(21.9)	55.33	＜0.01	1 940	527(27.2)	70.96	＜0.01
	哈尼族	763	230(30.1)			822	235(28.6)
	彝族	684	155(22.7)			695	214(30.8)
	傈僳族	302	116(38.4)			299	140(46.8)
	拉祜族	105	34(32.4)			149	67(45.0)
	傣族	117	36(30.8)			118	47(39.8)
	其他民族	297	78(26.3)			293	103(35.2)
家庭居住地	农村	3 111	831(26.7)	8.61	0.01	3 247	993(30.6)	0.56	0.45
	城镇	1 073	238(22.2)			1 069	340(31.8)
独生子女	是	692	182(26.3)	0.25	0.62	564	213(37.8)	14.39	＜0.01
	否	3 492	887(25.4)			3 752	1 120(29.9)
亲密朋友数量/个	0~2	355	158(44.5)	82.56	＜0.01	590	279(47.3)	96.36	＜0.01
	3~4	532	155(29.1)			829	272(32.8)
	≥5	3 297	756(22.9)			2 897	782(27.0)
自评家庭经济状况	差	635	268(42.2)	110.62	＜0.01	492	230(46.7)	69.36	＜0.01
	中	2 774	639(23.0)			3 226	951(29.5)
	好	775	162(20.9)			598	152(25.4)
自评学习压力	重	1 445	536(37.1)	154.76	＜0.01	1 595	754(47.3)	318.78	＜0.01
	中	2 554	495(19.4)			2 636	558(21.2)
	轻	185	38(20.5)			85	21(24.7)
家庭类型	双亲	3 380	801(23.7)	34.69	＜0.01	3 498	1 024(29.3)	22.56	＜0.01
	单亲	442	142(32.1)			420	158(37.6)
	组合^a	282	93(33.0)			335	126(37.6)
	其他	80	33(41.3)			63	25(39.7)
父亲文化程度	小学未毕业或没有上过学	516	174(33.7)	26.47	＜0.01	568	194(34.2)	3.95	0.41
	小学	950	248(26.1)			1 006	310(30.8)
	初中	1 933	459(23.7)			1 998	608(30.4)
	高中/中专	547	142(26.0)			509	155(30.5)
	大专及以上	238	46(19.3)			235	66(28.1)
母亲文化程度	小学未毕业或没有上过学	817	253(31.0)	31.50	＜0.01	883	306(34.7)	8.52	0.07
	小学	996	275(27.6)			1 049	313(29.8)
	初中	1 708	384(22.5)			1 764	518(29.4)
	高中/中专	448	120(26.8)			424	133(31.4)
	大专及以上	215	37(17.2)			196	63(32.1)
父亲职业	公职人员^b	1 917	501(26.1)	17.05	＜0.01	2 256	673(29.8)	4.24	0.52
	工人	284	61(21.5)			218	67(30.7)
	公司职员	990	261(26.4)			808	259(32.1)
	商人	329	58(17.6)			330	98(29.7)
	农民	126	33(26.2)			143	47(32.9)
	其他	538	155(28.8)			561	189(33.7)
母亲职业	公职人员^b	2 206	581(26.3)	23.85	＜0.01	2 454	747(30.4)	2.49	0.78
	工人	236	41(17.4)			173	53(30.6)
	公司职员	580	147(25.3)			467	152(32.5)
	商人	386	74(19.2)			372	118(31.7)
	农民	164	42(25.6)			160	43(26.9)
	其他	612	184(30.1)			690	220(31.9)
注：()内数字为检出率/%。a有继父或继母，b为公务员及事业单位人员。

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表 2 初一年级学生饮食模式的潜在剖面分析(n=8 500)

Table 2. Latent profile analysis of dietary patterns in first-grade middle school students(n=8 500)

模型	AIC值	BIC值	aBIC值	Entropy值	P_LMR值	P_BLRT值	类别概率
1	627 248.80	627 615.29	627 450.05	—	—	—	—
2	587 793.25	588 350.03	588 098.98	0.94	＜0.01	＜0.01	0.78/0.22
3	573 205.68	573 952.75	573 615.90	0.90	＜0.01	＜0.01	0.53/0.39/0.08
4	567 988.35	568 925.71	568 503.06	0.88	＜0.01	＜0.01	0.48/0.31/0.14/0.07
5	563 464.04	564 591.69	564 083.24	0.88	0.05	＜0.01	0.10/0.41/0.35/0.12/0.02

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表 3 初一年级学生饮食模式潜类别与抑郁症状的关联(n=8 500)

Table 3. Association between latent classes of dietary patterns and depressive symptoms in first-grade middle school students(n=8 500)

模型	潜类别	β值	标准误	Wald χ²值	P值	OR值(95%CI)
模型1	类别1					1.00
	类别2	0.04	0.06	0.61	0.43	1.04(0.94~1.16)
	类别3	-0.45	0.08	31.24	＜0.01	0.64(0.54~0.75)
	类别4	0.30	0.09	10.66	＜0.01	1.35(1.13~1.62)
模型2	类别1					1.00
	类别2	0.02	0.06	0.11	0.74	1.02(0.91~1.15)
	类别3	-0.47	0.09	28.91	＜0.01	0.62(0.52~0.74)
	类别4	0.25	0.10	5.75	0.02	1.28(1.05~1.57)
注：模型1未控制变量；模型2控制性别、年龄、民族、家庭居住地、独生子女、自评家庭经济状况、家庭类型、父/母亲文化程度、父/母亲职业、家庭变故、住院经历、疫情影响、被校园欺凌、被网络欺凌、抑郁症家族史、抽烟、饮酒、身体活动、自评学习压力、亲密朋友数量。

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