浙江省农村学生营养改善计划地区中小学生肥胖类型与血脂的关系

赵栋; 黄李春; 苏丹婷; 顾炜; 韩丹; 章荣华

doi:10.16835/j.cnki.1000-9817.2024098

浙江省农村学生营养改善计划地区中小学生肥胖类型与血脂的关系

doi: 10.16835/j.cnki.1000-9817.2024098

浙江省疾病预防控制中心营养与食品安全所，杭州 310051

基金项目:

浙江省医药卫生科技计划项目 2022RC123

详细信息

作者简介:
赵栋(1986-)，男，山东东阿人，硕士，主管医师，主要研究方向为学生营养与改善

通讯作者:
章荣华，E-mail：rhzhang@cdc.zj.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R723.14 R339.3⁺5
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出版历程
- 收稿日期: 2023-11-16
- 修回日期: 2023-12-28
- 网络出版日期: 2024-03-29
- 刊出日期: 2024-03-25

Association between obesity and dyslipidemia among rural primary and middle school students in Students Nutrition Improvement Program Areas of Zhejiang Province

Department of Nutrition and Food Safety, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou (310051), Zhejiang Province, China

摘要

摘要: 目的探讨中小学生不同肥胖类型与血脂指标的关联，为进一步控制中小学生肥胖及血脂偏高提供科学依据。方法于2021年9—11月在浙江省农村义务教育学生营养改善项目5个监测点采用分层整群随机抽样的方法选取1 244名中小学生进行身高、体重检测，并采集静脉血进行血脂检测。采用χ²检验和Logistic回归分析中小学生肥胖类型与血脂之间的关联。结果中小学生的超重率、肥胖率、腹型肥胖率、血脂偏高率分别为15.11%，12.46%，17.60%, 21.78%。高三酰甘油发生风险肥胖组是非超重肥胖组的3.97倍(95%CI=2.54~6.20)，腹型肥胖组是正常腰围组的4.45倍(95%CI=2.95~6.72)(P值均＜0.05)。胆固醇偏高超重肥胖且腰围正常组与非超重肥胖且腰围正常组相比OR值最高(OR=2.53，95%CI=1.45~4.42)，血脂和三酰甘油偏高超重肥胖且腰围异常组OR值最高(OR=1.82，95%CI=1.33~2.48；OR=3.64，95%CI=2.45~5.43)(P值均＜0.05)。结论浙江省农村义务教育学生营养改善计划地区中小学生超重肥胖、腹型肥胖、血脂异常检出率均较高。儿童腹型肥胖与血脂异常关系更为密切，应定期对中小学生进行腰围测量及相关知识的普及。
- 肥胖症 /
- 血脂异常 /
- 生长和发育 /
- 回归分析 /
- 学生
Abstract: Objective The study aimed to analyze the association between different types of obesity and dyslipidemia among rural primary and middle school students in Zhejiang Province, so as to inform strategies for prevention and control of childhood obesity and hyperlipidemia. Methods As part of Nutrition Improvement Programme for Rural Compulsory Education Students, 1 244 participants were selected by stratified cluster random sampling in 5 counties of Zhejiang Province during September to December 2021. Physical examination, detection of blood lipid and questionnaire survey were conducted. The Chi-square test and Logistic regression analyses were used to assess the association between different types of obesity and dyslipidemia. Results The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia were 15.11%, 12.46%, 17.60%, and 21.78%. Obesity and abdominal obesity were correlated to high risk of high triglycerides (OR=3.97, 95%CI=2.54-6.20; OR=4.45, 95%CI=2.95-6.72)(P < 0.05). Compared with the non overweight and obese group with normal waist circumference, the overweight and obesity group were correlated to high risk of high cholesterol (OR=2.53, 95%CI=1.45-4.42, P < 0.05). Abdominal overweight or obese group had the highest risk for dyslipidemia and triglycerides (OR=1.82, 95%CI=1.33-2.48; OR=3.64, 95%CI=2.45-5.43) (P < 0.05). Conclusions The prevalence rates of overweight, obesity, abdominal obesity, and hyperlipidemia are relatively high in rural primary and middle school students of Nutrition Improvement Programme for Rural Compulsory Education Students in Zhejiang Province. Abdominal obesity is a more important risk factor for hyperlipidemia. Waist circumference should be the focus of considerable attention.
- Obesity /
- Dyslipidemias /
- Growth and development /
- Regression analysis /
- Students
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表 1 不同性别和学段学生基本情况比较(x±s)

Table 1. Comparison of basic information among students of different genders and academic stages(x±s)

组别	选项	人数	统计值	BMI/(kg·m^-2)	腰围/cm	胆固醇/(mmol·L^-1)	三酰甘油/(mmol·L^-1)
学段	小学	727		18.11±3.57	61.53±9.06	4.57±0.83	1.05±0.51
	初中	517		20.59±3.75	67.73±9.44	4.14±0.77	1.18±0.62
			t值	-11.84	-11.69	9.25	-3.92
			P值	＜0.01	＜0.01	＜0.01	＜0.01
性别	男	618		19.48±4.17	65.75±10.67	4.32±0.82	1.06±0.59
	女	626		18.80±3.47	62.49±8.37	4.46±0.84	1.14±0.53
			t值	3.13	5.99	-2.94	-2.48
			P值	＜0.01	＜0.01	＜0.01	0.01

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表 2 不同BMI组中小学生血脂指标构成比较

Table 2. Comparison ratio of blood lipid index among primary and middle school students with different groups of BMI

BMI组别	人数	胆固醇			三酰甘油		血脂
BMI组别	人数	合适水平	临界高值	高胆固醇	合适水平	高三酰甘油	正常血脂	血脂偏高
非超重肥胖组	901	517(57.38)	263(29.19)	121(13.34)	835(92.67)	66(7.33)	728(80.80)	173(19.20)
超重组	188	90(47.87)	65(34.57)	33(17.55)	159(84.57)	29(15.43)	135(71.81)	53(28.19)
肥胖组	155	84(54.19)	54(34.84)	17(10.97)	118(76.13)	37(23.87)	110(70.97)	45(29.03)
χ²值		7.96			45.58		12.84
P值		0.09			＜0.01		＜0.01
注： ()内数字为构成比/%。

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表 3 不同腹型肥胖组中小学生血脂指标构成比较

Table 3. Comparison ratio of blood lipid index among primary and middle school students with different groups of abdominal obesity

腰围组别	人数	胆固醇			三酰甘油		血脂
腰围组别	人数	合适水平	临界高值	高胆固醇	合适水平	高三酰甘油	正常血脂	血脂偏高
正常腰围组	803	459(57.16)	241(30.01)	103(12.83)	748(93.15)	55(6.85)	653(81.32)	150(18.68)
腹型肥胖前期组	222	127(57.21)	64(28.83)	31(13.96)	199(89.64)	23(10.36)	173(77.93)	49(22.07)
腹型肥胖组	219	105(47.95)	77(35.16)	37(16.89)	165(75.34)	54(24.66)	147(67.12)	72(32.88)
χ²值		6.64			57.55		20.37
P值		0.16			＜0.01		＜0.01
注： ()内数字为构成比/%。

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表 4 中小学生肥胖类型与血脂关系的Logistic回归分析[n=1 244，OR值(95%CI)]

Table 4. Logistic regression analysis between obesity phenotypes and blood lipid among primary and middle school students[n=1 244, OR(95%CI)]

自变量	模型1			模型2
自变量	血脂	胆固醇	三酰甘油	血脂	胆固醇	三酰甘油
BMI组别
非超重肥胖组	1.00	1.00	1.00	1.00	1.00	1.00
超重组	1.65(1.16~2.37)^*	1.44(1.06~1.94)^*	2.31(1.44~3.69)^*	1.67(1.17~2.39)^*	1.47(1.08~1.99)^*	2.44(1.52~3.91)^*
肥胖组	1.72(1.17~2.53)^*	1.07(0.77~1.49)	3.97(2.54~6.20)^*	1.76(1.19~2.59)^*	1.08(0.77~1.52)	4.23(2.68~6.67)^*
腰围组别
正常腰围组	1.00	1.00	1.00	1.00	1.00	1.00
腹型肥胖前期组	1.23(0.86~1.77)	1.01(0.75~1.35)	1.57(0.94~2.62)	1.21(0.84~1.74)	0.95(0.70~1.27)	1.68(1.00~2.80)^*
腹型肥胖组	2.13(1.53~2.98)^*	1.43(1.08~1.90)^*	4.45(2.95~6.72)^*	2.15(1.54~2.99)^*	1.49(1.11~1.99)^*	4.56(3.01~6.90)^*
肥胖类型
非超重肥胖且腰围正常组	1.00	1.00	1.00	1.00	1.00	1.00
超重肥胖且腰围正常组	1.63(0.82~3.24)	2.53(1.45~4.42)^*	1.35(0.47~3.92)	1.52(0.76~3.04)	1.90(1.08~3.35)^*	1.71(0.58~5.04)
非超重肥胖且腰围异常组	1.46(0.95~2.22)	1.48(1.05~2.08)^*	1.63(0.89~2.98)	1.37(0.89~2.10)	1.24(0.88~1.76)	1.79(0.97~3.32)
超重肥胖且腰围异常组	1.82(1.33~2.48)^*	1.20(0.93~1.56)	3.64(2.45~5.43)^*	1.85(1.35~2.53)^*	1.24(0.95~1.62)	3.81(2.54~5.71)^*
注：因变量赋值——血脂和三酰甘油均为合适水平=0，高水平=1；胆固醇为合适水平=0，临界高值=1，高水平=2。模型2调整了性别和年龄；*P＜0.05。

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