天津市2019—2023年中小学生超重肥胖流行趋势及相关因素分析

刘忠慧; 赵赛赛; 肖英琛; 孙志颖; 张献伟; 徐渴; 高磊; 董彦会; 宋逸; 陈璐

doi:10.16835/j.cnki.1000-9817.2024234

天津市2019—2023年中小学生超重肥胖流行趋势及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2024234

1.
天津市疾病预防控制中心环境健康与公共卫生所，300011
2.
天津医科大学公共卫生学院
3.
北京大学公共卫生学院/儿童青少年卫生研究所

基金项目:

天津市医学重点学科(专科)建设项目 TJYXZDXK-051A

详细信息

作者简介:
刘忠慧(1981-)，女，河北沧州人，硕士，副主任医师，主要研究方向为儿童青少年健康

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: R179 R723.14 G479
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- 被引次数: 0
出版历程
- 收稿日期: 2024-04-18
- 修回日期: 2024-05-28
- 网络出版日期: 2024-08-31
- 刊出日期: 2024-08-25

Trends and factors associated with overweight and obesity among primary and secondary school students in Tianjin from 2019 to 2023

1.
Institute of Environmental and Public Health, Tianjin Center of Disease Control and Prevention, Tianjin (300011), China

摘要

摘要: 目的了解天津市中小学生超重肥胖流行趋势及其相关因素，为制定超重肥胖防控策略提供依据。方法于2019—2023年的每年9月，采用分层随机整群抽样方法，选取天津市16个区的197 707名中小学生按照《学生健康检查技术规范》进行体格检查，开展超重肥胖调查。通过问卷调查收集基本信息、吸烟、饮酒、饮食、体育锻炼及睡眠情况等。结果 2019—2023年天津市中小学生超重肥胖检出率分别为39.07%，43.33%，41.54%，43.92%和40.24%，呈增长趋势(χ_趋势²=7.96，P < 0.01)，超重检出率在职业高中及郊县中均呈增长趋势(χ_趋势²值分别为9.08，47.18)，肥胖检出率在男生、女生、小学、职业高中和郊县中均呈增长趋势(χ_趋势²值分别为108.34，15.99，7.32，10.95，14.75)(P值均＜0.01)。多因素Logistic回归分析结果显示，吸烟、饮酒、不健康饮食和不进行良好体育锻炼中小学生肥胖风险更高(OR值分别为1.26，1.13，1.08，1.21，P值均 < 0.05)。分层分析发现，不健康和中等水平生活方式的男生、不健康生活方式的小学生肥胖风险更高(OR值分别为1.15，1.11，1.27)；不健康生活方式的男生、女生和小学生，中等水平生活方式的女生、普通高中生超重风险更高(OR值分别为1.14，1.32，1.21，1.18，1.40)(P值均 < 0.05)。结论天津市中小学生超重和肥胖检出率呈增长趋势。应实施综合生活方式干预措施，更好地预防和控制超重肥胖的患病风险。
- 超重 /
- 肥胖症 /
- 回归分析 /
- 学生
Abstract: Objective To understand trends and related factors influencing overweight and obesity among primary and secondary school students in Tianjin, so as to provide a basis for formulating overweight and obesity prevention and control strategies. Methods In September of each year from 2019 to 2023, a survey was conducted among 197 707 primary and secondary school students in 16 districts of Tianjin through a stratified random cluster sampling method. Physical examination was carried out in accordance with the Technical Standard for Physical examination for Student, and overweight and obesity survey was carried out. Basic information, smoking, drinking, diet, physical exercise, and sleep status were collected through questionnaire surveys. Results The detection rates of overweight and obesity among primary and secondary school students in Tianjin from 2019 to 2023 were 39.07%, 43.33%, 41.54%, 43.92%, and 40.24%, respectively, showing an increasing trend(χ_trend²=7.96, P < 0.01). The detection rates of overweight increased in both vocational high schools and suburban counties (χ_trends²=9.08, 47.18, P < 0.01). The detection rates of obesity increased among both male and female students, in primary and vocational high schools and suburban counties (χ_trends²=108.34, 15.99, 7.32, 10.95, 14.75, P < 0.01). Multivariate Logistic regression analysis showed that smoking, drinking, unhealthful diet, and lack of proper physical exercise had a higher risk of obesity among primary and secondary school students (OR=1.26, 1.13, 1.08, 1.21, P < 0.05). Stratified analysis showed that the risk of obesity was higher among boys with unhealthful and moderate lifestyle habits, as well as primary school students with unhealthful lifestyle habits (OR=1.15, 1.11, 1.27, P < 0.05). Boys, girls and primary school students with unhealthful lifestyle habits, girls and ordinary high school students with moderate lifestyle habits had higher risk of being overweight (OR=1.14, 1.32, 1.21, 1.18, 1.40, P < 0.05). Conclusions The detection rates of overweight and obesity among primary and secondary school students in Tianjin shows an increasing trend. Comprehensive lifestyle should be implemented to better prevent and control the risk of overweight and obesity.
- Overweight /
- Obesity /
- Regression analysis /
- Students
注释:

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表 1 天津市2019—2023年中小学生人口学特征分布

Table 1. Distribution of domographic characteristics of primary and secondary school students in Tianjin from 2019 to 2023

年度	人数	性别		学段				地区
年度	人数	男生	女生	小学	初中	普通高中	职业高中	城区	郊县
2019	33 094	17 208(52.00)	15 886(48.00)	17 042(51.50)	8 319(25.14)	6 030(18.22)	1 703(5.15)	16 012(48.39)	17 082(51.62)
2020	33 175	17 331(52.24)	15 844(47.76)	17 089(51.51)	8 343(25.15)	5 986(18.04)	1 757(5.30)	16 445(49.57)	16 730(50.43)
2021	43 327	22 616(52.20)	20 711(47.80)	22 480(51.88)	11 360(26.22)	7 368(17.01)	2 119(4.89)	22 106(51.02)	21 221(48.98)
2022	43 225	22 335(51.67)	20 890(48.33)	22 085(51.09)	11 188(25.88)	7 619(17.63)	2 333(5.40)	22 640(52.38)	20 585(47.62)
2023	44 886	23 117(51.50)	21 769(48.50)	23 018(51.28)	11 374(25.34)	7 947(17.70)	2 547(5.67)	22 765(50.72)	22 121(49.28)
注： ()内数字为构成比/%。

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表 2 天津市不同性别与学段和地区中小学生2019—2023年超重、肥胖检出率变化趋势

Table 2. Trends of overweight and obesity detection rates among primary and secondary school students in Tianjin from 2019 to 2023 by gender, educational period and region

超重肥胖	年份	统计值	性别		学段				地区
超重肥胖	年份	统计值	男生	女生	小学	初中	普通高中	职业高中	城区	郊县
超重	2019		3 165(18.39)	2 325(14.64)	2 549(14.96)	1 511(18.16)	1 148(19.04)	282(16.56)	2 673(16.69)	2 817(16.49)
	2020		3 285(18.95)	2 444(15.43)	2 749(16.09)	1 578(18.91)	1 130(18.88)	272(15.48)	2 886(17.55)	2 843(16.99)
	2021		4 239(18.74)	3 028(14.62)	3 441(15.31)	2 041(17.97)	1 398(18.97)	387(18.26)	3 764(17.03)	3 503(16.51)
	2022		4 376(19.59)	3 322(15.90)	3 668(16.61)	2 127(19.01)	1 469(19.28)	434(18.60)	4 022(17.77)	3 676(17.86)
	2023		4 271(18.48)	3 051(14.02)	3 334(14.48)	2 002(17.60)	1 501(18.89)	485(19.04)	3 840(16.87)	3 482(15.74)
		χ_趋势²值	0.58	1.31	0.70	1.01	0.00	9.08	0.26	47.18
		P值	0.45	0.25	0.40	0.31	0.96	< 0.01	0.61	< 0.01
肥胖	2019		4 608(26.78)	2 832(17.83)	4 113(24.13)	1 831(22.01)	1 152(19.10)	344(20.20)	3 571(22.30)	3 869(22.65)
	2020		5 516(31.83)	3 131(19.76)	4 934(28.87)	2 066(24.76)	1 255(20.97)	392(22.31)	4 264(25.93)	4 383(26.20)
	2021		6 715(29.69)	4 018(19.40)	6 127(27.26)	2 609(22.97)	1 525(20.70)	472(22.27)	5 393(24.40)	5 340(25.16)
	2022		7 047(31.55)	4 241(20.30)	6 461(29.26)	2 707(24.20)	1 544(20.27)	576(24.69)	5 658(24.99)	5 630(27.35)
	2023		6 764(29.26)	3 974(18.26)	5 911(25.68)	2 636(23.18)	1 580(19.88)	611(23.99)	5 375(23.61)	5 363(24.24)
		χ_趋势²值	108.34	15.99	7.32	1.36	0.15	10.95	1.39	14.75
		P值	< 0.01	< 0.01	0.01	0.24	0.70	< 0.01	0.24	< 0.01
注： ()内数字为检出率/%。

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表 3 天津市中小学生超重肥胖与生活方式的多因素Logistic回归分析(n=44 886)

Table 3. Multivariate Logistic regression analysis of overweight, obesity, and lifestyle among primary and secondary school students in Tianjin(n=44 886)

自变量	选项	超重				肥胖
自变量	选项	β值	标准误	P值	OR值(95%CI)	β值	标准误	P值	OR值(95%CI)
吸烟	是	0.05	0.11	0.68	1.05(0.84~1.30)	0.23	0.10	0.02	1.26(1.03~1.54)
饮酒	是	0.11	0.06	0.07	0.90(0.79~1.01)	0.12	0.05	0.02	1.13(1.02~1.25)
健康饮食	否	0.05	0.03	0.07	1.05(1.00~1.12)	0.07	0.02	＜0.01	1.08(1.03~1.13)
良好体育锻炼	否	0.05	0.05	0.25	1.05(0.96~1.15)	0.19	0.04	＜0.01	1.21(1.12~1.31)
睡眠时间达标	否	0.03	0.03	0.34	1.03(0.97~1.11)	0.02	0.03	0.41	1.02(0.97~1.08)
注：吸烟、饮酒以否为参照组，健康饮食、良好体育锻炼、睡眠时长达标以是为参照组。

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表 4 天津市中小学生超重肥胖与生活方式关联的分层Logistic回归分析[OR值(95%CI)]

Table 4. Stratified Logistic regression analysis of the association between overweight, obesity and healthy lifestyle among primary and secondary school students in Tianjin[OR(95%CI)]

组别	选项	人数	超重		肥胖
组别	选项	人数	不健康生活方式	中等水平生活方式	不健康生活方式	中等水平生活方式
性别	男	23 117	1.14(1.03~1.27)^*	1.06(0.96~1.17)	1.15(1.05~1.25)^**	1.11(1.03~1.20)^**
	女	21 769	1.32(1.16~1.49)^**	1.18(1.05~1.32)^**	0.98(0.88~1.08)	0.96(0.87~1.05)
学段	小学	23 018	1.21(1.08~1.36)^**	1.04(0.94~1.14)	1.27(1.16~1.39)^**	1.08(0.99~1.16)
	初中	11 374	1.04(0.90~1.19)	1.09(0.96~1.24)	1.11(0.99~1.26)	0.95(0.85~1.06)
	普通高中	7 947	1.33(1.00~1.78)	1.40(1.04~1.88)^*	1.12(0.86~1.46)	1.06(0.81~1.38)
	职业高中	2 547	1.10(0.69~1.75)	0.86(0.53~1.39)	1.19(0.76~1.85)	1.28(0.81~2.01)
注： P < 0.05，*P < 0.01。

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