天津市2023年中小学生脊柱弯曲异常和营养不良共患现况

张依航; 李佳欣; 黄天彧; 蔡珊; 陈子玥; 党佳佳; 刘云飞; 师嫡; 蒋家诺; 刘忠慧; 陈璐; 张献伟; 董彦会; 宋逸

doi:10.16835/j.cnki.1000-9817.2024235

天津市2023年中小学生脊柱弯曲异常和营养不良共患现况

doi: 10.16835/j.cnki.1000-9817.2024235

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.
天津市疾病预防控制中心环境健康与公共卫生所

基金项目:

国家自然科学基金项目 82273654

详细信息

作者简介:
张依航(1998-)，女，内蒙古赤峰人，在读硕士，主要研究方向为儿童青少年健康与发展

通讯作者:
宋逸，E-mail: songyi@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: R179 R682.3 R153.2
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- 被引次数: 0
出版历程
- 收稿日期: 2024-04-17
- 修回日期: 2024-06-26
- 网络出版日期: 2024-08-31
- 刊出日期: 2024-08-25

Prevalence of comorbidity of spinal curvature abnormality and malnutrition among primary and middle school students in Tianjin in 2023

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

摘要

摘要: 目的分析2023年天津市10~18岁中小学生脊柱弯曲异常与营养不良共患现状，为学生常见病多病共防与学校卫生体系构建提供科学依据。方法 2023年9—10月采用分层整群随机抽样方法，抽取天津市31 884名10~18岁中小学生为研究对象。采用《儿童青少年脊柱弯曲异常的筛查》标准判断脊柱弯曲异常情况，根据《学龄儿童青少年营养不良筛查》和《学龄儿童青少年超重与肥胖筛查》标准判定生长迟缓、消瘦、超重、肥胖情况。采用χ²检验比较共患率的组间差异，采用多元Logistic回归模型分析不同群组共患类型的患病风险。结果天津市中小学生脊柱弯曲异常与营养不良共患率为1.6%，女生高于男生(1.8%，1.4%)，高中生(2.5%)高于初中和小学生(2.0%，0.5%)，郊县高于城区(2.1%，1.1%), 差异均有统计学意义(χ²值分别为9.45，141.92，46.94，P值均 < 0.05)。多元Logistic回归模型显示，初中女生姿势不良与生长迟缓和消瘦共患(OR=4.52，95%CI=1.84~11.06)以及姿势不良与超重肥胖共患(OR=2.67，95% CI=1.74~4.10)风险均高于男生，脊柱侧弯/前后弯曲异常与生长迟缓和消瘦共患(OR=0.10，95% CI=0.02~0.44)风险低于男生，高中女生脊柱侧弯/前后弯曲异常与超重肥胖共患(OR=0.27，95%CI=0.11~0.66)风险低于男生(P值均 < 0.05)。结论天津市中小学生存在脊柱弯曲异常与营养不良共患流行，且各类型共患存在性别和学段差异。需加大学校卫生工作中对脊柱弯曲异常的防控力度，对重点人群强化筛查，并及时干预。
- 脊柱弯曲 /
- 营养不良 /
- 共病现象 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the prevalence of comorbidity of spinal curvature abnormality and malnutrition among primary and secondary school students aged 10-18 years in Tianjin in 2023, so as to provide scientific basis for the combined prevention of common diseases and multiple diseases among students and the construction of school health system. Methods In September to October 2023, 31 884 primary and secondary school students aged 10 to 18 years in Tianjin were selected using stratified cluster random sampling. Abnormal spinal curvature in children and adolescents was assessed by Sereening of Spinal Curvature Abnormality of Children and Adolescents, while stunting, wasting, overweight, and obesity were determined according to the Screening for Malnutrition among School-age Children and Adolescents and Screening for Overweight and Obesity among School-age Children and Adolescents. The χ² test was used to compare between-group differences in co-prevalence, and multiple Logistic regression models were used to analyze the risk of different comorbidity types in different clusters. Results The co-prevalence of spinal curvature abnormality and malnutrition among primary and secondary school students in Tianjin was 1.6%, which was higher for girls than boys (1.8%, 1.4%), higher (2.5%) for senior high schools than for junior high schools and elementary schools (2.0%, 0.5%), and higher in rural than in urban areas (2.1%, 1.1%) (χ²=9.45, 141.92, 46.94, P < 0.05). Multiple Logistic regression models showed that junior high school girls had a higher risk of incorrect posture comorbid with stunting and wasting (OR=4.52, 95%CI=1.84-11.06) and incorrect posture comorbid with overweight and obesity (OR=2.67, 95%CI=1.74-4.10) than boys, and that scoliosis/sagittal spinal abnormality comorbid with stunting and wasting (OR=0.10, 95%CI=0.02-0.44) risk was lower than that of boys, senior high school girls had a lower risk of scoliosis/sagittal spinal abnormality comorbid with overweight and obesity (OR=0.27, 95%CI=0.11-0.66) (P < 0.05). Conclusions The co-prevalence of spinal curvature abnormality and malnutrition is specific among primary and secondary school students in Tianjin, and the comorbidity type varies by gender and education stage. There is a need to increase prevention and control of spinal curvature abnormalities in school health working, intensive screening of key populations, and timely intervention.
- Spinal curvatures /
- Malnutrition /
- Comorbidity /
- Regression analysis /
- Students
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图 1 天津市中小学生脊柱弯曲异常与营养不良共患各类型占比比较

注：气泡大小根据各类型共患占比绘制。

Figure 1. Comparison of the proportion of different types of spinal curvature abnormality and malnutrition comorbidity with different groups among primary and secondary school students in Tianjin

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表 1 天津市2023年不同组别中小学生脊柱弯曲异常、营养不良及共患检出率比较

Table 1. Comparison of detection rates of spinal curvature abnormality, malnutrition and comorbidities among primary and secondary school students with different groups in Tianjin from 2023

组别	选项	人数	统计值	脊柱弯曲异常	营养不良	二者共患
性别	男	16 316		491(3.0)	9 244(56.6)	228(1.4)
	女	15 568		1 004(6.4)	5 858(37.6)	285(1.8)
			χ²值	210.93	1 156.93	9.45
			P值	< 0.01	< 0.01	< 0.01
学段	小学	11 124		181(1.6)	5 537(49.8)	55(0.5)
	初中	10 896		616(5.7)	4 998(45.9)	215(2.0)
	高中	9 864		698(7.1)	4 567(46.3)	243(2.5)
			χ²值	388.83	40.18	141.92
			P值	< 0.01	< 0.01	< 0.01
居住地	城区	16 527		590(3.6)	7 827(47.4)	189(1.1)
	郊县	15 357		905(5.9)	7 275(47.4)	324(2.1)
			χ²值	96.13	0.00	46.94
			P值	< 0.01	0.98	< 0.01
住校	是	1 806		130(7.2)	812(45.0)	39(2.2)
	否	30 078		1 365(4.5)	14 290(47.5)	474(1.6)
			χ²值	26.98	4.44	3.67
			P值	< 0.01	0.04	0.06
民族	汉族	30 278		1 427(4.7)	14 348(47.4)	490(1.6)
	少数民族	1 606		68(4.2)	754(46.9)	23(1.4)
			χ²值	0.78	0.12	0.33
			P值	0.38	0.73	0.56
合计		31 884		1 495(4.7)	15 102(47.4)	513(1.6)
注： ()内数字为检出率/%。

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表 2 天津市中小学生脊柱弯曲异常与营养不良共患类型的分层Logistic回归分析[OR值(95%CI)]

Table 2. Stratified Logistic regression analysis of spinal curvature abnormality and malnutration co-morbidity types among primary and secondary school students in Tianjin[OR(95%CI)]

学段	性别	人数	姿态不良与生长迟缓和消瘦共患	脊柱侧弯/前后弯曲异常与生长迟缓和消瘦共患	姿态不良与超重肥胖共患	脊柱侧弯/前后弯曲异常与超重肥胖共患
小学	男	5 798	1.00	1.00	1.00	1.00
	女	5 326	2.46(0.76~8.00)	2.19(0.20~24.11)	1.82(0.89~3.73)	1.45(0.33~6.50)
初中	男	5 760	1.00	1.00	1.00	1.00
	女	5 136	4.52(1.84~11.06)^**	0.10(0.02~0.44)^**	2.67(1.74~4.10)^**	0.65(0.39~1.11)
高中	男	4 758	1.00	1.00	1.00	1.00
	女	5 106	1.64(0.87~3.10)	0.63(0.28~1.40)	1.39(1.00~1.93)	0.27(0.11~0.66)^**
注：因变量以无共患群体为参照组；**P < 0.01。

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