中学生健康危险行为与肥胖和抑郁症状的关联

孙志颖; 张献伟; 袁雯; 董彦会; 徐渴; 赵赛赛; 陈璐; 刘忠慧

doi:10.16835/j.cnki.1000-9817.2024304

中学生健康危险行为与肥胖和抑郁症状的关联

doi: 10.16835/j.cnki.1000-9817.2024304

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

基金项目:

天津市医学重点学科(专科)建设项目 TJYX2DXK-051A

详细信息

作者简介:
孙志颖(1992-)，女，河北邯郸人，硕士，主管医师，主要研究方向为儿童青少年健康与学校卫生

通讯作者:
刘忠慧，E-mail：liuzhonghui@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 C913.5 R723.14 G444
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出版历程
- 收稿日期: 2024-04-17
- 修回日期: 2024-08-07
- 网络出版日期: 2024-11-02
- 刊出日期: 2024-10-25

Association of health risk behaviors with obesity and depressive symptoms in middle school students

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

摘要

摘要: 目的了解天津市中学生肥胖和抑郁症状共患的趋势，为探索健康危险行为的聚集模式及其对肥胖和抑郁症状的影响提供依据。方法于2019—2023年在天津市16个区采用分层整群随机抽样的方法，共抽取93 435名中学生调查肥胖、抑郁症状和健康危险行为情况。采用潜类别分析对健康危险行为进行分类，通过χ²检验和Logistic回归分析探讨健康危险行为不同分类对肥胖和抑郁症状的影响。结果天津市中学生2019—2023年的肥胖检出率为先升高(2019，2020年：20.90%，23.35%)后降低再逐渐平稳(2021—2023年：22.20%~22.69%)，抑郁症状检出率呈降低趋势(21.65%下降至14.92%)。肥胖和抑郁症状共患检出率先升高(2019，2020年：4.62%，4.66%)后逐渐降低至2023年的3.43%，其中男生高于女生，城区高于郊区。潜类别分析将健康危险行为分为缺乏运动组、睡眠不足等不良行为组、不良饮食组和健康组4类，Logistic回归分析结果显示，调整人口学特征后，前3组中学生肥胖和抑郁症状共患检出风险分别是健康组的1.35(OR=1.35，95%CI=1.15~1.59)、4.20(OR=4.20，95%CI=3.50~5.04)、1.84(OR=1.84，95%CI=1.40~2.38)倍(P值均 < 0.05)。结论天津市中学生2019—2023年肥胖和抑郁症状共患率先上升后逐渐降低，应从运动、饮食、睡眠等多种行为方面对肥胖和抑郁进行综合干预。
- 危险行为 /
- 肥胖症 /
- 抑郁 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the tendency of obesity and depressive symptoms in middle school students in Tianjin, so as to provide a reference for exploring the clustering patterns of health risk behaviors and their effects on obesity and depressive symptoms. Methods A stratified cluster sampling method was used to investigate the obesity, depressive symptoms and health risk behaviors of middle school students from 16 counties of Tianjin from 2019 to 2023. The latent classes analysis was used to classify health risk behaviors. The χ² test and Logistic regression were used to analyze the effects of different categories on obesity and depression symptoms. Results The obesity detection rate of middle school students in Tianjin from 2019 to 2023 first increased (20.90% in 2019, 23.35% in 2020) and then decreased and gradually stabilized (2021-2023:22.20%-22.69%), and the detection rate of depressive symptoms showed a decreasing trend (from 21.65% to 14.92%). The detection rate of comorbidity of obesity and depressive symptoms first increased (4.62% in 2019, 4.66% in 2020) and then gradually decreased to 3.43% in 2023, and the rate was higher in boys than in girls and higher in urban areas than in suburban areas. Latent category analysis classified health risk behaviors into four categories: lack of exercise group, poor behaviors such as sleep group, poor diet group and healthy group. After adjusting for demographic characteristics, the results of Logistic regression analysis showed that the co-occurrence risk of obesity and depression symptoms among the top three groups of middle school students were 1.35(OR=1.35, 95%CI=1.15-1.58), 4.20(OR=4.20, 95%CI=3.50-5.04), and 1.84(OR=1.84, 95%CI=1.40-2.38)times, compared to the healthy group (P < 0.05). Conclusions From 2019 to 2023, the comorbidity rate of obesity and depression among middle school students in Tianjin increased first and then decreased gradually. Interventions should be made in the aspects of exercise, diet, sleep and other behaviors.
- Dangerous behavior /
- Obesity /
- Depression /
- 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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图 1 天津市中学生健康危险行为潜类别条件概率分布

Figure 1. Probability distribution of latent class of health risk behaviors among middle school students in Tianjin

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表 1 天津市2019—2023年不同组别中学生肥胖、抑郁症状及肥胖和抑郁症状共患检出率/%

Table 1. Obesity, depressive symptoms and comorbidity of obesity and depressive symptoms among middle school students with different groups in Tianjin from 2019 to 2023/%

组别	选项	肥胖					抑郁症状					肥胖与抑郁症状共患
组别	选项	2019年	2020年	2021年	2022年	2023年	2019年	2020年	2021年	2022年	2023年	2019年	2020年	2021年	2022年	2023年
性别	男	25.29	28.79	27.10	28.15	27.10	19.75	17.54	15.08	15.61	13.74	5.22	5.19	4.51	4.35	3.92
	女	16.32	17.29	17.04	17.08	17.04	23.65	21.10	19.08	19.21	16.16	3.99	4.09	3.48	3.43	2.92
学段	初中	22.21	24.97	23.05	23.96	23.79	18.70	16.20	14.75	13.41	11.68	4.41	4.20	3.49	3.22	2.78
	高中	19.25	21.10	20.83	19.91	20.40	23.69	22.52	18.79	21.42	18.64	4.63	5.01	4.43	4.48	3.92
	职高	20.36	22.42	22.42	25.49	23.61	28.95	22.65	23.12	22.82	18.46	5.58	5.69	5.29	5.11	5.04
地区	城区	21.19	23.65	22.21	22.53	22.16	24.43	20.68	18.99	18.42	15.54	5.30	5.11	4.42	4.19	3.68
	郊区	20.57	22.75	22.18	23.12	22.87	18.40	17.49	14.47	14.45	14.35	3.82	4.11	3.47	3.05	3.19
家庭类型	核心家庭	19.80	21.92	20.87	21.52	21.61	21.45	18.76	16.52	17.00	13.97	4.50	4.33	3.70	3.69	3.12
	大家庭	22.42	25.55	25.00	25.04	24.55	18.99	17.68	15.31	15.33	13.93	3.95	4.54	3.94	3.74	3.36
	单亲家庭	20.82	23.93	21.64	23.56	22.23	29.00	24.39	21.74	20.37	19.83	6.32	6.18	5.16	4.26	4.49
	重组家庭	22.68	19.63	21.76	19.53	18.72	31.27	25.56	26.17	24.19	24.20	7.22	7.41	6.34	4.19	4.11
	隔代家庭	24.48	25.06	24.11	24.49	26.03	26.84	23.89	21.68	19.44	19.11	6.78	5.62	5.61	5.98	5.51
	其他	30.00	23.75	15.69	19.78	18.40	32.91	26.25	23.53	26.11	24.80	12.66	6.25	3.92	5.56	6.40
合计		20.90	23.25	22.20	22.69	22.52	21.65	19.25	17.02	17.37	14.92	4.62	4.66	4.01	3.89	3.43

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表 2 天津市中学生健康危险行为潜在类别模型拟合指数(n=27 710)

Table 2. Fit index of latent class model of health risk behavior among middle school students in Tianjin(n=27 710)

分类数	AIC值	BIC值	αBIC值	Entropy值	P_LMR值	类别概率
1	128 958.01	129 023.84	128 998.42	—	—	1
2	126 787.84	126 927.74	126 873.72	0.45	< 0.05	0.71, 0.30
3	126 296.48	126 510.45	126 427.82	0.66	< 0.05	0.76, 0.03, 0.21
4	126 212.18	126 500.21^*	126 388.98^*	0.83	0.02^*	0.13, 0.72, 0.09, 0.06
5	126 191.16^*	126 553.26	126 413.43	0.89^*	0.51	0.01, 0.01, 0.76, 0.21, 0.01
注： ^*每个指标拟合最好效果。

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表 3 天津市2023年不同组别中学生健康危险行为潜类别分布比较(n=27 710)

Table 3. Comparison of the distribution of latent class of health risk behaviors among middle school students with different groups in Tianjin in 2023 (n=27 710)

组别	选项	人数	缺乏运动组	睡眠不足等不良行为组	不良饮食组	健康组	χ²值	P值
性别	男	14 148	5 171(36.55)	1 612(11.39)	887(6.27)	6 478(45.79)	416.44	< 0.01
	女	13 562	6 303(46.48)	826(6.09)	747(5.51)	5 686(41.93)
学段	初中	14 713	5 574(37.88)	1 020(6.93)	588(4.00)	7 531(51.19)	918.16	< 0.01
	高中	10 180	4 672(45.89)	961(9.44)	819(8.05)	3 728(36.62)
	职高	2 817	1 228(43.59)	457(16.22)	227(8.06)	905(32.13)
地区	城区	13 520	5 390(39.87)	1 278(9.45)	918(6.79)	5 934(43.89)	63.70	< 0.01
	郊区	14 190	6 084(42.88)	1 160(8.17)	716(5.05)	6 230(43.90)
家庭类型	核心家庭	16 180	6 877(42.50)	1 253(7.74)	929(5.74)	7 121(44.01)	183.97	< 0.01
	大家庭	7 286	2 894(39.72)	651(8.93)	378(5.19)	3 363(46.16)
	单亲家庭	2 829	1 150(40.65)	326(11.52)	209(7.39)	1 144(40.44)
	重组家庭	438	164(37.44)	73(16.67)	39(8.90)	162(36.99)
	隔代家庭	853	333(39.04)	115(13.48)	65(7.62)	340(39.86)
	其他	124	56(45.16)	20(16.13)	14(11.29)	34(27.42)
注： ()内数字为构成比/%。

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