天津市特殊儿童青少年体力活动和视屏时间与超重肥胖的关联

韩钰; 李值; 李芃宏; 崔庭凯; 熊文娟; 曲之毅; 席薇; 张欣

doi:10.16835/j.cnki.1000-9817.2025036

天津市特殊儿童青少年体力活动和视屏时间与超重肥胖的关联

doi: 10.16835/j.cnki.1000-9817.2025036

天津医科大学公共卫生学院，天津 300070

基金项目:

天津市教委科研计划项目 2020KJ201

详细信息

作者简介:
韩钰(1988-)，女，河南安阳人，博士，讲师，主要研究方向为儿童神经行为发育

通讯作者:
张欣，E-mail: zhangxin@tmu.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 G806 R723.14
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- 被引次数: 0
出版历程
- 收稿日期: 2024-08-08
- 修回日期: 2024-09-19
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Relationship of physical activity and screen time with overweight and obesity among children and adolescents with special needs in Tianjin

School of Public Health, Tianjin Medical University, Tianjin (300070), China

摘要

摘要: 目的了解天津市特殊儿童青少年体力活动和视屏时间与超重肥胖的关联，为制定特殊儿童肥胖的预防和干预措施提供科学依据。方法 2022年1月至2024年6月，在天津市多家特殊教育学校和机构招募296名2~18岁智力障碍和孤独症谱系障碍儿童青少年进行身高、体重测量，采用结构化问卷评估儿童青少年的体力活动和视屏时间，运用二元Logistic回归分析体力活动和视屏时间与超重肥胖的关联。结果天津市特殊儿童青少年超重率为17.2%，肥胖率为21.6%，超重肥胖合并检出率为38.9%；中高强度体力活动(MVPA)时长中位数为0.20 h/d，体力活动合格率为7.8%；视屏时长中位数为1.79 h/d，视屏时长合格率为68.2%。二元Logistic回归分析结果显示，较少的MVPA时长和较多的视屏时长会增加特殊儿童青少年超重肥胖的风险[OR值(95%CI)分别为1.80(1.06~3.07)，2.40(1.42~4.07)，P值均 < 0.05]。结论体力活动时长不足和视屏时长较多会增加特殊儿童青少年超重肥胖的风险，应尽早在特殊儿童青少年中开展综合性干预措施预防和减少超重肥胖的发生。
- 运动活动 /
- 注视，眼 /
- 超重 /
- 肥胖症 /
- 回归分析 /
- 儿童 /
- 青少年
Abstract: Objective To investigate the association of physical activity and screen time with overweight and obesity among children and adolescents with special needs in Tianjin, so as to provide scientific evidence for childhood obesity prevention and intervention measures in the population. Methods From January 2022 to June 2024, 296 children and adolescents with intellectual disabilities and autism spectrum disorders aged 2-18 years were recruited from special education schools and institutions in Tianjin. Height and weight were measured, and a standardized questionnaire was used to assess physical activity and screen time. Binary Logistic regression analysis was carried out to investigate the association of physical activity and screen time with overweight and obesity. Results The prevalence of overweight and obesity among children and adolescents with special needs in Tianjin were 17.2% and 21.6%, respectively, and the combined prevalence of overweight and obesity was 38.9%. The median of moderate-to-vigorous physical activity (MVPA) time was 0.20 h/d, and physical activity sufficiency rate was 7.8%. The median of screen time was 1.79 h/d, and the screen time compliance rate was 68.2%. The binary Logistic regression results showed that lower levels of MVPA time and increased screen time were associated with a higher risk of overweight and obesity among children and adolescents with special needs [OR(95%CI)=1.80(1.06-3.07), 2.40(1.42-4.07), P < 0.05]. Conclusions Insufficient physical activity and excessive screen time are associated with an increased risk of overweight and obesity among children and adolescents with special needs. Therefore, comprehensive intervention measures should be implemented as early as possible to prevent and reduce the incidence of overweight and obesity in this population.
- Motor activity /
- Fixation, ocular /
- Overweight /
- Obesity /
- Regression analysis /
- Child /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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表 1 不同组别特殊儿童青少年超重肥胖检出率比较

Table 1. Comparison of the detection rates of overweight and obesity among children and adolescents with special needs in different groups

组别	人数	统计值	超重	肥胖
性别
男	225		36(16.0)	49(21.8)
女	71		15(21.1)	15(21.1)
		χ²值	1.00	0.01
		P值	0.32	0.91
年龄/岁
2~5	82		14(17.1)	5(6.1)
6~9	118		13(11.0)	25(21.2)
10~13	48		10(20.8)	21(43.8)
14~18	48		14(29.2)	13(27.1)
		χ²值	8.43	26.39
		P值	0.04	< 0.01
残疾类型
智障	78		16(20.5)	23(29.5)
孤独症	218		35(16.1)	41(18.8)
		χ²值	0.80	3.87
		P值	0.37	0.04
父亲文化程度
初中及以下	61		13(21.3)	16(26.2)
高中/中专	67		14(20.9)	15(22.4)
大专及以上	168		24(14.3)	33(19.6)
		χ²值	2.37	1.18
		P值	0.31	0.56
母亲文化程度
初中及以下	59		13(22.0)	17(28.8)
高中/中专	66		15(22.7)	8(12.1)
大专及以上	171		23(13.5)	39(22.8)
		χ²值	4.07	5.46
		P值	0.13	0.07
家庭月收入/元
< 5 000	110		25(22.7)	22(20.0)
5 000~10 000	101		17(16.8)	21(20.8)
> 10 000	85		9(10.6)	21(24.7)
		χ²值	4.97	0.69
		P值	0.08	0.71
注：()内数字为检出率/%。

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表 2 不同组别特殊儿童青少年体力活动和视屏时长比较[M(P₂₅，P₇₅)，h/d]

Table 2. Comparison of the physical activity and screen time among children and adolescents with special needs in different groups[M(P₂₅, P₇₅), h/d]

组别	人数	统计值	体力活动时长	视屏时长
性别
男	225		0.21(0.00, 0.60)	1.57(0.86, 2.29)
女	71		0.14(0.04, 0.43)	1.86(1.14, 3.00)
		Z值	-0.67	-1.61
		P值	0.50	0.11
年龄/岁
2~5	82		0.27(0.06, 0.75)	1.29(0.50, 2.29)
6~9	118		0.29(0.02, 0.54)	1.64(0.98, 2.71)
10~13	48		0.14(0.00, 0.50)	2.21(1.29, 2.79)
14~18	48		0.07(0.00, 0.20)	2.18(1.29, 2.50)
		H值	15.30	16.25
		P值	0.00	< 0.01
残疾类型
智障	78		0.14(0.00, 0.38)	2.00(1.70, 2.61)
孤独症	218		0.21(0.04, 0.63)	1.29(0.71, 2.32)
		Z值	-2.52	-3.13
		P值	0.01	< 0.01
父亲文化程度
初中及以下	61		0.14(0.00, 0.27)	1.93(1.14, 2.46)
高中/中专	67		0.21(0.04, 0.50)	1.79(0.64, 2.79)
大专及以上	168		0.27(0.00, 0.66)	1.43(0.93, 2.29)
		H值	9.15	3.08
		P值	0.01	0.22
母亲文化程度
初中及以下	59		0.14(0.00, 0.29)	2.00(1.00, 2.50)
高中/中专	66		0.18(0.07, 0.56)	1.68(0.64, 2.52)
大专及以上	171		0.25(0.00, 0.58)	1.57(1.00, 2.50)
		H值	5.84	1.89
		P值	0.05	0.39
家庭月收入/元
< 5 000	110		0.14(0.00, 0.45)	1.86(0.84, 2.95)
5 000~10 000	101		0.21(0.00, 0.57)	1.79(1.14, 2.64)
> 10 000	85		0.29(0.02, 0.69)	1.50(0.79, 2.29)
		H值	4.18	2.76
		P值	0.12	0.25
BMI
非超重肥胖	181		0.17(0.00, 0.55)	1.29(0.71, 2.54)
超重肥胖	115		0.21(0.05, 0.50)	2.14(1.29, 2.50)
		Z值	-0.55	-3.01
		P值	0.58	< 0.01

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表 3 不同组别特殊儿童青少年体力活动视屏时长合格率比较

Table 3. Comparison of pass rates of physical activity and screen time among children and adolescents with special needs in different groups

组别	人数	统计值	体力活动	视屏时长
残疾类型
智障	78		6(7.7)	49(62.8)
孤独症	218		17(7.8)	153(70.2)
		χ²值	0.00	1.44
		P值	0.98	0.23
父亲文化程度
初中及以下	61		3(4.9)	40(65.6)
高中/中专	67		1(1.5)	42(62.7)
大专及以上	168		19(11.3)	120(71.4)
		χ²值	7.31	1.94
		P值	0.03	0.38
母亲文化程度
初中及以下	59		4(6.8)	39(66.1)
高中/中专	66		3(4.5)	45(68.2)
大专及以上	171		16(9.4)	118(69.0)
		χ²值	1.64	0.17
		P值	0.44	0.92
家庭月收入/元
< 5 000	110		5(4.5)	70(63.6)
5 000~10 000	101		11(10.9)	67(66.3)
> 10 000	85		7(8.2)	65(76.5)
		χ²值	3.00	3.90
		P值	0.22	0.14
BMI
非超重肥胖	181		15(8.3)	122(67.4)
超重肥胖	115		8(7.0)	80(69.6)
		χ²值	0.17	0.15
		P值	0.68	0.70
注：()内数字为合格率/%。

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表 4 特殊儿童青少年体力活动和视屏时长与超重肥胖Logistic回归分析(n=296)

Table 4. Logistic regression analysis of physical activity and screen time with overweight and obesity among children and adolescents with special needs(n=296)

模型	自变量	β值	标准误	P值	OR值(95%CI)
1	体力活动	0.14	0.24	0.55	1.15(0.72~1.84)
	视屏时长	1.06	0.25	＜0.01	2.88(1.77~4.69)
2	体力活动	0.55	0.27	0.04	1.74(1.03~2.93)
	视屏时长	0.89	0.26	< 0.01	2.44(1.47~4.06)
3	体力活动	0.59	0.27	0.03	1.80(1.06~3.07)
	视屏时长	0.88	0.27	< 0.01	2.40(1.42~4.07)
注：模型1为未校正模型；模型2校正性别、年龄混杂因素；模型3校正性别、年龄、残疾类型、父母文化程度、家庭月收入。

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参考文献(34)

[1]	NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2 416 population-based measurement studies in 128.9 million children, adolescents, and adults[J]. Lancet, 2017, 390(10113): 2627-2642. doi: 10.1016/S0140-6736(17)32129-3
[2]	董彦会, 陈力, 刘婕妤, 等. 1985—2019年中国7~18岁儿童青少年超重与肥胖的流行趋势及预测研究[J]. 中华预防医学杂志, 2023, 57(4): 461-469. DONG Y H, CHEN L, LIU J Y, et al. Epidemiology and prediction of overweight and obesity among children and adolescents aged 7-18 years in China from 1985 to 2019[J]. Chin J Prev Med, 2023, 57(4): 461-469. (in Chinese)
[3]	LLEWELLYN A, SIMMONDS M, OWEN C G, et al. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and Meta-analysis[J]. Obes Rev, 2016, 17(1): 56-67. doi: 10.1111/obr.12316
[4]	HINCKSON E A, CURTIS A. Measuring physical activity in children and youth living with intellectual disabilities: a systematic review[J]. Res Dev Disabil, 2013, 34(1): 72-86. doi: 10.1016/j.ridd.2012.07.022
[5]	SKELLY L J, SMYTH P P, DONNELLY M P, et al. Factors that potentially influence successful weight loss for adults with intellectual disabilities: a qualitative comparison[J]. J Intellect Disabil, 2021, 25(4): 458-475. doi: 10.1177/1744629520931681
[6]	MELVILLE C A, HAMILTON S, HANKEY C R, et al. The prevalence and determinants of obesity in adults with intellectual disabilities[J]. Obes Rev, 2007, 8(3): 223-230. doi: 10.1111/j.1467-789X.2006.00296.x
[7]	MAÏANO C, HUE O, MORIN A J, et al. Prevalence of overweight and obesity among children and adolescents with intellectual disabilities: a systematic review and Meta-analysis[J]. Obes Rev, 2016, 17(7): 599-611. doi: 10.1111/obr.12408
[8]	宗心南, 李辉, 张亚钦, 等. 中国9个城市学龄前儿童单纯性肥胖的影响因素研究[J]. 中华流行病学杂志, 2022, 43(1): 50-57. ZONG X N, LI H, ZHANG Y Q, et al. Risk factors of simple obesity in preschool children in nine cities of China[J]. Chin J Epidemiol, 2022, 43(1): 50-57. (in Chinese)
[9]	屈宁宁, 李可基. 国际体力活动问卷中文版的信度和效度研究[J]. 中华流行病学杂志, 2004, 25(3): 87-90. QU N N, LI K J. Study on the reliability and validity of International Physical Activity Questionaire (Chinese Vision, IPAQ)[J]. Chin J Epidemiol, 2004, 25(3): 87-90. (in Chinese)
[10]	中国学生体质与健康研究组. 2019年中国学生体质与健康调研报告[M]. 北京: 高等教育出版社, 2022: 21-50. National Student Physique and Research Group. Report on the physical fitness and health surveillance of Chinese school students in 2019 [M]. Beijing: Higher Education Press, 2022: 21-50. (in Chinese)
[11]	李辉, 宗心南, 季成叶, 等. 中国2~18岁儿童青少年超重和肥胖筛查体重指数界值点的研究[J]. 中华流行病学杂志, 2010, 31(6): 616-620. LI H, ZONG X N, JI C Y, et al. Body mass index cut-offs for overweight and obesity in Chinese children and adolescents aged 2-18 years[J]. Chin J Epidemiol, 2010, 31(6): 616-620. (in Chinese)
[12]	张云婷, 马生霞, 陈畅, 等. 中国儿童青少年身体活动指南[J]. 中国循证儿科杂志, 2017, 12(6): 401-409. ZHANG Y T, MA S X, CHEN C, et al. Physical activity guidelines for Chinese children and adolescents[J]. Chin J Evid Based Pediatr, 2017, 12(6): 401-409. (in Chinese)
[13]	ZHANG L, CHEN J, ZHANG J, et al. Regional disparities in obesity among a heterogeneous population of Chinese children and adolescents[J] JAMA Netw Open, 2021, 4(10): e2131040. doi: 10.1001/jamanetworkopen.2021.31040
[14]	石锦鸿, 职心乐, 席薇, 等. 天津市2014年儿童青少年超重肥胖现状及其影响因素[J]. 中国学校卫生, 2016, 37(8): 1130-1132, 1135. doi: 10.16835/j.cnki.1000-9817.2016.08.004 SHI J H, ZHI X L, XI W, et al. Prevalence and risk factors of overweight and obesity among children and adolescents in Tianjin in 2014[J]. Chin J Sch Health, 2016, 37(8): 1130-1132, 1135. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2016.08.004
[15]	CHOI E, PARK H, HA Y, et al. Prevalence of overweight and obesity in children with intellectual disabilities in Korea[J]. J Appl Res Intellect Disabil, 2012, 25(5): 476-483. doi: 10.1111/j.1468-3148.2012.00694.x
[16]	STEWART L, VAN DE VEN L, KATSAROU V, et al. High prevalence of obesity in ambulatory children and adolescents with intellectual disability[J]. J Intellect Disabil Res, 2009, 53(10): 882-886. doi: 10.1111/j.1365-2788.2009.01200.x
[17]	刘洋, 卢雁, 刘强, 等. 北京市智力障碍儿童青少年超重与肥胖现状调查[J]. 中国公共卫生, 2018, 34(7): 1017-1020. LIU Y, LU Y, LIU Q, et al. Overweight and obesity among children and adolescent with intellectual disabilities in Beijing[J]. Chin J Sch Health, 2018, 34(7): 1017-1020. (in Chinese)
[18]	刘洋, 原雅青, 王美娟, 等. 济南市智力障碍儿童青少年超重肥胖流行现状[J]. 中国学校卫生, 2019, 40(11): 1742-1744. doi: 10.16835/j.cnki.1000-9817.2019.11.042 LIU Y, YUAN Y Q, WANG M J, et al. Overweight and obesity among children and adolescent with intellectual disabilities in Jinan[J]. Chin J Sch Health, 2019, 40(11): 1742-1744. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.11.042
[19]	EMERSON E, ROBERTSON J, BAINES S, et al. Obesity in British children with and without intellectual disability: cohort study[J]. BMC Public Health, 2016, 16: 644. doi: 10.1186/s12889-016-3309-1
[20]	RANJAN S, NASSER J A, FISHER K. Prevalence and potential factors associated with overweight and obesity status in adults with intellectual developmental disorders[J]. J Appl Res Intellect Disabil, 2018, 31(Suppl 1): 29-38.
[21]	吕子昕, 李涛. 京津冀地区儿童青少年体力活动视屏和睡眠时间与超重肥胖的关系[J]. 中国学校卫生, 2022, 43(4): 502-506. doi: 10.16835/j.cnki.1000-9817.2022.04.005 LV Z X, LI T. Relationship between physical activity screen time and sleep duration and overweight and obesity among children and adolescents in Beijing-Tianjin-Hebei region[J]. Chin J Sch Health, 2022, 43(4): 502-506. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.04.005
[22]	张曌华, 张柳, 李红娟. 中国儿童青少年体力活动现状的Meta分析[J]. 中国学校卫生, 2020, 41(2): 173-178. doi: 10.16835/j.cnki.1000-9817.2020.02.004 ZHANG Z H, ZHANG L, LI H J. A Meta-analysis of physical activity among Chinese children and adolescents with accelerometer data[J]. Chin J Sch Health, 2020, 41(2): 173-178. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2020.02.004
[23]	EINARSSON I Ó, ÓLAFSSON Á, HINRIKSDÓTTIR G, et al. Differences in physical activity among youth with and without intellectual disability[J]. Med Sci Sports Exerc, 2015, 47(2): 411-418. doi: 10.1249/MSS.0000000000000412
[24]	MCCOY S M, JAKICIC J M, GIBBS B B. Comparison of obesity, physical activity, and sedentary behaviors between adolescents with autism spectrum disorders and without[J]. J Autism Dev Disord, 2016, 46(7): 2317-2326. doi: 10.1007/s10803-016-2762-0
[25]	吕雅杰, 蔡莉, 曾霞, 等. 中国6~13岁儿童24小时活动水平和相关因素分析[J]. 中国学校卫生, 2019, 40(12): 1791-1795. doi: 10.16835/j.cnki.1000-9817.2019.12.008 LV Y J, CAI L, ZENG X, et al. Levels and correlates of 24-hour movement behaviors in Chinese children aged 6-13 years[J]. Chin J Sch Health, 2019, 40(12): 1791-1795. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2019.12.008
[26]	原雅青, 刘洋, 王美娟, 等. 济南市智力障碍儿童青少年静态行为现状[J]. 中国学校卫生, 2022, 43(7): 982-985. doi: 10.16835/j.cnki.1000-9817.2022.07.006 YUAN Y Q, LIU Y, WANG M J, et al. Sedentary behavior among children and adolescents with intellectual disabilities in Jinan City[J]. Chin J Sch Health, 2022, 43(7): 982-985. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.07.006
[27]	TELAMA R, YANG X, VIIKARI J, et al. Physical activity from childhood to adulthood: a 21-year tracking study[J]. Am J Prev Med, 2005, 28(3): 267-273. doi: 10.1016/j.amepre.2004.12.003
[28]	MAHUMUD R A, SAHLE B W, OWUSU-ADDO E, et al. Association of dietary intake, physical activity, and sedentary behaviours with overweight and obesity among 282 213 adolescents in 89 low and middle income to high-income countries[J]. Int J Obes, 2021, 45(11): 2404-2418. doi: 10.1038/s41366-021-00908-0
[29]	TWAROG J P, POLITIS M D, WOODS E L, et al. Daily television viewing time and associated risk of obesity among U.S. preschool aged children: an analysis of NHANES 2009-2012[J]. Obes Res Clin Pract, 2015, 9(6): 636-638. doi: 10.1016/j.orcp.2015.09.004
[30]	WANG J, GAO Y, KWOK H H M, et al. Children with intellectual disability are vulnerable to overweight and obesity: a cross-sectional study among Chinese children[J]. Child Obes, 2018, 14(5): 316-326. doi: 10.1089/chi.2018.0015
[31]	RIMMER J A, ROWLAND J L. Physical activity for youth with disabilities: a critical need in an underserved population[J]. Dev Neurorehabil, 2008, 11: 141-148. doi: 10.1080/17518420701688649
[32]	MACDONALD M, ESPOSITO P, ULRICH D. The physical activity patterns of children with autism[J]. BMC Res Notes, 2011(4): 422.
[33]	BARLOW S E. Expert committee recommendations regarding the prevention, assessment, and treatment of child and adolescent overweight and obesity: summary report[J]. Pediatrics, 2007, 120(Suppl 4): S164-S192.
[34]	KATZ D L, CUSHMAN D, REYNOLDS J, et al. Putting physical activity where it fits in the school day: preliminary results of the ABC (Activity Bursts in the Classroom) for fitness program[J]. Prev Chronic Dis, 2010, 7(4): A82.