Association between physical activity levels and metabolic syndrome among children aged 8-9 years old in Pudong New Area, Shanghai
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摘要:
目的 了解上海市浦东新区8~9岁儿童24 h身体活动量及其与代谢综合征的关联，为儿童参与身体活动、降低代谢综合征风险提供科学依据。 方法 采用分层整群随机抽样方法从上海市浦东新区抽取13所学校，纳入2 013名8~9岁小学生，于2021年9月—2022年12月用Actigraph GT3X加速度传感器、身高坐高计、电子血压计、皮尺测量身体活动、身高、血压、腰围，采集学生空腹静脉血5 mL，检测甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FPG)水平，并进行线上问卷调查。采用t检验、单因素方差分析比较不同特征儿童24 h身体活动量差异，采用多因素Logistic回归分析24 h身体活动量与代谢综合征及其各组分的关联。 结果 小学生平均每日中高强度身体活动(MVPA)时长为(34.25±13.49)min，达标率为1.59%；睡眠(SLP)时长为(538.27±28.53)min，达标率为1.89%。代谢综合征、中心性肥胖(AO)、血压(BP)偏高、TG偏高、HDL-C偏低、FPG偏高检出率分别为2.48%，34.53%，10.38%，10.73%，1.24%，0.70%。多因素Logistic回归分析结果显示，静态行为(SB)时长每增加10 min，AO、BP偏高、TG偏高的风险分别增加2%(OR=1.02，95%CI=1.01~1.04)、5%(OR=1.05，95%CI=1.01~1.08)、6%(OR=1.06，95%CI=1.02~1.11)；MVPA时长每增加10 min，代谢综合征的风险降低27%(OR=0.73，95%CI=0.57~0.93)；SLP时长每增加10 min，AO、BP偏高、代谢综合征的风险分别降低16%(OR=0.84，95%CI=0.80~0.88)、9%(OR=0.91，95%CI=0.82~0.99)、15%(OR=0.85，95%CI=0.77~0.94)(P值均 < 0.05)。 结论 浦东新区8~9岁儿童MVPA和SLP时间严重不足，身体活动量与代谢综合征及其各组分之间存在关联。增加MVPA和SLP时间对维持儿童较低的代谢综合征风险具有重要意义。 Abstract:Objective To understand 24 h physical activity levels of children aged 8-9 years in Pudong New Area and to explore its association with metabolic syndrome, so as to provide scientific basis for children's participation in physical activities and reducing the risk of metabolic syndrome. Methods A stratified cluster random sampling method was adopted to select 13 schools in Pudong New Area, Shanghai. A total of 2 013 primary school students aged 8-9 years old were included as the research subjects. During September 2021 to December 2022, Actigraph GT3X accelerometer, height measuring gauge, electronic sphygmomanometer and waist circumference tape was used to measure physical activity, height, blood pressure and waist circumference, respectively. A total of 5 mL of venous blood was collected from students, and the levels of triglycerides (TG), high-density lipoprotein cholesterol (HDL-C) and fasting plasma glucose (FPG) were detected, and online questionnaires were conducted. The t-test and one-way ANOVA were employed to compare the differences in 24 h physical activity levels among children with different characteristics. Multivariate Logistic regression was used to analyze the association between the 24 h physical activity levels and metabolic syndrome as well as its components. Results Among primary school students, the average daily time of moderate to vigorous physical activity (MVPA) was (34.25±13.49)min, the attainment rate was 1.59%. The average daily sleep (SLP) time was (538.27±28.53) min, attainment rate was 1.89%. The detection rates of metabolic syndrome, abdominal obesity (AO), elevated blood pressure (BP), elevated TG, low HDL-C, and elevated FPG were 2.48%, 34.53%, 10.38%, 10.73%, 1.24% and 0.70%, respectively. Multivariate Logistic regression analysis showed that, for every 10-minute increase in sedentary behavior (SB) time, the risks of AO, elevated BP, and elevated TG increased by 2% (OR=1.02, 95%CI=1.01-1.04), 5% (OR=1.05, 95%CI=1.01-1.08), and 6% (OR=1.06, 95%CI=1.02-1.11), respectively (P < 0.05). For every 10-minute increase in MVPA time, the risk of metabolic syndrome decreased by 27% (OR=0.73, 95%CI=0.57-0.93, P < 0.05). For every 10-minute increase in SLP time, the risks of AO, elevated BP, and metabolic syndrome decreased by 16% (OR=0.84, 95%CI=0.80-0.88), 9% (OR=0.91, 95%CI=0.82-0.99), and 15% (OR=0.85, 95%CI=0.77-0.94), respectively (P < 0.05). Conclusions The time of MVPA and SLP are seriously insufficient among children aged 8-9 years in Pudong New Area. There is an association between physical activity levels and metabolic syndrome as well as its components. Increasing the time of MVPA and SLP is of great significance for maintaining a relatively low risk of metabolic syndrome in children. -
Key words:
- Motor activity /
- Metabolic syndrome X /
- Regression analysis /
- Child
1) 利益冲突声明 所有作者声明无利益冲突。2) 秦存与麦合力亚克孜·吐尔孙尼亚孜为共同第一作者。 -
表 1 不同组别儿童24 h身体活动量平均时长比较(x ± s，min)
Table 1. Comparison of the average physical activity duration of 24 h among children with different groups(x ± s, min)
组别 人数 统计值 SB LPA MPA VPA MVPA SLP 性别 男 1 079 546.48±92.56 263.50±58.45 19.60±6.55 17.51±8.14 37.10±13.92 535.65±27.95 女 934 572.75±82.16 245.58±49.42 16.33±5.64 14.63±7.14 30.96±12.19 541.29±28.92 t值 -6.75** 7.45** 12.03** 8.44** 10.56** -4.45** 出生体重 低出生体重 69 555.12±101.65 244.13±65.97 16.52±6.57 14.58±8.64 31.10±14.32 535.59±31.03 正常出生体重 1 846 558.85±88.44 255.53±54.44 18.12±6.36 16.21±7.83 34.34±13.50 538.72±28.48 巨大儿 98 557.76±87.63 256.46±59.97 18.36±6.14 16.55±7.05 34.91±12.63 531.62±27.03 F值 0.06 1.45 2.21 1.57 2.03 3.21* 婴儿期喂养方式 纯母乳喂养 664 557.87±85.92 255.11±51.97 18.03±5.91 15.97±7.31 34.00±12.52 539.49±27.56 混合喂养 925 561.38±86.81 256.64±54.78 18.28±6.55 16.47±8.19 34.75±14.03 537.15±28.19 奶粉喂养 424 554.00±97.31 252.11±60.57 17.73±6.60 15.83±7.79 33.56±13.76 538.80±30.67 F值 1.04 0.98 1.10 1.30 1.29 1.39 家庭人均月收入/元 < 2 000 134 556.61±91.81 256.28±58.22 17.50±5.75 15.72±7.44 33.21±12.59 542.58±29.49 2 000~ < 6 000 538 554.55±96.33 254.60±58.16 17.62±6.50 15.28±7.58 32.90±13.45 539.80±28.03 6 000~ < 10 000 503 558.66±83.01 254.41±51.87 18.01±5.87 16.23±7.28 34.24±12.46 540.05±29.80 10 000~ < 20 000 547 557.23±88.04 253.85±54.98 18.30±6.43 16.28±7.54 34.58±13.29 537.29±27.46 ≥20 000 291 569.95±83.76 259.59±54.01 18.90±6.93 17.74±9.48 36.64±15.65 532.21±27.92 F值 1.52 0.60 2.40* 4.84** 3.93* 5.13** 心血管疾病家族史 无 1 942 558.71±88.10 255.18±55.03 18.05±6.27 16.12±7.61 34.17±13.19 538.40±28.36 有 71 557.48±107.74 255.21±59.04 18.98±8.40 17.49±12.33 36.47±20.05 534.81±32.87 t值 0.12 -0.00 -1.21 -1.45 -1.41 0.91 合计 2 013 558.67±88.84 255.18±55.16 18.08±6.36 16.17±7.83 34.25±13.49 538.27±28.53 注： *P < 0.05，**P < 0.01。 
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表 2 不同代谢综合征组儿童24 h平均身体活动量比较(x ± s，min)
Table 2. Comparison of the average physical activity level of 24 h in children between different metabolic syndrome groups(x ± s, min)
代谢综合征指标 选项 人数 统计值 SB LPA MPA VPA MVPA SLP 代谢综合征 否 1 963 558.54±88.08 255.09±54.69 18.10±6.34 16.24±7.83 34.34±13.48 538.60±28.56 是 50 563.73±115.78 258.79±71.88 17.20±7.00 13.45±7.09 30.65±13.71 525.18±24.47 t值 -0.41 -0.36 0.99 2.50* 1.91 3.29* AO 否 1 318 555.63±85.18 252.59±52.08 17.79±6.24 16.34±8.04 34.13±13.64 543.07±27.93 是 695 564.43±95.19 260.09±60.31 18.63±6.55 15.85±7.39 34.48±13.22 529.16±27.44 t值 -2.11* -2.78* -2.84* 1.34 -0.56 10.69** BP偏高 否 1 804 556.93±87.57 255.33±54.58 18.11±6.36 16.26±7.87 34.36±13.55 539.40±28.45 是 209 573.68±98.08 253.89±60.04 17.84±6.35 15.45±7.36 33.29±12.99 528.55±27.43 t值 -2.58* 0.36 0.57 1.41 1.09 5.24** TG偏高 否 1 797 557.92±88.11 255.44±54.64 18.13±6.38 16.33±7.91 34.45±13.61 538.92±28.73 是 216 564.87±94.70 253.06±59.38 17.70±6.19 14.87±6.92 32.57±12.38 532.89±26.25 t值 -1.09 0.60 0.93 2.59* 1.94 2.94* HDL-C偏低 否 1 988 558.74±89.00 254.94±55.02 18.07±6.37 16.17±7.85 34.24±13.53 538.37±28.59 是 25 552.97±76.42 274.23±63.73 18.94±5.04 16.38±6.10 35.32±10.45 530.44±22.39 t值 0.32 -1.74 -0.68 -0.13 -0.40 1.38 FPG偏高 否 1 999 558.26±88.91 255.19±55.23 18.07±6.34 16.19±7.84 34.26±13.50 538.35±28.55 是 14 616.55±54.07 254.57±45.97 19.38±9.03 13.92±5.94 33.30±13.91 526.73±23.25 t值 -2.45* 0.04 -0.77 1.08 0.26 1.52 注： *P < 0.05，**P < 0.01。
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表 3 儿童24 h身体活动量与代谢综合征及其各组分的多因素Logistic回归分析[OR值(95%CI), n=2 013]
Table 3. Multivariate Logistic regression analysis of 24 h physical activity levels with metabolic syndrome and its components among children[OR(95%CI), n=2 013]
模型 指标 仅AO 仅BP偏高 仅TG偏高 仅HDL-C偏低 仅FPG偏高 代谢综合征 1 SB 1.03(1.02~1.05)** 1.06(1.018~1.10)* 1.07(1.03~1.11)* 1.04(0.90~1.19) 1.23(0.98~1.56) 1.01(0.98~1.05) 2 MVPA 0.98(0.90~1.06) 0.89(0.73~1.08) 0.95(0.79~1.14) 1.04(0.53~2.03) 1.25(0.60~2.61) 0.75(0.59~0.95)* 3 SLP 0.83(0.80~0.87)** 0.89(0.82~0.98)* 0.92(0.85~1.00) 1.07(0.74~1.54) 0.59(0.35~0.97)* 0.85(0.77~0.94)* 4 SB 1.02(1.01~1.04)* 1.05(1.01~1.08)* 1.06(1.02~1.11)* 1.05(0.89~1.23) 1.45(0.95~2.21) 1.01(0.98~1.04) MVPA 0.94(0.86~1.03) 0.87(0.71~1.08) 0.99(0.80~1.21) 1.09(0.57~2.29) 3.28(0.83~12.98) 0.73(0.57~0.93)* SLP 0.84(0.80~0.88)** 0.91(0.82~0.99)* 0.95(0.87~1.04) 1.12(0.74~1.68) 0.61(0.32~1.16) 0.85(0.77~0.94)* 注：模型1，2，3调整性别、出生体重、家庭人均月收入、婴儿期喂养方式、膳食情况、心血管疾病家族史；模型4调整了性别、出生体重、家庭人均月收入、婴儿期喂养方式、膳食情况、心血管疾病家族史以及另外2类身体活动时间；*P < 0.05，**P < 0.01。
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