广西中小学生龋齿与超重肥胖共患现状及相关因素分析

罗月梅; 任轶文; 陈力; 董邕晖; 袁雯; 马军; 董彦会; 李艳; 周为文

doi:10.16835/j.cnki.1000-9817.2025096

广西中小学生龋齿与超重肥胖共患现状及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2025096

1.
广西壮族自治区疾病预防控制中心学校卫生所, 南宁 530028
2.
北京大学公共卫生学院/儿童青少年卫生研究所

基金项目:

广西壮族自治区卫生健康委自筹经费科研课题 Z-A20230422

详细信息

作者简介:
罗月梅(1992-), 女, 广西平南人, 硕士, 主管医师, 主要从事儿童青少年卫生与健康工作

通讯作者:
周为文, E-mail: 381011550@qq.com

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 R788+^.1
计量
- 文章访问数: 9
- HTML全文浏览量: 5
- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2024-10-29
- 修回日期: 2025-01-14
- 网络出版日期: 2025-05-08
- 刊出日期: 2025-04-25

Comorbidity and associated factors of overweight/obesity and dental caries among primary and secondary school students in Guangxi

1.
Institute of School Health, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning (530028), Guangxi Zhuang Autonomous Region, China

摘要

摘要: 目的探讨广西壮族自治区中小学生龋齿与超重肥胖共患状况及其相关因素, 为制定针对性的预防策略提供科学依据。方法采用分层整群随机抽样法, 于2023年9—11月在广西调查178 700名小学四年级至高中三年级学生, 包括体格检查、口腔筛查及问卷调查。运用χ²检验和二元Logistic回归分析, 探究中小学生龋齿与超重肥胖共患的相关因素。结果广西中小学生龋齿及超重肥胖共患率为9.55%, 城区(9.95%)高于郊县(9.24%), 男生(10.54%)高于女生(8.54%), 小学生(11.49%)高于高中生(8.92%)及初中生(8.05%), 不住校学生(11.44%)高于住校学生(7.94%), 差异均有统计学意义(χ²值分别为26.07, 207.91, 471.54, 629.14, P值均<0.01)。多因素Logistic回归分析结果显示, 吃谷薯类早餐(OR=0.91, 95%CI=0.88~0.94)、过去1周喝过奶(OR=0.89, 95%CI=0.83~0.95)、睡眠达标(OR=0.95, 95%CI=0.91~0.99)、早和(或)晚刷牙(OR=0.82, 95%CI=0.73~0.93)的学生龋齿及超重肥胖共患的风险更低; 过去1周喝过饮料(OR=1.14, 95%CI=1.09~1.20)、过去1周吃过油炸食品(OR=1.11, 95%CI=1.06~1.17)、每天吃≥1次水果(OR=1.06, 95%CI=1.02~1.11)、每天吃≥1种水果(OR=1.07, 95%CI=1.01~1.12)、吃鱼禽肉蛋类早餐(OR=1.03, 95%CI=1.05~1.13)的学生龋齿及超重肥胖共患风险更高(P值均<0.05)。结论广西中小学生的饮食习惯和生活方式与龋齿及超重肥胖的共患相关。引导学生形成健康的生活习惯, 有助于预防龋齿及超重肥胖的发生。
- 龋齿 /
- 超重 /
- 肥胖症 /
- 共病现象 /
- 回归分析 /
- 学生
Abstract: Objective To explore the comorbidity and associated factors of dental caries and overweight/obesity among primary and secondary school students in Guangxi, so as to provide a scientific basis for the development of targeted prevention strategies. Methods A stratified cluster random sampling method was used to survey 178 700 students from the fourth grade of primary school to the third year of high school in Guangxi Zhuang Autonomous Region from September to November 2023, including physical examination, oral screening, and questionnaire survey. Chi-square tests and binary Logistic regression analysis were employed to investigate the related factors of the co-occurrence of dental caries and overweight/obesity among students. Results The comorbidity rate of dental caries and overweight/obesity was 9.55%, with urban areas (9.95%) higher than rural counties (9.24%), boys (10.54%) higher than girls (8.54%), primary school students (11.49%) higher than senior high school students (8.92%) and junior high school students (8.05%), and non-boarding students (11.44%) higher than boarding students (7.94%), and all differences were statistically significant (χ²=26.07, 207.91, 471.54, 629.14, P<0.01). Multivariate Logistic regression analysis showed that consuming cereal for breakfast (OR=0.91, 95%CI=0.88-0.94), drinking milk in the past week (OR=0.89, 95%CI=0.83-0.95), meeting sleep standards (OR=0.95, 95%CI=0.91-0.99), and brushing teeth at least once a day (OR=0.82, 95%CI=0.73-0.93) had a lower risk of the comorbidity of dental caries and overweight/obesity. In contrast, drinking beverages in the past week (OR=1.14, 95%CI=1.09-1.20), consuming fried foods in the past week (OR=1.11, 95%CI=1.06-1.17), eating fruit ≥1 time every day (OR=1.06, 95%CI=1.02-1.11), consuming fruit ≥1 type every day (OR=1.07, 95%CI=1.01-1.12), and having fish, poultry, meat, or egg-based breakfasts (OR=1.03, 95%CI=1.05-1.13) had a higher risk of the comorbidity of dental caries and overweight/obesity (P<0.05). Conclusions Dietary habits and lifestyle behaviors are associated with the comorbidity of dental caries and overweight/obesity among primary and secondary school students in Guangxi. Guiding students to form healthy living habits is helpful to preven dental caries and overweight/obesity.
- caries /
- Overweight /
- Obesity /
- Comorbidity /
- Regression analysis /
- Students
注释:

1) 利益冲突声明所有作者声明无利益冲突。

HTML全文

表 1 广西不同组别中小学生龋齿及超重肥胖共患检出率比较

Table 1. Comparison of the detection rate of caries and overweight and obesity among primary and middle school students in different groups in Guangxi

组别	选项	人数	检出人数	χ²值	P值
监测点	城区	77 239	7 688(9.95)	26.07	<0.01
	郊县	101 461	9 372(9.24)
是否住校	是	96 755	7 684(7.94)	629.14	<0.01
	否	81 945	9 376(11.44)
性别	男	89 721	9 461(10.54)	207.91	<0.01
	女	88 979	7 599(8.54)
学段	小学	64 830	7 452(11.49)	471.54	<0.01
	初中	63 261	5 094(8.05)
	高中	50 609	4 514(8.92)
注：()内数字为检出率/%。

下载: 导出CSV

表 2 广西中小学生龋齿及超重肥胖共患相关因素的Logistic回归分析(n=178 700)

Table 2. Logistic regression analysis of associated factors for the comorbidity of dental caries and overweight/obesity among primary and secondary school students in Guangxi(n=178 700)

自变量	选项	β值	标准误	OR值(95%CI)	P值
监测点	郊县	0.04	0.02	1.04(1.00~1.08)	0.04
性别	女	-0.10	0.02	0.90(0.87~0.94)	<0.01
学段	高中	-0.07	0.02	0.93(0.90~0.96)	<0.01
是否住校	否	-0.38	0.02	0.69(0.65~0.72)	<0.01
喝饮料频率	过去一周喝过	0.13	0.03	1.14(1.09~1.20)	<0.01
吃油炸食物频率	过去一周吃过	0.11	0.02	1.11(1.06~1.17)	<0.01
每天吃水果频率	≥1次	0.06	0.02	1.06(1.02~1.11)	<0.01
每天吃水果的种类	≥1种	0.06	0.03	1.07(1.01~1.12)	0.01
饮奶频率	过去一周喝过	-0.12	0.03	0.89(0.83~0.95)	<0.01
是否吃谷薯类早餐	是	-0.10	0.02	0.91(0.88~0.94)	<0.01
是否吃鱼禽肉蛋类早餐	是	0.08	0.02	1.09(1.05~1.13)	<0.01
刷牙频率	早和(或)晚刷牙	-0.20	0.06	0.82(0.73~0.93)	<0.01
睡眠是否达标	是	-0.05	0.02	0.95(0.91~0.99)	<0.01
注：监测点以城区，性别以男生，学段以小学，住校情况以是，是否吃谷薯类、鱼禽肉蛋类早餐以否，睡眠是否达标以否，喝饮料频率、吃油炸食物频率、喝奶频率以过去一周没喝(吃)过，每天吃水果的频率以＜1次，每天吃水果的种类以＜1种为参照。

下载: 导出CSV

参考文献(24)

[1]	China resident nutrition and chronic disease status report(2020)[J]. Acta Nutr Sinica, 2020, 42(6): 521. (in Chinese)
[2]	冯希平. 中国居民口腔健康状况: 第四次中国口腔健康流行病学调查报告[R]. 西安, 2018. FENG X P. Oral health status of Chinese residents: the fourth national epidemiological survey report on oral health in China[R]. Xi'an, 2018. (in Chinese)
[3]	MOHAJERI A, BERG G, WATTS A, et al. Obesity and dental caries in school children[J]. J Clin Med, 2024, 13(3): 860. doi: 10.3390/jcm13030860
[4]	SILVA A E, MENEZES A M, DEMARCO F F, et al. Obesity and dental caries: systematic review[J]. Rev Saud Public, 2013, 47(4): 799-812. doi: 10.1590/S0034-8910.2013047004608
[5]	ABU EL QOMSAN M A, ALASQAH M N, ALQAHTANI F A, et al. Intricate evaluation of association between dental caries and obesity among the children in Al-Kharj City (Saudi Arabia)[J]. J Contemp Dent Pract, 2017, 18(1): 29-33. doi: 10.5005/jp-journals-10024-1983
[6]	SAKEENABI B, SWAMY H S, MOHAMMED R N. Association between obesity, dental caries and socioeconomic status in 6- and 13-year-old school children[J]. Oral Health Prev Dent, 2012, 10(3): 231-241.
[7]	YANG F, ZHANG Y, YUAN X, et al. Caries experience and its association with weight status among 8-year-old children in Qingdao, China[J]. J Int Soc Prev Commun Dent, 2015, 5(1): 52-58. doi: 10.4103/2231-0762.151978
[8]	SHI R, LIN C, LI S, et al. Obesity is negatively associated with dental caries among children and adolescents in Huizhou: a cross-sectional study[J]. BMC Oral Health, 2022, 22(1): 76. doi: 10.1186/s12903-022-02105-5
[9]	FARSI D J. BMI, dental caries, and risk factors among elementary school children: a cross-sectional study[J]. Children (Basel), 2024, 11(9): 1145. http://www.mdpi.com/2227-9067/11/9/1145/xml
[10]	CHI D L, LUU M, CHU F. A scoping review of epidemiologic risk factors for pediatric obesity: implications for future childhood obesity and dental caries prevention research[J]. J Public Health Dent, 2017, 77(Suppl 1): S8-S31. http://pubmed.ncbi.nlm.nih.gov/28600842/
[11]	ALSHIHRI A A, ROGERS H J, ALQAHTANI M A, et al. Association between dental caries and obesity in children and young people: a narrative review[J]. Int J Dent, 2019, 2019: 9105759. http://doc.paperpass.com/foreign/rgArti2019133872829.html
[12]	中华人民共和国卫生部. 学生健康检查技术规范: GB/T 26343-2010[S]. 2011. Ministry of Health of the PRC. Technical standard for physical examination for students: GB/T 26343-2010[S]. 2011. (in Chinese)
[13]	中华人民共和国卫生部. 中小学生一日学习时间卫生要求: GB/T 17223-2012[S]. 2013. Ministry of Health of the PRC. Health requirements of daily learningtime for secondary and elementary school students: GB/T 17223-2012[S]. 2013. (in Chinese)
[14]	中华人民共和国国家卫生和计划生育委员会. 学龄儿童青少年超重与肥胖筛查: WS/T 586-2018[S]. 2018. National Health and Family Planning Commission of the PRC. Screening for overweight and obesity among school-age children and adolescents: WS/T 586-2018[S]. 2018. (in Chinese)
[15]	刘忠慧, 赵赛赛, 肖英琛, 等. 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[J]. 中国学校卫生, 2024, 45(8): 1176-1180. doi: 10.16835/j.cnki.1000-9817.2024234 LIU Z H, ZHAO S S, XIAO Y C, et al. Trends and factors associated with overweight and obesity among primary and secondary school students in Tianjin from 2019 to 2023[J]. Chin J Sch Health, 2024, 45(8): 1176-1180. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024234
[16]	赫丽君, 韩小丽, 徐烨, 等. 上海市崇明区2019-2021年学生龋齿患病情况分析[J]. 健康教育与健康促进, 2023, 18(2): 161-163. HE L J, HAN X L, XU Y, et al. Analysis of caries prevalence among students in Chongming District from 2019 to 2021[J]. Health Educ Health Prom, 2023, 18(2): 161-163. (in Chinese)
[17]	方杭燕, 雷钞. 2020年浙江省杭州市某区中小学生龋齿患病情况及相关因素分析[J]. 上海预防医学, 2024, 36(9): 904-906, 924. FANG H Y, LEI C. Prevalence of dental caries and related factors among primary and secondary school students in a district of Hangzhou City, Zhejiang Province in 2020[J]. Shanghai J Prev Med, 2024, 36(9): 904-906, 924. (in Chinese)
[18]	杨彦玲, 张强, 闵向东, 等. 2016-2017年云南省6~17岁儿童青少年超重肥胖现状及相关因素[J]. 卫生研究, 2023, 52(3): 369-374. YANG Y L, ZHANG Q, MIN X D, et al. Status and related factors of overweight and obesity among children and adolescents aged 6-17 in Yunnan Province during 2016-2017[J]. J Hyg Res, 2023, 52(3): 369-374. (in Chinese)
[19]	MAKI K C, PHILLIPS-EAKLEY A K, SMITH K N. The effects of breakfast consumption and composition on metabolic wellness with a focus on carbohydrate metabolism[J]. Adv Nutr, 2016, 7(3): 613S-621S. doi: 10.3945/an.115.010314
[20]	TENNERT C, REINMUTH A C, BREMER K, et al. An oral health optimized diet reduces the load of potential cariogenic and periodontal bacterial species in the supragingival oral plaque: a randomized controlled pilot study[J]. Microbiologyopen, 2020, 9(8): e1056. doi: 10.1002/mbo3.1056
[21]	DE LIMA L C M, BERNARDINO V M M, LEAL T R, et al. Sleep disorders, anxiety and obesity associated with untreated dental caries in children eight to ten years of age[J]. J Public Health Dent, 2024, 84(1): 13-20. doi: 10.1111/jphd.12595
[22]	周斯亮, 李星秀, 顾昉, 等. 浙江省2017-2019年中小学生睡眠时长与体质量指数关联的追踪调查[J]. 中国学校卫生, 2022, 43(6): 847-850. doi: 10.16835/j.cnki.1000-9817.2022.06.012 ZHOU S L, LI X X, GU F, et al. A follow-up study on the correlation between sleep duration and body mass index in primary and middle school students in Zheijiang from 2017 to 2019[J]. Chin J Sch Health, 2022, 43(6): 847-850. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2022.06.012
[23]	AOUN E, BALLO L, ELHABONY S, et al. Association between dental caries and obesity among Libyan schoolchildren during the armed conflict in Benghazi[J]. BMC Oral Health, 2023, 23(1): 44. doi: 10.1186/s12903-023-02728-2
[24]	STEWART R, CONWAY D I, MACPHERSON L M D, et al. Obesity and dental caries in childhood: trends in prevalence and socioeconomic inequalities: a multicohort population-wide data linkage study[J]. Arch Dis Child, 2024, 109(8): 642-648. doi: 10.1136/archdischild-2023-326587