深圳市宝安区小学生睡眠状况及其与超重肥胖的关联

黄韵; 刘艳红; 黄莉; 李彦柔; 吴明泽

doi:10.16835/j.cnki.1000-9817.2025108

深圳市宝安区小学生睡眠状况及其与超重肥胖的关联

doi: 10.16835/j.cnki.1000-9817.2025108

深圳市宝安区慢性病防治院健康教育与促进科, 广东 518000

基金项目:

深圳市宝安区科技计划项目 2024JD234

详细信息

作者简介:
黄韵(1988-), 女, 广西梧州人, 硕士, 主治医师, 主要研究方向为慢性病预防与控制

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中图分类号: R179 Q428 R723.14
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- 被引次数: 0
出版历程
- 收稿日期: 2025-01-06
- 修回日期: 2025-02-07
- 网络出版日期: 2025-05-08
- 刊出日期: 2025-04-25

Association between sleep status and overweight/obesity among primary school students in Bao'an District of Shenzhen

Education and Promotion Section, Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen (518000), Guangdong Province, China

摘要

摘要: 目的分析小学生不同睡眠状况与超重肥胖的关联,为制定儿童超重肥胖防控策略提供依据。方法 2023年11月, 采用分层整群随机抽样方法, 对深圳市宝安区7所学校一至六年级3 931名小学生进行问卷调查和体格检查, 采用Logistic回归分析探讨小学生睡眠状况与超重肥胖的关联。结果小学生超重肥胖检出率为22.59%, 男生超重肥胖检出率(27.04%)高于女生(17.44%), 独生子女(25.81%)高于非独生子女(21.76%), 差异均有统计学意义(χ²值分别为51.48, 5.98, P值均<0.05)。多因素Logistic回归分析结果显示, 控制混杂因素后, 小学生周末夜间睡眠时长(OR=0.83, 95%CI=0.75~0.91)、一周平均每日睡眠时长(OR=0.76, 95%CI=0.64~0.89)和周末追赶睡眠时长(OR=0.89, 95%CI=0.81~0.97)与小学生超重肥胖发生风险均呈负相关(P值均<0.05)。与上学日午睡时长<0.5 h相比, 上学日午睡时长0.5~<1 h和≥1 h的小学生发生超重肥胖的风险分别增加20%(OR=1.20, 95%CI=1.02~1.42)、37%(OR=1.37, 95%CI=1.02~1.83)(P值均<0.05)。结论增加周末夜间睡眠时长、一周平均每日睡眠时间和周末追赶睡眠时长有助于降低小学生超重肥胖风险, 上学日午睡时间过长是小学生超重肥胖的正性相关因素。
- 睡眠 /
- 超重 /
- 肥胖症 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the association between different sleep statuses and overweight/obesity among primary school students, so as to provide a basis for the development of childhood overweight and obesity prevention and control strategies. Methods In November 2023, a total of 3 391 primary school students of grade 1-6 from seven schools in Baoan District, Shenzhen, were surveyed by questionnaires and physical examinations by using multi-stage cluster sampling. The Logistic regression analysis was used to explore the association between primary school students' sleep status and overweight/obesity. Results The detection rate of overweight/obesity in primary school students was 22.59%, the detection rate of overweight/obesity in boys (27.04%) was higher than that in girls (17.44%), the only child (25.81%) had higher rates than non-only child (21.76%), and the differences were statistically significant (χ²=51.48, 5.98, P<0.05). Multivariate Logistic regression analysis showed that, after controlling for confounders, primary school students' weekend nighttime sleep duration (OR=0.83, 95%CI=0.75-0.91), weekly average nighttime sleep duration (OR=0.76, 95%CI=0.64-0.89), and weekend compensated sleep duration (OR=0.89, 95%CI=0.81-0.97) were negatively associated with the risk of developing overweight/obesity (P<0.05). Compared with to primary school students with school days nap durations<0.5 h, those whose napped for 0.5-<1 h and ≥1 h on school days had a 20% (OR=1.20, 95%CI=1.02-1.42) and 37% (OR=1.37, 95%CI=1.02-1.83) increased risk of overweight/obesity, respectively (P<0.05). Conclusions Increasing weekend nighttime sleep duration, average weekly nighttime sleep duration, and weekend compensatory sleep duration can reduce the risk of overweight and obesity in primary school students. School days nap duration is a risk factor for overweight/obesity among primary school students.
- Sleep /
- Overweight /
- Obesity /
- Regression analysis /
- Students
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表 1 不同特征小学生超重肥胖检出率比较

Table 1. Comparison of overweight and obesity detection rates in primary school students with different characteristics

特征	选项	人数	超重肥胖	χ²/$X_{趋势}^2$值	P值	特征	选项	人数	超重肥胖	χ²/$X_{趋势}^2$值	P值
性别	男	2 108	570(27.04)	51.48	<0.01	母亲文化程度^a	初中及以下	202	57(28.22)	4.13	0.13
	女	1 823	318(17.44)				高中或中专	675	156(23.11)
年级	一	719	128(17.80)	29.98	<0.01		大专及以上	3 019	668(22.13)
		二	826	157(19.01)		上学日夜间睡眠时长/h^a	<9	1 842	465(25.24)	12.84	<0.01
		三	625	142(22.72)			9~<10	1 964	399(20.32)
		四	562	145(25.80)			≥10	122	24(19.67)
		五	568	141(24.82)		周末夜间睡眠时长/h^a	<9	370	115(31.08)	21.88	<0.01
		六	631	175(27.73)			9~<10	1 611	382(23.71)
民族	汉族	3 772	842(22.32)	3.81	0.05		≥10	1 936	389(20.09)
	其他	159	46(28.93)			一周平均每日睡眠时长/h^a	<9	1 321	359(27.18)	24.54	<0.01
是否独生子女	是	802	207(25.81)	5.98	0.01		9~<10	2 429	500(20.58)
	否	3 129	681(21.76)				≥10	164	27(16.46)
是否与父母同住	是	3 705	831(22.43)	0.95	0.33	上学日就寝时间^a	22:00前	1 063	220(20.70)	4.73	0.03
	否	226	57(25.22)				22:00—23:00	2 570	590(22.96)
中高强度活动时间/(h·d^-1)	<0.5	1 081	224(20.72)	10.30	0.04		23:00后	295	78(26.44)
	0.5~<1	1 582	393(24.84)			周末就寝时间^a	22:00前	302	61(20.20)	10.50	<0.01
	1~<1.5	782	160(20.46)				22:00—23:00	2 204	462(20.96)
	1.5~<2	282	70(24.82)				23:00后	1 422	365(25.67)
	≥2	204	41(20.10)			周末追赶睡眠时长/h^a	<0.5	1 130	287(25.40)	8.00	0.01
视屏时间/(h·d^-1)	<1	3 245	706(21.76)	9.28	0.01		0.5~<1	956	217(22.70)
	1~<2	529	134(25.33)				≥1	1 828	382(20.90)
	≥2	157	48(30.57)			上学日午睡时长/h	<0.5	1 563	332(21.24)	3.21	0.07
父亲文化程度^a	初中及以下	187	56(29.95)	8.89	0.01		0.5~<1	2 032	472(23.23)
	高中或中专	621	154(24.80)				≥1	336	84(25.00)
	大专及以上	3 091	671(21.71)			周末午睡时长/h	<0.5	2 717	610(22.45)	0.34	0.56
父亲是否超重肥胖^a	否	1 884	306(16.24)	85.04	<0.01		0.5~<1	662	146(22.05)
	是	1 940	557(28.71)				≥1	552	132(23.91)
母亲是否超重肥胖^a	否	3 183	644(20.23)	54.56	<0.01	睡眠质量	睡眠不良	2 767	621(22.44)	0.12	0.74
	是	722	238(32.96)				睡眠良好	1 164	267(22.94)
注：()内数字为检出率/%。^a存在缺失数据。

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表 2 小学生不同睡眠状况与超重肥胖的Logistic回归分析(n=3 931)

Table 2. Logistic regression analysis on different sleep statuses and overweight and obesity among primary school studnets(n=3 931)

自变量	选项	模型1		模型2
自变量	选项	OR值(95%CI)	P值	OR值(95%CI)	P值
上学日夜间睡眠时长^a		0.80(0.70~0.92)	<0.01	0.88(0.76~1.02)	0.08
上学日夜间睡眠时长/h	<9	1.38(0.87~2.18)	0.17	1.29(0.79~2.10)	0.31
	9~<10	1.04(0.66~1.65)	0.86	1.03(0.64~1.68)	0.89
	≥10	1.00		1.00
周末夜间睡眠时长^a		0.78(0.71~0.86)	<0.01	0.83(0.75~0.91)	<0.01
周末夜间睡眠时长/h	<9	1.79(1.40~2.30)	<0.01	1.43(1.10~1.87)	0.01
	9~<10	1.24(1.05~1.45)	0.01	1.16(0.98~1.37)	0.08
	≥10	1.00		1.00
一周平均每日睡眠时间^a		0.67(0.58~0.78)	<0.01	0.76(0.64~0.89)	<0.01
一周平均每日睡眠时间/h	<9	1.89(1.23~2.91)	<0.01	1.78(1.12~2.82)	0.01
	9~<10	1.32(0.86~2.01)	0.21	1.43(0.91~2.25)	0.12
	≥10	1.00		1.00
周末追赶睡眠时长^a		0.88(0.81~0.96)	<0.01	0.89(0.81~0.97)	0.01
周末追赶睡眠时长/h	<0.5	1.29(1.08~1.54)	0.01	1.21(1.01~1.46)	0.04
	0.5~<1	1.11(0.92~1.34)	0.27	1.14(0.94~1.39)	0.19
	≥1	1.00		1.00
上学日就寝时间	22:00前	0.73(0.54~0.98)	0.04	0.90(0.65~1.24)	0.51
	22:00—23:00	0.83(0.63~1.09)	0.18	0.99(0.74~1.33)	0.96
	23:00后	1.00		1.00
周末就寝时间	22:00前	0.73(0.54~0.99)	0.05	0.85(0.61~1.18)	0.33
	22:00—23:00	0.77(0.66~0.90)	<0.01	0.92(0.78~1.09)	0.33
	23:00后	1.00		1.00
上学日午睡时长/h	<0.5	1.00		1.00
	0.5~<1	1.12(0.96~1.32)	0.16	1.20(1.02~1.42)	0.03
	≥1	1.24(0.94~1.63)	0.13	1.37(1.02~1.83)	0.04
周末午睡时长/h	<0.5	1.00		1.00
	0.5~<1	0.98(0.80~1.20)	0.83	1.06(0.85~1.32)	0.60
	≥1	1.09(0.88~1.35)	0.46	1.20(0.95~1.51)	0.13
睡眠质量	睡眠不良	1.03(0.87~1.21)	0.74	1.02(0.86~1.22)	0.82
	睡眠良好	1.00		1.00
注：^a为连续型变量；模型1未调整变量；模型2调整了性别、年级、是否独生子女、中高强度活动时间、视屏时间、父母文化程度、父母营养状况等变量。

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参考文献(32)

[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]	World Health Organization. Obesity and overweight[EB/OL]. (2024-03-01)[2024-11-01]. https://www.who.int/zh/news-room/fact-sheets/detail/obesity-and-overweight.
[3]	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)
[4]	BENDOR C D, BARDUGO A, PINHAS-HAMIEL O, et al. Cardiovascular morbidity, diabetes and cancer risk among children and adolescents with severe obesity[J]. Cardiovasc Diabetol, 2020, 19(1): 79. doi: 10.1186/s12933-020-01052-1
[5]	CHEN Y, ZHANG J, YUAN L, et al. Obesity and risk of depressive disorder in children and adolescents: a Meta-analysis of observational studies[J]. Child Care Health Dev, 2024, 50(2): e13237. doi: 10.1111/cch.13237
[6]	李艺璇, 陈发青, 张静, 等. 甘肃省中小学生超重肥胖与睡眠时长现状及相关性[J]. 中国学校卫生, 2024, 45(1): 115-120. doi: 10.16835/j.cnki.1000-9817.2024026 LI Y X, CHEN F Q, ZHANG J, et al. Prevalence of overweight and obesity and their associations with sleep duration among primary and secondary school students in Gansu Province[J]. Chin J Sch Health, 2024, 45(1): 115-120. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2024026
[7]	王一然, 黄晓培, 严惠, 等. 河南省7~18岁儿童青少年睡眠时长与超重肥胖的关联[J]. 中华疾病控制杂志, 2021, 25(3): 306-310, 358. WANG Y R, HUANG X P, YAN H, et al. Correlation between sleep duration and overweight/obesity among children and adolescents aged 7-18 in Henan Province[J]. Chin J Dis Control Prev, 2021, 25(3): 306-310, 358. (in Chinese)
[8]	杨连建, 刁华, 李婷, 等. 重庆沙坪坝中小学生睡眠时间与超重肥胖的相关性分析[J]. 现代预防医学, 2020, 47(11): 1980-1984. YANG L J, DIAO H, LI T, et al. Correlation between sleep duration and overweight-obesity among primary and middle school students, Shapingba, Chongqing[J]. Mod Prev Med, 2020, 47(11): 1980-1984. (in Chinese)
[9]	WANG Y, LUO S, HOU Y, et al. Association between overweight, obesity and sleep duration and related lifestyle behaviors is gender and educational stages dependent among children and adolescents aged 6-17 years: a cross-sectional study in Henan[J]. BMC Public Health, 2022, 22(1): 1650-1660. doi: 10.1186/s12889-022-14068-x
[10]	LIN J Y, WANG G, MENG M, et al. Associations of short sleep duration with appetite-regulating hormones and adipokines: a systematic review and Meta-analysis[J]. Obes Rev, 2020, 21(11): e13051. doi: 10.1111/obr.13051
[11]	张子娟, 丁怡, 马希雅, 等. 山西省高年级小学生睡眠时间现状及其影响因素研究[J]. 现代预防医学, 2023, 50(9): 1619-1623, 1636. ZHANG Z J, DING Y, MA X Y, et al. Study on the status and influencing factors of sleep time of senior primary school students in Shanxi Province[J]. Mod Prev Med, 2023, 50(9): 1619-1623, 1636. (in Chinese)
[12]	李生慧, 金星明, 沈晓明, 等. 儿童睡眠习惯问卷中文版制定及测量性能考核[J]. 中华儿科杂志, 2007, 45(3): 176-180. doi: 10.3760/j.issn:0578-1310.2007.03.005 LI S H, JING X M, SHEN X M, et al. Development and psychometric properties of the Chinese version of Children's Sleep Habits Questionnaire[J]. Chin J Pediatr, 2007, 45(3): 176-180. (in Chinese) doi: 10.3760/j.issn:0578-1310.2007.03.005
[13]	陈文娟, 李锋, 李生慧, 等. 常用儿童睡眠时间评估方法的比较研究[J]. 中华儿科杂志, 2012, 50(4): 293-297. doi: 10.3760/cma.j.issn.0578-1310.2012.04.014 CHEN W J, LI F, LI S H, et al. Comparative study of children's sleep evaluation methods[J]. Chin J Pediatr, 2012, 50(4): 293-297. (in Chinese) doi: 10.3760/cma.j.issn.0578-1310.2012.04.014
[14]	中华人民共和国国家卫生和计划生育委员会. 中小学生健康体检管理办法(2021年版)[EB/OL]. (2021-09-30)[2024-11-01]. https://www.gov.cn/gongbao/content/2022/content_5671122.htm.
[15]	《中国人群身体活动指南》编写委员会. 中国人群身体活动指南(2021)[M]. 北京: 人民卫生出版社, 2021. Editorial Committee of Physical Activity Guidelines for Chinese Population. Physical activity guidelines for the Chinese population (2021)[M]. Beijing: People's Medical Publishing House, 2021. (in Chinese)
[16]	钟祥彬, 陈琪, 顾浩琰, 等. 山东省初中生睡眠时间和视屏时间与超重肥胖的关联研究[J]. 现代预防医学, 2023, 50(19): 3534-3539. ZHANG X B, CHEN Q, GU H Y, et al. Study on the relationship of sleep time and video time with overweight and obesity among junior high school students in Shandong Province[J]. Mod Prev Med, 2023, 50(19): 3534-3539. (in Chinese)
[17]	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]. 2012-12-21. Ministry of Health of the PRC. Health requirements of daily learning time for secondary and elementary school students: GB/T 17223-2012[S]. 2012-12-21. (in Chinese)
[18]	PARUTHI S, BROOKS L J, D'AMBROSIO C, et al. Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine[J]. J Clin Sleep Med, 2016, 12(6): 785-786. doi: 10.5664/jcsm.5866
[19]	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]. 北京: 中国标准出版社, 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]. Beijing: Standards Press of China, 2018. (in Chinese)
[20]	中华人民共和国国家卫生和计划生育委员会. 成人体重判定: WS/T 428-2013[S]. 北京: 中国标准出版社, 2013. National Health and Family Planning Commission of the PRC. Adult weight assessment: WS/T 428-2013[S]. Beijing: Standards Press of China, 2013. (in Chinese)
[21]	National Health Commission of the PRC. Report on nutrition and chronic diseases of residents in China (2020)[M]. Beijing: People's Medical Publishing House, 2021. (in Chinese)
[22]	ZHANG J, LI Y, LI F, et al. Association between sugar-free beverage intake and childhood obesity among Chinese children and adolescents. [J]. Pediatr Obes, 2024, 19(3): e13096. doi: 10.1111/ijpo.13096
[23]	中华人民共和国国家卫生和计划生育委员会. 儿童青少年肥胖防控实施方案[EB/OL]. (2020-10-16)[2024-11-01]. https://www.gov.cn/zhengce/zhengceku/2020-10/24/content_5553848.htm.
[24]	GUO Y, MILLER M, CAPPUCCIO F P. Short duration of sleep and incidence of overweight or obesity in Chinese children and adolescents: a systematic review and Meta-analysis of prospective studies[J]. Nutr Metab Cardiovasc Dis, 2021, 31(2): 363-371. doi: 10.1016/j.numecd.2020.11.001
[25]	HAN S H, YEE J Y, PYO J S. Impact of short sleep duration on the incidence of obesity and overweight among children and adolescents[J]. Medicina (Kaunas), 2022, 58(8): 1037-1046. doi: 10.3390/medicina58081037
[26]	MILLER M A, KRUISBRINK M, WALLACE J, et al. Sleep duration and incidence of obesity in infants, children, and adolescents: a systematic review and Meta-analysis of prospective studies[J]. Sleep, 2018, 41(4): 1-19. http://www.xueshufan.com/publication/2785146914
[27]	李艳辉, 陶然, 高迪, 等. 我国儿童青少年睡眠不足与肥胖的关联性研究[J]. 中华流行病学杂志, 2020, 41(6): 845-849. doi: 10.3760/cma.j.cn112338-20190711-00514 LI Y H, TAO R, GAO D, et al. A study on the relationship between insufficient sleep and obesity among children and adolescents in China[J]. Chin J Epidemiol, 2020, 41(6): 845-849. (in Chinese) doi: 10.3760/cma.j.cn112338-20190711-00514
[28]	CHAPUT J P, MCHILLl A W, COX R C, et al. The role of insufficient sleep and circadian misalignment in obesity[J]. Nat Rev Endocrinol, 2023, 19(2): 82-97. doi: 10.1038/s41574-022-00747-7
[29]	LIU S, WANG X, ZHENG Q, et al. Sleep deprivation and central appetite regulation[J]. Nutrients, 2022, 14(24): 5196-5208. doi: 10.3390/nu14245196
[30]	TAVERAS E M, RIFAS-SHIMAN S L, BUB K L, et al. Prospective study of insufficient sleep and neurobehavioral functioning among school-age children[J]. Acad Pediatr, 2017, 17(6): 625-632. doi: 10.1016/j.acap.2017.02.001
[31]	CHOI Y, KIM S, LEE M, et al. Effect of catch-up sleep on obesity in Korean adolescents: a nationwide cross-sectional study[J]. Front Pediatr, 2023, 11: 1213558. doi: 10.3389/fped.2023.1213558
[32]	曾祥宇, 黄彦, 刘斯博, 等. 睡眠时长、饮食习惯与学龄儿童肥胖的关系[J]. 中华疾病控制杂志, 2021, 25(5): 600-604, 611. ZENG X Y, HUAGN Y, LIU S B, et al. The association between sleep duration, eating habits and obesity of school-aged children[J]. Chin J Dis Control Prev, 2021, 25(5): 600-604, 611. (in Chinese)