Association between moderate-to-vigorous physical activity and weight-adjusted waist index with psychological sub-health among middle school students
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摘要:
目的 了解中学生中高强度体力活动(MVPA)和体重调整腰围指数(WWI)与心理亚健康之间的关联，为中学生心理健康干预和促进提供参考。 方法 2023年9—11月，采用分层整群随机抽样方法对中国东、西、南、北、中部的江苏、新疆、广东、吉林、河南47 372名12~17岁中学生进行MVPA、WWI和心理亚健康调查，将WWI进行四分位数划分(Q1、Q2、Q3、Q4)。采用χ2检验、Logistic回归分析、广义线性模型的Logistic回归分析进行数据分析。 结果 中学生心理亚健康检出率为21.0%，其中男生检出率(21.4%)高于女生(20.5%)，差异有统计学意义(χ2=6.49，P＜0.05)；中学生心理亚健康情绪问题、行为问题、社会适应困难维度检出率分别为27.8%，26.9%，17.5%。以中学生MVPA和WWI各组组合为自变量，调整协变量后进行广义线性模型的Logistic回归分析，以中学生MVPA>60 min/d中Q1组为参照组，中学生MVPA＜30 min/d中Q4组中学生心理亚健康检出风险最高(OR=1.58，95%CI=1.38~1.81)，Q1~Q3组中学生心理亚健康检出风险分别为1.34(1.17~1.53)，1.30(1.13~1.49)，1.42(1.24~1.62)(P值均 < 0.01)。 结论 中学生MVPA和WWI与心理亚健康之间存在关联，MVPA较低、WWI较高的中学生心理亚健康检出率较高。应采取措施有效提高中学生MVPA水平、降低WWI，促进心理健康发展。 Abstract:Objective To examine the association between moderate-to-vigorous physical activity (MVPA) and weight-adjusted waist index (WWI) with psychological sub-health in middle school students, so as to provide a basis for mental health intervention and promotion. Methods From September to November 2023, a stratified cluster random sampling method was used to survey 47 372 middle school students aged 12-17 in Jiangsu, Xinjiang, Guangdong, Jilin and Henan provinces from eastern, western, southern, northern and central of China. MVPA, WWI, and psychological subhealth were assessed, with WWI categorized into quartiles (Q1-Q4). Data were analyzed using χ2 test, Logistic regression analysis and Logistic regression analysis of generalized linear models. Results The overall prevalence of psychological sub-health among middle school students was 21.0%, with higher rates in boys(21.4%) than girls(20.5%) (χ2=6.49, P < 0.05). The detection rates of emotional problems, behavioral problems and social adaptation difficulties in middle school students were 27.8%, 26.9% and 17.5%, respectively. The combination of MVPA and WWI groups was used as independent variables, and the covariates were adjusted to perform Logistic regression analysis of generalized linear model; while the Q1 group with MVPA>60 min/d was used as the reference group, the Q4 group with MVPA < 30 min/d had the highest risk of psychological sub-health detection(OR=1.58, 95%CI=1.38-1.81), and the detection risks of psychological sub-health among middle school students in Q1-Q3 groups were 1.34(1.17-1.53), 1.30(1.13-1.49) and 1.42(1.24-1.62)(P < 0.01). Conclusions MVPA and WWI are significantly associated with psychological sub-health in middle school students. Lower MVPA and higher WWI in middle school students correlate with increased sub-health risks. Interventions should aim to enhance MVPA levels and reduce WWI to improve mental well-being in middle school students. -
Key words:
- Motor activity /
- Weight-adjusted waist index /
- Mental health /
- Regression analysis /
- Students
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表 1 不同组别中学生心理亚健康检出率比较
Table 1. Comparison of detection rates of psychological sub-health among middle school students in different groups
组别 选项 人数 检出人数 χ2值 P值 家庭月收入/元 ＜1 000 5 217 1 391(26.7) 119.67 ＜0.01 1 000~4 000 16 955 3 477(20.5) >4 000~6 000 14 268 2 804(19.7) ＞6 000 10 932 2 262(20.7) 上下学方式 积极 20 762 4 251(20.5) 5.47 0.02 消极 26 610 5 683(21.4) 每周摄入零食频次 ≤1 13 982 2 463(17.6) 537.49 ＜0.01 2~4 28 069 5 734(20.4) ≥5 5 321 1 737(32.6) 每日睡眠时长/h ＜6 7 522 2 417(32.1) 734.67 ＜0.01 6~8 32 925 6 454(19.6) >8 6 925 1 063(15.4) 注：( )内数字为检出率/%。 
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表 2 不同MVPA和WWI分组中学生心理亚健康及各维度检出率比较
Table 2. Comparison of psychological sub-health and detection rates of various dimensions in MVPA and WWI groupsof middle school students
组别 选项 人数 情绪问题 行为问题 社会适应困难 心理亚健康 检出人数 χ2值 检出人数 χ2值 检出人数 χ2值 检出人数 χ2值 MVPA /(min·d-1) ＜30 21 754 6 977(32.1) 368.66 6 398(29.4) 133.48 4 482(20.6) 280.43 5 292(24.3) 276.10 30~60 18 998 4 623(24.3) 4 667(24.6) 2 867(15.1) 3 489(18.4) >60 6 620 1 565(23.6) 1 661(25.1) 922(13.9) 1 153(17.4) WWI四分位数 Q1 12 040 3 426(28.5) 24.43 3 275(27.2) 26.86 2 227(18.5) 14.52 2 484(20.6) 25.47 Q2 11 903 3 178(26.7) 3 024(25.4) 1 990(16.7) 2 377(20.0) Q3 11 706 3 149(26.9) 3 107(26.5) 2 003(17.1) 2 432(20.8) Q4 11 723 3 412(29.1) 3 320(28.3) 2 051(17.5) 2 641(22.5) 注：( )内数字为检出率/%；P值均＜0.01。
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表 3 中学生MVPA和WWI与心理亚健康的Logistic回归分析(n=47 372)
Table 3. Logistic regression analyses of MVPA and WWI with psychological sub-health among middle school students(n=47 372)
组别 选项 模型1 模型2 模型3 OR值(95%CI) P值 OR值(95%CI) P值 OR值(95%CI) P值 MVPA /(min·d-1) >60 1.00 1.00 1.00 30~60 1.07(0.99~1.15) 0.09 1.06(0.99~1.14) 0.12 1.01(0.94~1.09) 0.86 ＜30 1.52(1.42~1.64) ＜0.01 1.51(1.41~1.63) ＜0.01 1.32(1.23~1.42) ＜0.01 WWI四分位数 Q1 1.00 1.00 1.00 Q2 0.96(0.90~1.02) 0.20 0.96(0.90~1.02) 0.22 0.97(0.91~1.03) 0.31 Q3 1.01(0.95~1.07) 0.78 1.01(0.95~1.08) 0.69 1.03(0.97~1.10) 0.38 Q4 1.12(1.05~1.19) ＜0.01 1.13(1.06~1.20) ＜0.01 1.14(1.07~1.22) ＜0.01 注：模型1为粗模型，模型2在模型1的基础上调整了年龄、家庭月收入，模型3在模型2的基础上调整了上下学方式、每周摄入零食频次、睡眠时长。
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表 4 中学生MVPA和WWI联合效应与心理亚健康Logistic回归分析
Table 4. Logistic regression analyses of combined effects of MVPA and WWI with psychological sub-health among middle school students
MVPA/(min·d-1) WWI四分位数 OR值(95%CI) P值 >60 Q1 1.00 (n=6 620) Q2 0.84(0.70~1.01) 0.06 Q3 0.88(0.74~1.05) 0.17 Q4 0.95(0.80~1.14) 0.60 30~60 Q1 0.96(0.84~1.11) 0.62 (n=18 998) Q2 0.94(0.82~1.09) 0.41 Q3 0.95(0.82~1.09) 0.46 Q4 1.07(0.93~1.23) 0.34 ＜30 Q1 1.34(1.17~1.53) ＜0.01 (n=21 754) Q2 1.30(1.13~1.49) ＜0.01 Q3 1.42(1.24~1.62) ＜0.01 Q4 1.58(1.38~1.81) ＜0.01 注：模型调整了年龄、家庭月收入、上下学方式、每周摄入零食频次、睡眠时长。
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