睡眠饮食行为和中小学生超重肥胖与血压偏高共存的关联

杨帆; 姚庆兵; 朱维维; 胡明亮; 李莎莎; 陆盛华

doi:10.16835/j.cnki.1000-9817.2025221

睡眠饮食行为和中小学生超重肥胖与血压偏高共存的关联

doi: 10.16835/j.cnki.1000-9817.2025221

江苏省扬州市疾病预防控制中心儿童青少年健康促进科，225000

基金项目:

扬州市基础研究计划(联合专项)卫生健康类项目 2024-4-26

详细信息

作者简介:
杨帆(1994-)，女，安徽安庆人，硕士，主管医师，主要研究方向为儿童青少年健康

通讯作者:
陆盛华，E-mail: lsh_wsj@yangzhou.gov.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 Q428 R723.14 R544.1
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- 文章访问数: 20
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- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2025-03-24
- 修回日期: 2025-05-30
- 网络出版日期: 2025-08-02
- 刊出日期: 2025-07-25

Association of sleep and eating behavior on the comorbidity of overweight/obesity and elevated blood pressure among primary and secondary school students

Child and Adolescent Health Promotion Section, Yangzhou Center for Disease Control and Prevention, Yangzhou 225000, Jiangsu Province, China

摘要

摘要: 目的分析扬州市中小学生超重肥胖与血压偏高共存状况及其影响因素，探究睡眠、饮食行为和超重肥胖与血压偏高共存的关联，为制定学生常见病共存共防策略提供参考依据。方法采用分层整群随机抽样方法，于2023年10—11月在扬州市6个县(市、区)36所学校抽取8 735名中小学生为调查对象，对其进行体格检查，并采用学生健康状况及影响因素调查表进行问卷调查。采用χ²检验比较不同组别中小学生超重肥胖与血压偏高共存检出率的差异，运用Logistic回归模型探讨睡眠和饮食行为及其联合作用和超重肥胖与血压偏高共存的关联。结果扬州市中小学生超重肥胖与血压偏高共存检出率为9.85%，男生(12.14%)高于女生(7.59%)，差异有统计学意义(χ²=50.86，P < 0.01)。调整性别、地区、学段、父母文化程度、吸烟、饮酒、中高强度运动频率后，多因素Logistic回归分析结果显示，总体及小学生非每天吃早餐+睡眠不足组发生超重肥胖与血压偏高共存的风险高于每天吃早餐+睡眠充足组(总体：OR=1.52，95%CI=1.18~1.96；小学生：OR=2.79，95%CI=1.61~4.82)(P值均 < 0.01)。从不同性别小学生来看，非每天吃早餐+睡眠不足的女生发生超重肥胖与血压偏高共存的风险是每天吃早餐+睡眠充足组的3.59倍(95%CI=1.65~7.82，P＜0.01)。结论中小学生睡眠、早餐行为和超重肥胖与血压偏高共存有关，尤其是在小学女生中。
- 睡眠 /
- 饮食习惯 /
- 超重 /
- 肥胖症 /
- 血压 /
- 回归分析 /
- 学生
Abstract: Objective To analyze the prevalence and determinants of comorbid overweight/obesity and elevated blood pressure among primary and secondary school students in Yangzhou City, and to explore the association between sleep patterns, eating behavior and the comorbidity of overweight/obesity and elevated blood pressure, so as to provide reference for developing prevention strategies targeting common comorbidities in students. Methods By using stratified cluster random sampling, a total of 8 735 primary and secondary school students were selected from 36 schools in six counties of Yangzhou from October to November 2023. Students underwent physical examinations and a questionnaire survey was conducted using the questionnaire on students' health status and influencing factors. The Chi-square test was used to compare the detection rate of comorbid overweight/obesity and elevated blood pressure in different groups of primary and secondary school students. The Logistic regression model was used to explore the association between sleep and dietary behaviors and their combined effects and coexistence. Results The detection rate of comorbid overweight/obesity and elevated blood pressure among primary and secondary school students in Yangzhou was 9.85%, which was higher among boys (12.14%) than girls (7.59%)(χ²=50.86, P < 0.01). After controlling for gender, residence, educational stage, parental education, smoking, drinking, and moderate to vigorous exercise, multivariate Logistic regression analysis showed that irregular breakfast consumption and inadequate daily sleep were associated with a higher risk of comorbidities compared with regular breakfast consumption and adequate daily sleep among overall and primary school students (overall: OR=1.52, 95%CI=1.18-1.96, primary school students: OR=2.79, 95%CI=1.61-4.82)(both P < 0.05). From the perspective of primary school students of different genders, the risk of comorbidities in girls who consumed breakfast irregularly and had inadequate daily sleep was 3.59 times higher than that in girls who consumed breakfast irregularly and had inadequate daily sleep (95%CI=1.65-7.82, P < 0.01). Conclusion The sleep patterns and breakfast behaviors of primary and secondary school students are found to be associated with comorbid overweight/obesity and elevated blood pressure, especially in primary school girls.
- Sleep /
- Food habits /
- Overweight /
- Obesity /
- Blood pressure /
- Regression analysis /
- Students
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 不同组别中小学生超重肥胖与血压偏高共存检出率比较

Table 1. Comparison of the detection rates of comorbidity for overweight/obesity and elevated blood pressue among primary and secondary school students in different groups

组别	选项	人数	共存人数	χ²值	P值	组别	选项	人数	共存人数	χ²值	P值
性别	男	4 324	525(12.14)	50.86	< 0.01	喝过酒	是	1 619	186(11.49)	6.05	0.01
	女	4 411	335(7.59)				否	7 116	674(9.47)
地区	城区	5 120	472(9.22)	5.47	0.02	中高强度	低频率	2 593	261(10.07)	12.29	< 0.01
	郊县	3 615	388(10.73)			运动	中频率	4 013	430(10.72)
学段	小学	2 887	148(5.13)	110.32	< 0.01		高频率	2 129	169(7.94)
	初中	2 927	373(12.74)			每天喝含糖饮料/次	＜1	7 929	768(9.69)	2.46	0.12
	高中	2 921	339(11.61)				≥1	806	92(11.41)
父亲文化程度^*	小学及以下	487	40(8.21)	25.73	< 0.01	每天吃油炸食物/次	＜1	8 237	812(9.86)	0.03	0.87
	初中/中专/高中	6 052	659(10.89)				≥1	498	48(9.64)
	大学	1 935	147(7.80)			每天吃新鲜水果/次^*	＜1	2 365	248(10.49)	1.49	0.22
	硕士及以上	260	14(5.38)				≥1	6 368	612(9.61)
母亲文化程度^*	小学及以下	849	102(12.01)	34.27	< 0.01	每天喝奶制品/次	＜1	3 313	343(10.35)	1.55	0.21
	初中/中专/高中	5 898	629(10.66)				≥1	5 422	517(9.54)
	大学	1 740	115(6.61)			每天吃蔬菜/次	＜1	1 088	90(8.27)	3.47	0.06
	硕士及以上	246	14(5.69)				≥1	7 647	770(10.07)
住校情况	是	971	88(9.06)	0.75	0.39	每天吃早餐	是	7 014	649(9.25)	14.08	< 0.01
	否	7 764	772(9.94)				否	1 721	211(12.26)
睡眠充足	是	1 921	147(7.65)	13.35	< 0.01	早餐、睡眠联合作用	每天吃早餐+睡眠充足	1 615	119(7.37)	26.53	< 0.01
	否	6 814	713(10.46)				每天吃早餐+睡眠不足	5 399	530(9.93)
吸过烟	是	441	59(13.38)	6.53	0.01		非每天吃早餐+睡眠充足	306	28(9.15)
	否	8 294	801(9.66)				非每天吃早餐+睡眠不足	1 415	183(12.93)
注：()内数字为检出率/%；^*数据有缺失。

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表 2 睡眠与早餐行为联合作用和不同性别学段中小学生超重肥胖与血压偏高共存单因素Logistic回归分析[OR值(95%CI), n=8 735]

Table 2. Univariate Logstic regression analysis of the combined effect of sleep and breakfast behavior and the coexistence of overweight, obesity, and elevated blood pressure in primary and secondary school students of different genders and academic stages[OR(95%CI), n=8 735]

自变量	性别		学段			总体
自变量	男生	女生	小学	初中	高中	总体
每天吃早餐+睡眠不足组	1.40(1.08~1.81)^*	1.44(1.01~2.05)^*	1.03(0.70~1.52)	1.11(0.81~1.54)	1.17(0.76~1.78)	1.37(1.11~0.68)^**
非每天吃早餐+睡眠充足组	1.19(0.68~2.10)	1.49(0.76~2.91)	1.90(0.72~4.99)	0.48(0.17~1.37)	1.09(0.59~2.02)	1.27(0.82~1.95)
非每天吃早餐+睡眠不足组	1.98(1.45~2.70)^**	1.97(1.32~2.94)^**	2.73(1.60~4.67)^**	1.10(0.75~1.62)	1.41(0.90~2.22)	1.87(1.47~2.38)^**
注：^* P＜0.05，^**P＜0.01。

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表 3 睡眠与早餐行为联合作用和不同性别学段中小学生超重肥胖与血压偏高共存多因素Logistic回归分析[OR值(95%CI), n=8 735]

Table 3. Multivariate Logistic regression analysis of the combined effect of sleep and breakfast behavior and the coexistence of overweight, obesity, and elevated blood pressure in primary and secondary school students of different genders and academic stages[OR(95%CI), n=8 735]

自变量	性别		学段			总体
自变量	男生	女生	小学	初中	高中	总体
每天吃早餐+睡眠不足组	1.17(0.90~1.52)	1.25(0.87~1.79)	1.04(0.70~1.53)	1.22(0.88~1.69)	1.10(0.72~1.70)	1.20(0.97~1.48)
非每天吃早餐+睡眠充足组	0.92(0.51~1.63)	1.19(0.60~2.36)	1.95(0.73~5.18)	0.50(0.17~1.43)	1.10(0.59~2.06)	1.03(0.66~1.60)
非每天吃早餐+睡眠不足组	1.50(1.09~2.07)^*	1.57(1.04~2.39)^*	2.79(1.61~4.82)^**	1.25(0.84~1.86)	1.38(0.87~2.19)	1.52(1.18~1.96)^**
注：^* P＜0.05，^** P＜0.01。

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