校园周边中长期PM<sub>2.5</sub>暴露与中小学生超重肥胖的关联

罗月梅; 张登城; 秦阳; 陆武韬; 蒋家诺; 陈力; 郭桐君; 马军; 董彦会; 李艳

doi:10.16835/j.cnki.1000-9817.2025222

校园周边中长期PM_2.5暴露与中小学生超重肥胖的关联

doi: 10.16835/j.cnki.1000-9817.2025222

罗月梅¹,
张登城^{2, 3},
秦阳²,
陆武韬¹,
蒋家诺²,
陈力²,
郭桐君²,
马军²,
董彦会²,
李艳^1, ,

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
3.
西藏自治区疾病预防控制中心公共卫生监测所

基金项目:

广西壮族自治区卫生健康委自筹经费科研课题项目 Z-A20230422

广西医疗卫生适宜技术开发与推广应用项目 S2021065

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:
李艳，E-mail: 36889069@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 R122.2
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- 文章访问数: 8
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-13
- 修回日期: 2025-07-01
- 网络出版日期: 2025-08-02
- 刊出日期: 2025-07-25

Association between medium- to long-term ambient PM_2.5 exposure and overweight/obesity among primary and secondary school students

1.
School Health Department, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China

摘要

摘要: 目的探讨校园周边中长期PM_2.5暴露与中小学生超重肥胖之间的关联性，为科学防控中小学生超重肥胖提供数据支撑和理论依据。方法 2023年9—11月，采用分层整群随机抽样方法从广西全区14个设区市111个区县，抽取251 183名小学一年级至高中三年级学生(7~18岁)作为研究对象。PM_2.5质量体积浓度数据源自中国大气成分近实时追踪数据集。运用Mann-Whitney U检验比较是否超重肥胖儿童青少年PM_2.5暴露水平，采用二元Logistic回归模型探究校园周边PM_2.5水平与中小学生超重肥胖之间的量化关系，并进一步利用限制性立方样条分析PM_2.5质量体积浓度与中小学生超重肥胖风险之间的非线性关联特征。结果广西中小学生超重肥胖检出率为19.5%，监测项目开始前一年的PM_2.5质量体积浓度中位数超重肥胖组(23.22 μg/m³)高于非超重肥胖组(22.63 μg/m³)(Z=-15.66，P＜0.01)，在性别(男、女)、学段(小学、初中、高中)亚组分析中也呈现出一致的结果(P值均＜0.01)。二元Logistic回归分析结果显示，最近一年PM_2.5月平均质量体积浓度每增加10 μg/m³，中小学生超重肥胖的风险为原来的1.12倍(OR=1.12，95%CI=1.09~1.15，P＜0.01)。限制性立方样条分析结果显示，PM_2.5的月均水平与中小学生超重肥胖发生风险之间存在非线性关联(P_趋势＜0.01)；当PM_2.5暴露水平＜22.68 μg/m³时，超重肥胖发生风险与PM_2.5关联无统计学意义；当PM_2.5暴露水平≥22.68 μg/m³时，超重肥胖的风险随着PM_2.5暴露水平的增加而上升。结论校园周边中长期PM_2.5暴露与儿童青少年超重肥胖之间存在关联。
- 颗粒物 /
- 超重 /
- 肥胖症 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the association between medium- to long-term PM_2.5 exposure around school areas and overweight/obesity among primary and secondary school students in Guangxi, providing data support and theoretical foundations for scientifically addressing overweight and obesity in primary and secondary school students. Methods From September to November 2023, a stratified cluster random sampling method was employed to select 251 183 students aged 7-18 years (grade 1 to grade 12) from 14 prefecture level cities (111 districts and counties) in Guangxi. PM_2.5 mass concentration data were obtained from the Tracking Air Pollution in China (TAP) dataset. Preliminary comparative analysis was conducted using the Mann-Whitney U test, while binary Logistic regression models were applied to quantify the relationship between PM_2.5 exposure and overweight/obesity. Restricted cubic spline analysis was further utilized to examine the nonlinear association between PM_2.5 concentration and overweight/obesity risk. Results The detection rate of overweight/obesity among Guangxi students in 2023 was 19.5%. The median PM_2.5 concentration in the year prior to the study was higher in the overweight/obesity group (23.22 μg/m³) compared to the non-overweight/obesity group (22.63 μg/m³) (Z=-15.66, P < 0.01), and consistent trends were observed across gender (male/female) and educational stage (primary/junior/senior high school) subgroups (all P < 0.01). Binary Logistic regression revealed that for every 10 μg/m³ increase in the annual average PM_2.5 concentration, the risk of overweight/obesity increased by 12% (OR=1.12, 95%CI=1.09-1.15, P < 0.01). Restricted cubic spline analysis indicated a nonlinear relationship between monthly PM_2.5 levels and overweight/obesity risk (P_trend < 0.01). Below 22.68 μg/m³, PM_2.5 exposure showed no significant association with obesity risk; above the threshold, the risk increased with rising PM_2.5 levels. Conclusion Medium- to long-term PM_2.5 exposure around school environments is significantly associated with overweight/obesity among primary and secondary school students.
- Particulate matter /
- Overweight /
- Obesity /
- 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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图 1 PM_2.5暴露与中小学生超重肥胖发生风险的关系

Figure 1. Relationship between PM_2.5 exposure levels and the risk of overweight and obesity among primary and secondary school students

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表 1 不同组别中小学生超重肥胖率比较

Table 1. Comparison of prevalence of overweight/obesity among different groups of primary and secondary school students

组别	选项	人数	超重肥胖人数	χ²值	P值
地区	城区	103 901	22 491(21.6)	510.48	＜0.01
	郊县	147 282	26 538(18.0)
性别	男	128 570	30 198(23.5)	2 640.34	＜0.01
	女	122 613	18 831(15.4)
学段	小学	133 025	28 100(21.1)	468.38	＜0.01
	初中	65 809	11 507(17.5)
	高中	52 349	9 422(18.0)
注：()内数字为检出率/%。

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表 2 是否超重肥胖中小学生调查前一年月均PM_2.5暴露水平比较[M(IQR)，μg/m³]

Table 2. Comparison of monthly average PM_2.5 exposure levels among overweight and obese primary and secondary school students in the previous year[M(IQR), μg/m³]

超重肥胖	人数	监测点		性别		学段			合计
超重肥胖	人数	城区	郊县	男	女	小学	初中	高中	合计
否	202 154	25.24(6.63)	21.54(4.91)	22.60(5.82)	22.68(5.87)	22.43(5.94)	22.23(5.50)	23.59(6.46)	22.63(5.86)
是	49 029	25.85(7.03)	21.73(4.82)	23.32(6.47)	23.19(6.48)	22.68(6.47)	22.88(6.17)	24.18(6.43)	23.22(6.47)
Z值		-11.98	-1.69	-13.10	-8.98	-9.93	-9.06	-9.79	-15.66
P值		＜0.01	0.09	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01

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