南京市中学生超重肥胖现状及影响因素的研究

目的了解南京地区青少年单纯性肥胖患病率,并进行相关危险因素分析,提出相应的干预措施。方法2016年10月,以南京市中学的在校学生为调查对象。采取整群抽样方法,随机抽选市区及郊区各一个区域,纳入共14所中学,将所选学校全部在校学生作为调查对象,共8695例。设计"青少年肥胖危险因素问卷调查表",调查学生基本情况、父母情况、饮食情况、运动情况、夜眠情况等,并对学生的身高、体重、腰围进行测量。采用体重指数(body mass index,BMI)作为结局变量,将学生分为正常体重组、超重组和肥胖组,分析超重及肥胖的影响因素。统计学分析采用χ^2检验和Logistic回归分析。结果有效问卷8522份(98.01%,8522/8695),超重及肥胖共1966例(23.07%,1966/8522)。男生与女生组的超重率、肥胖率比较,差异均无统计学意义(P>0.05)。初中生肥胖率高于高中生(P<0.05),两组间超重率比较差异无统计学意义(P>0.05)。单因素分析结果显示,超重肥胖的中学生中,11项指标的比例高于正常体重组,3项指标的比例低于正常体重组(P<0.05)。以上述14个差异有统计学意义的变量为自变量,以是否有超重或肥胖为因变量,进行Logistic回归分析,结果显示,不吃早餐(OR=2.306)、父亲未接受过正规教育(OR=1.277)、母亲未受过正规教育(OR=1.196)、祖父母均肥胖史(OR=1.131)、父母均肥胖史(OR=1.113)、出生体重≥4000 g(OR=1.113)为超重肥胖的危险因素。每天吃蔬菜/水果的数量在5种及以上(OR=0.958)为超重肥胖的保护因素。结论南京市中学生超重、肥胖的现状较为严峻。家庭遗传、出生体重较高、不吃早餐等因素与超重肥胖密切相关,建立良好的生活行为及饮食习惯是干预肥胖的有力措施。

Influencing factors associated with obesity and overweight among middle school students in Nanjing

Objective To understand the prevalence of obesity among adolescents in Nanjing, to analyze the relevant risk factors, and to propose the corresponding intervention measures. Methods Students in Nanjing middle school were investigated in October, 2016. A total of 14 middle schools were randomly selected from one district in the urban area and one in the suburban area by using the cluster sampling method. A total of 8 695 students were selected as the objects of the survey. The questionnaire was designed to investigate the students’ basic situation, parents’ situation, diet, exercise and sleep. Their height, weight and waist circumference were measured. Body mass index(BMI) was used as outcome variable, and students were divided into normal weight group, overweight group and obesity group, to analyze the influencing factors of overweight and obesity. Statistical analysis was performed by χ^2 test and Logistic regression analysis. Results There were 8 522 valid questionnaires(98.01%, 8 522/8 695) in which 1 966 cases of overweight and obesity(23.07%, 1 966/8 522) were contained. There was no significant difference in overweight rate and obesity rate between the male and female groups(P>0.05). The obesity rate of middle school students was higher than that of high school students(P<0.05), and there was no significant difference in overweight rate between the two groups(P>0.05). The results of single factor analysis showed that among the overweight and obese middle school students, the proportion of 11 indicators was higher than that of the normal weight group, and the proportion of 3 indicators was lower than that of the normal weight group(P<0.05). Logistic regression analysis was conducted with the 14 statistically significant difference as independent variables and overweight or obesity as dependent variables. The results showed that breakfast skipping(OR=2.306), lack of formal education in the father(OR=1.277), lack of formal education in the mother(OR=1.196), history of obesity in both grandparents(OR=1.131), history of obesity in both parents(OR=1.113) and birth weight ≥ 4 000 g(OR=1.113) were risk factors for overweight obesity. A daily intake of 5 or more kinds of vegetables/fruits(OR=0.958) was a protective factor for overweight and obesity. Conclusions The situation of overweight and obesity among middle school students is serious in Nanjing. Family heredity, high birth weight, breakfast skipping and other factors are closely related to overweight and obesity. Establishing good life behavior and eating habits is a powerful measure to intervene obesity.