膳食环境因素对儿童青少年肥胖影响的多水平混合效应模型研究

目的分析2011年中国12省(自治区、直辖市)膳食环境因素对7～17岁中国儿童青少年肥胖的影响。方法利用2011年"中国健康与营养调查"的膳食环境和体格测量数据,本调查采用多阶段分层整群随机抽样方法、连续3天24小时回顾法膳食调查、个人-家庭-社区的问卷调查及身高和体重测量等体格检查方法。选择相关资料完整的1416名7～17岁儿童青少年作为研究对象(男性占50.71%;7～10岁年龄组占43.50%,11～14岁37.43%,15～17岁19.07%),结合2011年国家统计年鉴中的膳食环境数据,构建三水平(省-社区-个人)肥胖与否的二分类结局Logistic随机截距混合效应模型,分析膳食环境因素对儿童青少年肥胖的影响,确定其中危险因素的特性。结果鉴于对单独构建的"省-个体"和"社区-个体"二水平的空模型进行分层的随机效应检验时P值分别为P<0.005和0.050

Multi-level mixed effect model study on the association between dietary environmental risk factors and obesity among Chinese children and adolescents

OBJECTIVE To analyze the influence of dietary environmental factors in 12 provinces of China on obesity among children and adolescents aged 7-17 in 2011.METHODS Based on the dietary environmental and physical examination data of China Health and Nutrition Survey 2011(Multi-stage stratified cluster random sampling method,3 day 24 hour retrospective method,individual-household-community questionnaire survey and physical examination method such as height and weight measurement were used),1416 children and adolescents aged 7-17(male 50.71%;the age group of 7-10 years old accounted for 43.50%,that of 11-14 years old 37.43%,and that of 15-17 years old 19.07%)with complete data were selected as the research subjects,and combined with the dietary environmental data of the corresponding provinces from National Statistical Yearbook 2011,a three-level(province-community-individual)logistic mixed effect(random intercept)model was constructed to binary outcome variables of obesity or not,the effect of dietary environments on obesity in children and adolescents was analyzed,and the characteristics of risk factors were determined.RESULTS Considering that the P values of the two-level empty model of"provinceindividualu andn community-individual"constructed separately were P<0.005 and 0.050