深圳市龙岗区中小学生超重、肥胖状况调查分析

目的分析深圳市龙岗区中小学生超重与肥胖状况。方法采用多级分层整群抽样法对深圳市龙岗区7所中小学校7～18岁的学生进行体格检查和问卷调查。应用＂中国学龄儿童青少年超重、肥胖筛查体质指数分类标准＂筛查出各年龄组男女生超重与肥胖人数,分析比较各年龄组男女生超重与肥胖检出率。结果深圳市龙岗区中小学生男生超重、肥胖率分别为12.27%和7.65%,女生超重、肥胖率分别为8.71%和5.25%,男女生超重率均高于肥胖率。小学男、女生超重检出率分别为14.43%和10.20%（χ2=24.901,P〈0.01）,小学男、女生肥胖检出率分别为10.65%和7.19%（χ2=22.130,P〈0.01）,差异均有统计学意义。中学男、女生超重检出率分别为10.10%和7.16%（χ2=16.148,P〈0.01）,中学男、女生肥胖检出率分别为4.62%和3.24%（χ2=24.990,P〈0.01）,差异均有统计学意义。结论深圳市龙岗区中小学生超重与肥胖问题严重,尤其是小学男生。各学校、社区、家庭及有关管理部门应进一步加强中小学生的健康卫生教育工作,防止中小学生超重、肥胖进一步蔓延。     

不同体重青少年饮食行为、身体活动状况

目的:比较不同体重青少年饮食行为、身体活动状况。方法:采用中国青少年健康相关行为调查问卷中的饮食行为、身体活动相关内容对湖南省长沙、湘潭市两地的1034名青少年进行问卷调查。结果:本样本超重/肥胖率达17.3%,男生肥胖率高于女生(χ~2=23.847,P0.01)、独生子女高于非独生子女(χ~2=26.027,P0.01)、城镇高于农村(χ~2=7.514,P0.05)。体重正常、超重和肥胖青少年每天喝1次及以上汽水饮料的比例分别为25.7%、33.7%和72.8%,每周吃4次及以上快餐的比例分别为4.7%、11.4%和18.2%,每天都吃早餐的比例分别为42.8%、37.6%和0.00%,且差异显著(P0.01)。肥胖青少年的不良减肥行为发生频率更高(P0.01)。40.6%的青少年1周内每天运动1小时的天数小于1天,每天看电视、上网或玩游戏超过3小时的青少年比例分别为26.7%和29.8%,不同体重青少年在1周每天运动、课外学习时间上存在差异(χ~2=15.525,P0.01;χ~2=9.990,P0.05),在每天看电视、上网或玩游戏的时间上不存在差异(P0.05)。结论:青少年饮食行为、身体活动总体情况并不乐观,超重、肥胖青少年的不良饮食行为更为明显。     

农村地区中小学生同胞暴力的现况调查

目的:分析农村地区中小学生同胞暴力的流行现状及相关因素。方法:在湖南省采用多阶段分层整群抽样,采用自编同胞暴力问卷对1655例农村地区多子女家庭的中小学生进行同胞暴力发生情况的调查,并分析同胞暴力的相关因素。结果:过去半年内,湖南省农村地区中小学生同胞暴力发生率为30. 5%(504/1655),遭受同胞暴力发生率为26. 2%(434/1655),实施同胞暴力发生率为19. 0%(314/1655)。男生实施同胞暴力的发生率高于女生[21. 4%(176/821) vs. 16. 5%(138/834)]。同胞暴力类型中,言语侮辱的发生率最高,为25. 3%(419/1655)。多因素分析结果表明同胞数量≥4人发生同胞暴力的风险较高(遭受,OR=1. 65,95%CI:1. 17~2. 32;实施,OR=1. 82,95%CI:1. 25~2. 66);而同胞关系为姐妹(遭受,OR=0. 65,95%CI:0. 48~0. 90;实施,OR=0. 49,95%CI:0. 34~0. 71)、同胞年龄差≥6岁(遭受,OR=0. 41,95%CI:0. 30~0. 57;实施,OR=0. 50,95%CI:0. 35~0. 72)发生同胞暴力的风险较低。结论:农村地区中小学生同胞暴力现象较为普遍,同胞数量多是同胞暴力潜在的危险因素,而同胞关系为姐妹、同胞年龄差大是同胞暴力可能的保护因素。     

青少年精神分裂症患者的健康相关危险行为

目的:探讨青少年精神分裂症患者的健康相关危险行为特点及危险因素。方法:按照疾病和有关健康问题的国际统计分类第十次修订本(ICD-10)诊断标准,纳入精神分裂症患者90例,年龄13~18岁,同时纳入性别、年龄相匹配的正常青少年对照180例,完成青少年健康相关危险行为问卷(AHRBI)评定。分别对AHRBI量表各因子分与精神分裂症的关系、精神分裂症患者各维度危险行为的风险因素进行logistic回归分析。结果:精神分裂症组AHRBI总分和健康妥协行为、破坏纪律行为、无保护性行为、自杀自伤行为、吸烟饮酒行为5项因子分均显著高于正常对照组[如总分,51.5(0,130)vs.47(38,79);均P0.05]。Logistic回归分析显示青少年精神分裂症与健康妥协行为因子、破坏纪律行为因子、无保护性行为因子、自杀自伤行为因子关联(均P0.05);破坏纪律行为是攻击与暴力行为(OR=1.57,95%CI:1.13~2.19)、无保护性行为(OR=1.32,95%CI:1.08~1.61)的危险因素,吸烟与饮酒行为是健康妥协行为(OR=2.79,95%CI:1.01~8.33)、无保护性行为(OR=1.83,95%CI:1.29~2.58)的危险因素,攻击与暴力行为是自杀自伤行为(OR=1.39,95%CI:1.15~1.68)的危险因素,抗精神病药物是自杀自伤行为(OR=0.12,95%CI:0.14~0.95)的保护因素,急性发病次数是吸烟饮酒行为(OR=0.95,95%CI:0.90~0.99)的保护因素,无保护性行为是吸烟饮酒行为(OR=2.38,95%CI:1.11~5.13)的危险因素。结论:青少年精神分裂症患者总体健康相关危险行为多于正常青少年,各危险行为间有一定关联。抗精神病药物是自杀自伤行为的保护因素,急性发病次数是吸烟饮酒行为的保护因素。     

肥胖及超重小学生的自尊水平及相关因素

目的:探讨肥胖及超重小学生的自尊状况及相关因素。方法:通过两阶段抽样,在长沙市抽取4~6年级小学生1410人,按WHO公布的儿童体质量指数(body mass index,BMI)筛查参考值,将受试分为正常(n=1084)、超重组(n=211)和肥胖组(n=115),用自尊量表(the self-Esteem scale,SES)进行调查,并对小学生低自尊的相关因素进行回归分析。结果:(1)超重和肥胖小学生SES得分低于正常学生,肥胖男生SES得分低于正常和超重男生,超重和肥胖女生SES得分低于正常女生;(2)肥胖学生中低自尊者比例高于正常和超重学生,但高自尊比例在3组间差异无统计学意义;(3)肥胖、超重、祖辈认为太胖、对身高不满意、对体质量不满意为小学生低自尊的危险因素(OR=1.45~3.74),对成绩满意为小学生低自尊的保护因素(OR=0.22)。结论:超重和肥胖小学生自尊水平低于正常体质量小学生;除肥胖和超重外,对自己身高和体质量不满意也是小学生低自尊的相关因素。     

初诊青年2型糖尿病临床特点及危险因素分析

目的 明确青年初诊2型糖尿病的临床特点并探讨相关危险因素,为预防高危因素青年人发生2型糖尿病提供理论依据。方法 选择我院内分泌科2017年1月~2018年3月住院的313例初诊2型糖尿病患者,以40岁为界将其分为青年组及非青年组,分析患者的临床特点及危险因素。结果 青年组男性构成率为75.76%,非青年组男性构成率为55.87%,两组性别构成率比较,差异有统计学意义（P＜0.05）;青年组收缩压（128.88±17.97）mmHg低于非青年组（137.47±19.44）mmHg,差异有统计学意义（P＜0.05）;青年组体重指数（26.02±4.80）kg/m2高于非青年组（24.52±3.41）kg/m2,差异具有统计学意义（P＜0.05）;青年组甘油三酯（3.62±3.44）mmol/L高于非青年组（2.87±3.35）mmol/L,差异有统计学意义（P＜0.05）;青年组高密度脂蛋白（1.03±0.35）mmol/L低于非青年组（1.14±0.37）mmol/L,差异有统计学意义（P＜0.05）。初诊2型糖尿病为青年人的危险因素为性别（OR=2.07,95%CI:1.09~3.93,P＜0.05）、BMI（OR=2.10,95%CI:1.14~3.18,P＜0.05）及HDL-C（OR=1.98,95%CI:1.11~3.52,P＜0.05）。结论 男性、超重及肥胖、低高密度脂蛋白是青年人发生2型糖尿病的危险因素。     

北京市顺义区学龄儿童少年体重指数与体脂百分比关系的研究

目的 分析北京市顺义区儿童少年体重指数（BMI）和体脂百分比（PBF）的关系。方法 采用整群抽样法抽取顺义区小学生1477人,其中男生804人,平均年龄8.3岁,女生673人,平均年龄8.2岁;初中生1996人,其中男生1028人,平均年龄13.7岁,女生968人,平均年龄13.6岁,使用人体成分分析仪H-Key350测定PBF,并计算BMI,比较两者判定超重、肥胖的一致性。结果 北京市顺义区中小学生BMI与PBF两者呈正相关,小学生总体、男生、女生BMI与PBF均呈高度正相关,相关系数分别为0.907、0.919和0.904;初中生总体、男生、女生BMI与PBF的相关系数分别为0.694、0.833和0.845;与BMI标准判定超重相比,PBF判定的超重有较高特异度,小学和初中分别为84.71%和80.47%;而灵敏度差为14.42%和20.24%;与BMI标准判定肥胖相比,PBF判定的肥胖有较高灵敏度,小学和初中分别为99.86%和91.93%,而特异度差,只有73.56%和61.27%。结论 用PBF判断超重标准对于确定顺义区初中生和小学生超重和肥胖分别有较高特异度和灵敏度,可以使用PBF对学龄儿童开展超重和肥胖的筛查。     

大学生非自杀性自伤行为危险因素分析

目的:构建多水平模型探讨大学生非自杀性自伤行为的现况及相关因素。非自杀性自伤行为是指个体在没有明确自杀意图的情况下故意、重复地改变或伤害自己身体组织且不被社会认可的行为。方法:选取某综合性大学三所学院21个班级的644名学生,分别采用传统二分类logistic回归模型和二分类两水平logistic回归模型,对父母关系、情绪管理、人格倾向等因素进行分析,探讨影响自伤行为的危险因素。结果:自伤行为检出率21.0%,最常用的3种形式依次为拽扯头发、故意掐自己、故意打自己。自伤行为在班级水平上具有聚集性,两水平模型结果显示父母经常吵架(OR=1.38,95%CI 1.02~1.87)、消极情绪管理(OR=1.31,95%CI 1.05~1.64)、药物依赖(OR=1.93,95%CI 1.22~3.04)、神经质(情绪稳定性差)(OR=1.42,95%CI 1.04~1.94)是自伤行为的危险因素。结论:自伤行为存在班级水平聚集,提示该行为可能受班级环境影响。此外自伤行为与父母关系和自身特质(情绪管理、神经质和药物依赖)存在相关。     

妊娠期糖尿病相关危险因素分析

目的 探讨妊娠期糖尿病相关的危险因素。方法 收集2012年10月~2014年2月在中山大学附属第三医院产检并住院分娩的483例GDM患者和327例非GDM患者的临床资料,并对其临床资料进行单因素和多因素统计分析。结果 早期空腹血糖（10~22 周）、文化程度、中孕期甘油三脂、孕前BMI指数、年龄和孕期体重增加比较中,GDM组和非GDM组数据差异有统计学意义（P均＜0.05）,多因素分析显示早期空腹血糖（10~22周）[OR=2.380,95%CI 1.409~4.021,P=0.001]、文化程度[OR=1.775,95%CI 1.082~2.909,P=0.023]、中孕期甘油三脂[OR=1.295,95%CI1.081~1.551,P=0.005]、孕前BMI[OR=1.146,95%CI1.053~1.247,P=0.002]和年龄[OR=1.113,95%CI 1.050~1.181,P=0.001]是GDM临床相关危险因素。结论 早期空腹血糖（10~22周）、文化程度、中孕期甘油三脂、孕前BMI、年龄是GDM的危险因素。     

青少年超重、肥胖与抑郁和行为问题的关系

目的:调查青少年超重和肥胖的流行状况,探究青少年体质量与其抑郁和行为问题的关系及其调节因素。方法:样本由北京18个区县的94所高级中学的10 773名中学生组成,年龄12~18岁。根据"中国学龄儿童青少年超重、肥胖筛查体质量指数值(BMI)分类标准"对青少年的体质量状况进行超重和肥胖筛查,用流调中心用抑郁量表(CES-D)、青少年行为自评量表(YSR)测量青少年的抑郁症状和行为问题。采用回归分析性别、年龄、家庭经济状况等人口学资料与青少年BMI的关系,及其对青少年体质量与抑郁症状和行为问题之间关系的调节效应。结果:超重与肥胖的发生率分别为11.6%(1075/9282)和6.2%(571/9282)。对于女孩,体质量指数与其抑郁症状得分和行为问题得分之间存在正向关联(β=0.27、0.37,均P0.01)。家庭经济状况对女孩超重肥胖与抑郁症状得分之间的关系起到调节作用:家庭经济状况低下的女孩因超重肥胖更易产生抑郁症状(β=0.61,P0.001)。父亲受教育程度对男孩超重肥胖与行为问题得分之间的关系起到调节作用,父亲受教育程度低其男孩不易因超重肥胖而发生行为问题(β=0.20,P0.05)。结论:青少年与超重肥胖相关的抑郁症状存在性别差异;家庭经济状况和父亲受教育程度对体质量与青少年心理健康的关系起到调节作用。     

Weekend catch-up sleep is associated with decreased risk of being overweight among fifth-grade students with short sleep duration

Previous studies have reported a relationship between short sleep duration and childhood overweight. Although school‐aged children tend to compensate for weekday sleep deficit by increasing weekend sleep duration, the association between weekend catch‐up sleep and childhood overweight remains unclear. This study aimed to examine the relationship between weekend catch‐up sleep and being overweight in children. A total of 936 school children (48.2% boys) aged 10 or 11 years participated in this school‐based cohort study. Anthropometric measurements including height and body weight were carried out. We obtained data on sleep patterns, lifestyle and parent characteristics using questionnaires. The main outcome measure was childhood overweight. After adjusting for the relevant confounding variables (age, sex, breakfast eating, screen time and parental obesity), longer sleep on weekdays and weekends was associated with decreased odds of childhood overweight (OR: 0.68; 95% CI: 0.54–0.86; OR: 0.64; 95% CI: 0.53–0.77, respectively). Participants with increased catch‐up sleep duration during weekends also had decreased odds of being overweight (OR: 0.67; 95% CI: 0.53–0.85). There was an interaction between weekday sleep duration and weekend catch‐up sleep in relation to childhood overweight, and this effect of weekend catch‐up sleep on being overweight was stronger as the participants slept less on weekdays (P = 0.024). These results indicate that weekend catch‐up sleep is independently associated with decreased risk of being overweight in fifth‐grade students, and this effect can be varied by the weekday sleep duration. A prospective study is required to confirm this observation.     

Epidemiology of abdominal obesity among adolescents from a Brazilian State Capital

The objective of this study was to investigate the effects of socioeconomic, demographic and lifestyle factors on abdominal obesity in adolescents from a Brazilian state capital. In this cross-sectional study, 656 high school students (423 girls and 233 boys) from public schools, ranging in age from 14 to 19 yr, were evaluated. Abdominal obesity was identified based on waist circumference. Socioeconomic data (socioeconomic status, household head's education, and school grade), demographic data (gender and age), and information regarding lifestyle (physical activity, eating habits, aerobic fitness, and nutritional status) were collected. Logistic regression was used for multivariate analysis. The prevalence of abdominal obesity was 6.6% (95% confidence interval [CI]: 4.6-8.4). Being in the second (odds ratio [OR] = 0.41; 95% CI: 0.19-0.88) or third year (OR = 0.18; 95% CI: 0.06-0.59) of high school was a protective factor against abdominal obesity. In addition, students presenting low aerobic fitness (OR = 4.10; 95% CI: 1.62-10.4) and those with excess weight (OR = 208.6; 95% CI: 47.7-911.7) had a higher probability of abdominal obesity. In conclusion, demographic factors such as school grade, lifestyle habits, low aerobic fitness and excess weight are associated with central obesity.     

阳春市中学生单纯性肥胖症流行病学调查

目的研究阳春市中学生超重、肥胖的流行现状及其影响因素。方法采用分层整群随机抽样的方法，对该市中学生进行现场调查。结果阳春市中学生超重发生率为6．98％，肥胖率为2．81％；男生超重、肥胖检出率显著高于女生。父母肥胖、进食快、喜吃蔬菜是肥胖的影响因素。结论中学生肥胖的发生主要与不良饮食习惯、生活方式密切相关，还与父母因素有关。     

中国学生欺负相关行为报告率的Meta分析

目的:使用Meta分析评价2000-2015年中国学生欺负相关行为状况,为校园欺负相关行为的研究提供资料。方法:系统检索中国知网文献总库、万方数据库和维普信息资源库中有关中国学生欺负相关行为的研究,使用Meta分析报告率,对性别、年级和地区进行亚组分析。结果:共筛选20篇研究文献,总调查样本22831人。Meta分析结果,学生欺负卷入行为报告率为26.7%(95%CI=21.0%~32.3%),欺负报告率为7.3%(95%CI=4.9%~9.8%),被欺负报告率为15.9%(95%CI=12.8%~19.0%),欺负-被欺负报告率为4.8%(95%CI=2.5%~7.0%)。亚组分析结果显示,男生欺负相关行为报告率高于女生,大学生高于中小学生,中西部地区学生高于东部地区。结论:中国学生欺负行为的状况应引起社会的广泛关注。     

The incidence of acute myocardial infarction in relation to overweight and obesity: a meta-analysis

Introduction

Epidemiological evidence suggests that overweight and obesity have been associated with acute myocardial infarction (AMI). However, data on this issue are controversial. This study aims to use meta-analysis to determine whether overweight and obesity are related to AMI.

Material and methods

We searched PubMed and Embase databases up to October 23^rd, 2013 for related literature. The association of overweight and obesity with AMI was assessed by odd ratio (OR) with 95% confidence interval (CI) as the effect size. Then subgroup analysis was performed according to gender, area and study type.

Results

Five primary studies (one cohort study and four case-control studies) were included in this meta-analysis involving 36 803 participants, 14 883 of whom had an AMI. There was a significant association between overweight and AMI (OR = 1.27, 95% CI: 1.21–1.33, p < 0.001). Similar results revealed a relation between obesity and AMI (OR = 1.22, 95% CI: 1.07–1.40, p = 0.003). Subgroup analysis showed that overweight and obesity were positively associated with AMI risk except for obese subjects in Europe. There was no publication bias (Begg''s test p = 0.972, Egger''s test p = 0.858).

Conclusions

Both overweight and obesity increased the incidence of AMI, and it is necessary to control weight to prevent AMI. A large number of studies is needed to explore the mechanisms that link overweight and obesity with AMI.     

Association of Physical Activity and Sitting Time with Overweight/Obesity in Chinese Occupational Populations

AbstractThe aim of this study was to explore association of physical activity and sitting time with overweight/obesity in Chinese occupational populations for the development of intervention and prevention strategies for obesity.MethodsA total of 23,112 participants were selected from the 2010–2012 China National Nutrition and Health Survey (CNNHS). A logistics regression model was used to examine the associations of physical activity and sitting time with overweight/obesity by gender after adjusting for age, educational level, marital status, and family economic level.ResultsThe prevalence of overweight/obesity based on the WHO definition and the WGOC definition was 30.8% and 41.3%, respectively. Male employees with moderate and heavy occupation activity intensity had a lower risk for overweight/obesity than those with light occupation activity intensity (moderate: OR 0.90, 95% CI 0.82–0.98; heavy: OR 0.75, 95% CI 0.65–0.86), and the risk of overweight/obesity of male employees with long work-time spent sitting was higher than those with short work-time spent sitting (2–4.9 h/day: OR 1.26, 95% CI 1.14–1.40; ≥5 h/day: OR 1.29, 95% CI 1.15–1.44). The risk of overweight/obesity of male employees with active transportation mode was lower than those with inactive transportation mode (OR 0.91, 95% CI 0.84–0.99), while the risk of overweight/obesity of female employees with active transportation mode was higher (OR 1.14, 95% CI 1.04–1.25). Female employees with leisure-time physical activity (LTPA) for ≥150 min/week had lower risk of overweight/obesity than those with LTPA for <150 min/week (OR 0.69, 95% CI 0.56–0.84). There was no significant association of leisure-time sitting and housework time with overweight/obesity in Chinese occupational populations.ConclusionOccupation activity intensity, LTPA, transportation mode, and work sitting time were associated with overweight/obesity. Reducing work sitting time, moderate and heavy occupation activity intensity, and an active transportation mode could help male employees decrease the risk of overweight/obesity. Increasing leisure-time physical activity could reduce the risk of overweight/obesity in women. Our findings provided insight into the association of physical activity and sitting time with overweight/obesity. It will be necessary to carry out workplace-based interventions, have an active transportation mode, and increase leisure-time physical activity to decrease the risks of overweight/obesity.     

Genetic and Environmental Factors in Breakfast Eating Patterns

Despite many studies on the prevalence of breakfast eating, we know little about factors that determine breakfast eating patterns. Our aim was to find out to which extent breakfast eating frequency is influenced by genetic and environmental factors using twin and twin-family models in a population sample of 16-year-old twins (n = 5250) and their parents (n = 4663). In common effects sex-limitation models, additive genetic effects explained 41% (95% CI: 21-63%) of the variance in breakfast eating in girls and 66% (95% CI: 47-79%) in boys, and common environmental effects 45% (95% CI: 23-62%) in girls and 14% (95% CI: 5-29%) in boys. Of twin-family models, phenotypic assortment models fitted the data best. Heritability estimates increased somewhat (72%, 95% CI: 46-98% in girls and 63%, 95% CI: 38-89%) in boys. Common family environment remained substantial in both sexes. Cultural transmission was nonsignificant. The relative influence of genetic and family factors on adolescent breakfast eating frequency differs by sex and is generation-specific.     

Weight control behaviors among obese,overweight, and nonoverweight adolescents

OBJECTIVE: To evaluate weight control behaviors, eating, and physical activity behaviors among obese, overweight, and nonoverweight female and male adolescents. METHODS: A representative sample of 8,330 7th, 9th, and 11th grade public school students in Connecticut participated in the study. Adolescents responded to questions about weight control behaviors (dieting, exercise, vomiting, diet pills, and laxatives), healthy eating behaviors, breakfast consumption, and vigorous physical activity. RESULTS: In comparison to nonoverweight youths, overweight adolescents were less likely to eat breakfast and less likely to engage in vigorous physical activity than nonoverweight youths. Higher prevalences of unhealthy weight control behaviors were evident among overweight youths. CONCLUSIONS: Overweight adolescents use more unhealthy weight management strategies and are not engaging in healthier strategies, such as increased physical activity or healthier eating. These findings suggest the need to provide consistent messages about healthy weight loss methods to adolescents.