学龄期儿童超重和肥胖的危险因素分析

目的探讨学龄期儿童超重和肥胖的影响因素,为儿童超重和肥胖的防治提供基础资料。方法选取155名7~11岁儿童作为研究对象,其中肥胖104例、超重51例,160例7~11岁正常体重儿作为正常对照。通过问卷调查的方式研究儿童肥胖的影响因素,对相关因素采用多因素非条件Logistic回归分析。结果人工喂养、父亲超重或肥胖、母亲超重或肥胖、食欲好食量大、经常喝饮料或吃甜品、每天运动时间〈2 h是儿童肥胖的危险因素。结论儿童超重或肥胖的形成并非单一因素造成,与父母的肥胖程度和生活方式密切相关。     

南宁市儿童睡眠呼吸障碍与超重和肥胖关系的调查

目的调查南宁市学龄前及学龄儿童睡眠打鼾和相关的超重和／或肥胖发生关系。方法采取随机整群分层抽样方法,应用由家长完成的问卷调查表,对12个幼儿园、8所小学和6所初级中学的6999名2—14岁儿童进行调查,确定夜间睡眠打鼾及相关症状的发生情况。实际发放调查问卷总数为9000份,应答8150份,回收率为90．6％。有效问卷6999份。结果本组儿童打鼾现患率32．7％,男性儿童打鼾发生率（44．22％）高于女性儿童（28．58％）,差异有统计学意义（P〈0．01）。儿童打鼾现患率以5岁以下儿童相对较高为35．86％。打鼾儿童有较高的体重超重现患率（13．61％）和肥胖现患率（8．68％）。超重和／或肥胖儿童打鼾发生率（13．61％）高于无超重和／或肥胖儿童（8．68％）（P〈0．05）。超重和／或肥胖儿童有打轩并呼吸暂停的发生率为3．04％,与无超重和／或肥胖儿童的有打鼾但不伴呼吸暂停的发生率1．13％相比较,差异有统计学意义（P〈0．01）。Logistic回归分析与睡眠打鼾儿童相关因素中扁桃体肥大、超重和／或肥胖及肥胖家族史为打鼾发生的危险因素。结论超重和／或肥胖儿童有较高的夜间睡眠打鼾报告率。适当控制体重对避免夜间睡眠打鼾或睡眠呼吸障碍的发生有意义。     

我国11城市儿童单纯性肥胖症调查及影响因素分析

对我国１１ 个大、中城市５６ １５０ 名中、小学生进行肥胖及有关影响因素的调查, 单纯性肥胖症总检出率为６．３７％ , 男生８．２２％ , 女生４．３６％ 。配对病例－对照研究表明： 有肥胖家族史、１ 岁以内超重、常食高脂高盐饮食、进食速度较快、较少运动与肥胖发生有关。肥胖组儿童高血压检出率 （１４．７４％ ） 明显高于对照组 （２．９２％ ）, 心肺功能明显低于对照组。相当一部分儿童及家长对肥胖症及其危害缺乏正确的认识, 亟待加强有关的健康教育     

Calpain10基因多态性与超重肥胖、胰岛素抵抗的相关性研究

目的：探讨昆明地区2型糖尿病（T2DM）钙蛋白酶10基因（Calpain10基因）的多态性（SNP）与超重肥胖、胰岛素抵抗（IR）的关系．方法；选取昆明市城市社区居民非超重肥胖者111名及超重肥胖者151名．检测空腹血糖（FPG）、空腹胰岛素（FINS）、C肽（C-P）水平。计算胰岛素抵抗指数（HOMAA）．应用聚合酶链式反应双引物等位基因特异性扩增法（PCR-ASA）检测Calpain10基因SNP43位点（G／A）及SNP44位点（T/C）基因型．结果：（1）GG基因型频率随着BMI值的增大呈逐渐增加的趋势，但各组基因型频率间无显著性差异（P〉0．05）；（2）BMI〉28．00组的TC基因型频率显著高于其余各组（P〈0．05）；（3）GG基因型组中，WHR≥0．90者的FPG、FINS、C-P水平及HOMA-IR均显著高于WHR〈0．90者（P〈0．05）；（4）TT基因型组中，WHR≥0．90者的FPG、FINS、C-P水平及HOMA-IR均显著高于WHR〈0．90者（P〈0．05）．结论；昆明地区人群中Calpain10基因SNP44的多态性与肥胖有关，同为TT基因型者中具有中心性肥胖者存在明显的胰岛素抵抗现象．SNP43的多态性与肥胖无关。但同为SNP43GG基因型者中具有中心性肥胖者存在明显的胰岛素抵抗现象。     

广州市海珠区10～14岁小学生肥胖现状及影响因素分析

目的 了解小学生肥胖现状及影响因素。方法 在海珠区随机抽取3所小学,对1100名学生进行体格检查,并对调查对象发放有关肥胖影响因素的调查问卷。结果 本次调查肥胖检出率为5．82％,其中男生533人,肥胖检出率为6．57％;女生567人,肥胖检出率为5．11％,男女间肥胖检出率差异无统计学意义;各年龄组肥胖检出率差异有统计学意义,其中11岁组的肥胖检出率最高;对相关影响因素进行logistic回归分析,进食速度OR=1．615,家长肥胖OR=1．808。结论 不良的生活方式与肥胖的发生密切相关,进食速度、家长肥胖是肥胖的危险因素。     

吉林省中小学教师超重与肥胖现状及健康素养水平调查

目的：了解吉林省中小学教师的超重与肥胖现状及其健康素养水平.方法：采用问卷调查的方式对吉林省20所学校的2085名中小学教师进行调查研究.结果：中小学教师群体超重与肥胖总体检出率为24.4％.多因素Logistic回归分析表明,女性、吃肥肉每周2次及以下是超重和肥胖的保护性因素,而年龄、较低学历、不支持以注重学生健康为核心的教育理念、不能做到吃饭以素为主是导致超重和肥胖的危险因素.结论：吉林省中小学教师的超重和肥胖现状不容乐观,健康素养水平有待提高,建议把健康生活方式课程纳入中小学教师的培训中.     

Prevalence of Overweight and Obesity among Students Aged 7-22 Years in Jiangsu Province,China

Objective To report the prevalence and trend of overweight and obesity among students aged 7-22 years in Jiangsu, 2010 to 2013. Methods This cross-sectional study was carried out as part of students physical fitness and health survey in Jiangsu province. A total of 255,581 subjects (50.03%males and 49.97%females) enrolled in 82 school and 10 universities in Jiangsu. Weights and heights were obtained for each subject and its body mass index (BMI) was calculated using the Chinese Working Group on Obesity in China (CWGO). Results Anthropometric measurement including bodyweight, height, BMI and bust were significantly different between males in urban compared to females living rural areas (P<0.001). The total prevalence of overweight and obesity was 12.4%and 5.7%. Males had a significantly higher rate than in female’s student. The prevalence of overweight and obesity by age groups was (14.5%, 10.3%) at age 7-11 years, (11.2%, 6.8%) at age 12-14 years, (11.7%, 3.1%) at age 15-17 years, and (11.4%, 2.3%) at age 18-22 years. By regions; the highest prevalence of overweight obesity reported in Taizhou (10%, 14.2%), Xuzhou (9.4%, 12.5%), and Nanjing (9.2%, 15.6%), respectively.     

单纯性肥胖儿童心理行为问题的研究进展

随着社会经济的发展,人们生活水平的提高,儿童肥胖日益严重,已成为世界瞩目的公共卫生问题。肥胖不仅影响儿童的生理健康,而且给儿童带来一系列心理行为问题。而肥胖的发生、发展与这些心理行为问题又有着一定的关联,并对肥胖的治疗产生巨大影响。该文就单纯性肥胖的评定指标、单纯性肥胖儿童的心理行为特征进行综述,以便于及时发现与儿童单纯性肥胖相关的心理行为问题,并采取有针对性的干预措施。     

中国5岁以下儿童超重的时空演变模式高精度识别与预测研究

背景 低龄儿童超重问题呈现普遍化、严重化的趋势在一定程度上降低了未来人口素质,给中国健康人力资本存量的可持续发展带来巨大风险。目的 科学认识中国5岁以下儿童超重率的时空演变模式与未来发展趋势,旨在为控制儿童超重现象、提升地方政府治理效能、实施精准的干预措施提供支持。方法 于2022年4月,以华盛顿大学卫生计量与评估研究所提供的全球105个中低收入国家5 km×5 km格网数据集作为数据源,提取2000—2019年中国(除香港特别行政区、澳门特别行政区、台湾地区)5岁以下儿童超重率5 km×5 km格网数据,逐像元计算2000—2019年平均5岁以下儿童超重率,使用泰尔森估算法、Mann-Kendall检验法与Hurst指数估计法,逐像元对5岁以下儿童超重率的时空演变模式与未来发展趋势进行刻画。结果 2000—2019年20年间,5岁以下儿童超重情况在山东省、湖南省的大部分地区及福建省、广东省、海南省、北京市、天津市等省份的局部地区较为普遍,其中湖南省全省的平均5岁以下儿童超重率达29.42%;5岁以下儿童超重率明显增长的地区面积占研究区总面积(不含数据缺失区域)的60.59%,中部与东...     

Clustering of Risk Behaviors and their Social Determinants among Primary School Learners in Beijing,China: A Cross-sectional Study

Background:

Studies in developed countries reveal that poor lifestyle choices triggering diseases typically cluster among children. However, there is insufficient evidence on the clustering of risk behaviors among children in developing countries. This study aimed to determine the clustering of risk behaviors and their social determinants among 4^th-and 5^th -grade learners in Beijing, China.

Methods:

The sample comprised of 967 learners from six primary schools enrolled migrant and resident learners by two-stage stratified cluster sampling. Prevalence denoted the risk behaviors and their clustering. A log-linear model was used to explore the clustering patterns. Ordinal logistic regression determined the influence of demographic characteristics, school environment, and family context on behavioral clustering.

Results:

The prevalence of none, one, two, and three or more risk factors was 61.2%, 20.0%, 10.8%, and 8.1% for infectious diseases and 46.0%, 30.6%, 15.4%, and 8.0% for chronic diseases, respectively. Some behaviors appeared dependent and were more likely to be observed together. The three most influential factors for infectious diseases were school type (odds ratio [OR] =4.47, 95% confidence interval [CI] 3.00–6.66), school located in an inner suburb (OR = 0.27, 95% CI 0.18–0.38), and gender (OR = 0.56, 95% CI 0.42–0.74). Regarding risk behaviors for chronic diseases, clustering was not associated with household registration status and number of appliances, but was significantly associated with school type (OR = 5.36, 95% CI 3.72–7.73), school located in an inner suburb (OR = 0.59, 95% CI 0.43–0.81), and gender (OR = 0.61, 95% CI 0.47–0.78). School environment variables were the most significant contributor to the number of risk behaviors.

Conclusions:

The characteristics of schools enrolling migrants and residents influenced the number of risk behaviors. Therefore, improved school conditions and integrated behavioral interventions are particularly recommended for health promotion.     

北京市某社区脑卒中高危人群超重、肥胖现况调查

目的了解北京市某社区脑卒中高危人群分布及超重肥胖状况,以明确干预工作的重点,为社区制定脑卒中防治干预策略服务。方法采取随机整群抽样调查的方法对社区50岁及以上(1961年12月31日前出生)本市户籍居民605人进行问卷调查及体检。结果 605名居民中有473人被评估为脑卒中高危人群,占总人数的78.1%。超重220人,占高危人群总数的46.5%;肥胖89人,占高危人群总数的18.8%;中心性肥胖226人,占高危人群总数的47.8%,女性中心性肥胖不同年龄组比较差异有统计学意义(χ2=7.575,P=0.023),年龄越高,中心性肥胖发生率越高;男性中心性肥胖不同年龄组比较差异无统计学意义;中心性肥胖不同年龄组间比较、不同性别间比较差异无统计学意义。结论社区中老年人群超重肥胖发生率较高,应立足社区卫生服务,从宣传教育和健康促进入手,对高危人群进行体重管理及综合干预,降低或延缓脑卒中发生。     

The Influence of Secular Trends in Body Height and Weight on the Prevalence of Overweight and Obesity among Chinese Children and Adolescents

Objective To explore the influence of secular trends in body height and weight on the prevalence of overweight and obesity among Chinese children and adolescents. Methods The data were obtained from five cross-sectional Chinese National Surveys on Students’ Constitution and Health. Overweight/obesity was defined as BMI-for-age Z-score of per the Wold Health Organization (WHO) reference values. Body height and weight for each sex and age were standardized to those reported in 1985 (standardized height: SHY; standardized weight: SWY) and for each sex and year at age 7 (standardized height: SHA; standardized weight: SWA) using the Z-score method. Results The prevalence of overweight/obesity in Chinese children was 20.2% among boys and 10.7%among girls in 2010 and increased continuously from 1985 to 2010. Among boys and girls of normal weight, SHY and SHA were significantly greater than SWY and SWA, respectively (P < 0.001). Among boys and girls with overweight/obesity, SHY was significantly lower than SWY (P < 0.001), and showed an obvious decreasing trend after age 12. SHA was lower than SWA among overweight boys aged 7-8 years and girls aged 7-9 years. SHY/SHW and SHA/SWA among normal-weight groups were greater than among overweight and obese groups (P < 0.001). Conclusion The continuous increase in the prevalence of overweight/obesity among Chinese children may be related to a rapid increase in body weight before age 9 and lack of secular increase in body height after age 12.     

National Nutrition and Health Systematic Survey for Children 0-17 Years of Age in China

The main purpose of the National Nutrition and Health Systematic Survey for children 0-17 years of age in China (CNHSC) was to collect basic data on the nutrition, development, and health status for children in different regions across China using evidence-based, reliable, and cost-effective approaches. Children and their parents or guardians from seven regions (south, southwest, north, northwest, eastern, central, and northeast China) in China were recruited. A multi-stage stratified randomized sampling method was used. Two provinces were randomly sampled from each of the seven regions, from which one urban district and one rural country were also randomly sampled, resulting in a total of 28 survey counties/districts. Dietary surveys, health examinations, laboratory testing, and questionnaires were used to collect dietary intake, nutritional status, child development, and health status information. Nutrition, health, and lifestyle assessment of children and their parents was determined using the Knowledge Attitude Practice (KAP) survey. Greater than 100,000 children (38,000 children < 6 years of age and 66,000 children 6-17 years of age) completed the survey. The survey provided comprehensive data on child nutrition and health status for future studies and will serve as the basis for an integrated nutrition and health improvement strategies proposal for children in China.     

广州市中小学生伤害相关危险行为现况调查

目的了解广州市中小学生伤害相关危险行为的现况,为制定预防和控制措施提供科学依据。方法2004年1月-4月,采用分层整群抽样的方法,抽取广州市8所小学、9所中学的8222名学生进行问卷调查。结果调查对象乘骑摩托车、坐汽车的比例为83．9％以上,其中,不使用安全带的比例为13．3％;滑板车、溜冰、踢足球等运动的参与率为69．5％,其中,不使用护膝的比例为44．0％;危险剧烈运动的参与率为78．3％,其中,不佩带防护装置的比例为26．8％。三者均是郊区学生、低年级学生及男生的发生率较高（P〈0．05）。中小学生携带武器外出的比例为6．1％,觉得不安全而没有上学的比例为2．7％,被人恐吓或伤害的比例为4．4％,因打架受伤而需经医护人员处理的比例为3．6％。个人财物被偷或破坏的比例为29．1％,被别人性骚扰的比例为7．1％。暴力的发生率也呈现郊区学生、低年级学生及男生的发生率较高的趋势（P〈0．05）。曾轻微伤害自己的比例为14．3％,曾认真地考虑过自杀的比例为16．1％,曾实施自杀行为的比例为4．2％,郊区学生、低年级的发生率较高（P〈0．05）。采用不合适减肥方法的比例为23．0％,女生的比例高于男生（P〈0．05）。结论广州市中小学生伤害相关危险行为的发生率不容乐观,应努力培养青少年自我保护的意识和能力,从而预防伤害的发生。     

Prevalence and Years of Life Lost due to Disability from Dental Caries among Children and Adolescents in Western China, 1990-2015

Objective To analyze the prevalence and years lived with disability (YLD) from dental caries among children and adolescents and the time trends over the past two decades in Sichuan province, the largest province in west China. Methods Based on the Global Burden of Disease Study 2015 (GBD2015), which systematically assessed the epidemiological characteristics of major diseases and their transitions by country and region from 1990 to 2015, we extracted the estimated results for China. We then used the Bayesian meta-regression method to estimate the sex- and age-specific prevalences and YLDs from dental caries among children and adolescents under 15 years old in Sichuan province and compared them with global and national indicators for the same period. Results In 2015, there were almost 6 million cases of dental caries in children and adolescents (aged < 15 years) in Sichuan province, accounting for 6% of the total cases in China. For children under 5 years, the prevalence of deciduous caries was 55.9%, and the YLDs value was 10.8 per 100,000, while it was 24.3% and 5.1 per 100,000 respectively among 5- to 14-year-olds; for those aged 5 to 14 years, the prevalence of permanent caries was 21.5%, and the YLDs value was 11.5 per 100,000. From 1990 to 2015, the prevalence of dental caries for children under 5 years increased substantially, by 16.2%, and the YLDs increased by 8.7%. Among those aged 5 to 14 years, the prevalence increased and the YLDs decreased. Conclusion Dental caries remains a huge health burden in Western China. In contrast to the global and national data, the trend has increased rapidly over the past 25 years in this region. This work provides suggestions for the prevention and control for oral health in China with the policy of two-child.     

银川市学龄儿童血铅水平及与智商和学习成绩关系调查

目的：了解银川市区学龄儿童血铅水平现状，探讨其与智商及学习成绩的关系。方法：选择银川市无铅污染源的老城区3所小学共324名7－12岁儿童进行血铅水平测定和智力、学习成绩调查。结果：儿童血铅水平范围0．19－1．00μmol/L，无性别差异。血铅值＞0．483μmol/L的比值为635。不同血铅水平与智商及学习成绩未见明显相关。结论：在本研究的铅暴露范围内，铅对儿童智力的影响不明显，其损害作用可能被其它因素所掩盖。     

潍坊市中小学生生长发育状况

目的了解中小学生生长发育状况,为学生营养保健工作提供依据。方法采用分层整群抽样的方法对6所学校2880名学生的身高、体重、胸围进行测量。结果1996年至2006年7～18岁学生身高、体重、胸围的平均增长值男生依次为2·72cm、3·96kg、2·38cm,女生依次为2·17cm、2·17kg、2·13cm。结论7～18岁学生三项形态指标均随年龄的增长而增长且呈长期加速趋势,身高和体重的突增高峰年龄城乡一致,胸围的突增高峰年龄城市早于乡村。     

小学生同房间共眠状况及其影响因素研究

背景　儿童同房间共眠可能影响其睡眠质量,并引发一系列睡眠问题。目的　调查广州市小学生同房间共眠状况,并分析其影响因素。方法　根据广州市登记在册的小学名单,2014年应用随机数字法抽取1所省重点、1所市重点和1所区重点小学符合研究标准的2 462名在校小学生为研究对象。采用定式化睡眠问卷调查小学生最近1年的睡眠状况,问卷包括5部分：基本资料、家庭资料、父母资料、睡眠问题及儿童通常是否自己睡一间房？并依据最后一部分结果将儿童分为非共眠组和共眠组。问卷经学生带回家后与家长一起完成填写,1周内交回。结果　共发放调查问卷2 462份,回收有效问卷2 345份,有效回收率为95.2%。2 345名小学生中,男1 218名,女1 127名;年龄（9.5±1.7）岁;共眠1 217名（51.9%）,非共眠1 128名（48.1%）。两组儿童年龄、近1年规律服药情况、单亲家庭情况、就寝环境、居住面积情况、家庭月收入情况比较,差异有统计学意义（P<0.05）。7~14岁儿童同房间共眠发生率随年龄增长而降低（χ2趋势=30.91,P<0.01）。非共眠组儿童母亲、父亲年龄均大于共眠组（P<0.05）;两组儿童母亲不愿晨起情况比较,差异有统计学意义（P<0.05）;两组儿童父亲文化程度、晨起口干、惊醒、不愿晨起、经常流汗、日间困倦、入睡困难、晨起头痛、睡眠感缺失情况比较,差异有统计学意义（P<0.05）。两组儿童打鼾、惊醒、不愿晨起、经常流汗、经常翻身、日间困倦、特殊俯睡体位、磨牙、尿床、呓语情况比较,差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示,年龄〔OR=0.713,95%CI（0.659,0.772）〕、单亲家庭〔OR=1.348,95%CI（1.098,1.655）〕、儿童打鼾〔OR=1.115,95%CI（1.020,1.219）〕、居住面积〔OR=0.908,95%CI（0.826,0.997）〕是小学生发生同房间共眠的影响因素（P<0.05）。结论　广州市小学生与其家人同房间共眠状况较普遍（51.9%）,低龄、单亲家庭、儿童打鼾、居住面积小是其同房间共眠的重要影响因素。     

Association of the Common Genetic Variant Upstream of INSIG2 Gene with Obesity Related Phenotypes in Chinese Children and Adolescents

Objective To study the association between the rs7566605 variant of INSIG2 and obesity-related phenotypes in Chinese children and adolescents. Methods The study sample consisted of two independent cohorts of Chinese children and adolescents. Anthropometric indices, lipids, blood pressure, fasting glucose, insulin and percentage of fat mass were determined. PCR with restriction fragment length polymorphism analysis was performed for genotyping the rs7566605 variant. Results In each of the two independent cohorts, no significant association was observed between rs7566605 and obesity under additive, dominant or recessive model. We also did not detect any difference in the genotype frequency between all the obese children and controls. Furthermore, we did not find evidence of an association between body composition indices and metabolic phenotypes in all children. However, the triglyceride level of CC homozygotes was significantly higher than that of GG＋GC genotypes in obese children （P=0.022）. Additionally, we observed a non-significant trend of severe obesity in a post-hoc test. Conclusion INSIG2 rs7566605 variant is not associated Chinese childhood obesity in two independent cohorts. Further study is needed to verify the effect of rs7566605 on triglyceride in obese children.