杭州市中小学生中心性肥胖影响因素多水平模型分析

目的了解杭州市中小学生中心性肥胖流行特征及其影响因素,为制定中小学生中心性肥胖及相关代谢性疾病的防控策略提供理论依据。方法采用分层随机整群抽样方法,抽取杭州市4个城区和5个郊县的23所学校711个班级在校学生27 967名进行体格测量,以同种族、同年龄、同性别腰围P90作为诊断中心性肥胖的界值点。不同组间中心性肥胖检出率比较采用χ^2检验,影响因素分析采用多水平统计模型。结果杭州市中小学生中心性肥胖检出率为17.69%,城区学生(20.98%)高于郊县学生(15.61%),男生(20.40%)高于女生(14.92%),小学生(20.83%)高于初中生(19.89%)和高中生(15.30%),差异均有统计学意义(χ^2值分别为131.80,131.80,144.20,123.64,P值均<0.01)。学校和班级的随机效应均有统计学意义(P值均<0.01)。结论杭州市中小学生中心性肥胖检出率较高。除个体因素的影响外,学校和班级的宏观管理方面也有待进一步改进。

Multilevel analysis on abdominal obesity among primary and middle school students in Hangzhou

Objective To explore the epidemiological characteristics and influencing factors of abdominal obesity among primary and middle school students in Hangzhou, and to provide evidence for abdominal obesity prevention. Methods A total of 27 967 students from 711 classes 23 primary and middle schools in 4 districts and 5 counties in Hangzhou were investigated. The 90 th percentile(P90) of waist circumference of the same ethnicity, age and gender was used as the diagnostic value for abdominal obesity. Chi-square test was used to identify the deference among groups. Multilevel analysis was applied on the influencing factors of abdominal obesity. Results The rate of abdominal obesity among primary and middle school students in Hangzhou was 17.69%, with urban(20.98%) higher than rural(15.61%), boys’(20.40%) higher than girls’(14.92%), highest in primary school students(20.83%) and lowest in high school students(15.30%). The effects of school and class on abdominal obesity among primary and middle school students were significant(P<0.01). Conclusion The rate of abdominal obesity among primary and middle school students in Hangzhou was higher than national average level. In addition to the individual factors, management on healthy food and nutrition should be a high priority on every class and every school.