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贵州省中小学生超重肥胖、血压偏高及其共病现状及影响因素分析

Prevalence and determinants of overweight/obesity, elevated blood pressure, and their comorbidities among primary and secondary school students in Guizhou province: a cross-sectional survey

  • 摘要:
    目的 分析贵州省7~18岁中小学生超重肥胖和血压偏高流行现状及影响因素,为制定有效的干预措施提供科学依据。
    方法 于2022年9月 — 2023年3月,采用多阶段分层整群抽样方法,抽取贵州省90个区县的187 674名7~18岁中小学生为研究对象,测量其身高、体重和血压,并进行问卷调查,采用χ2检验和多因素logistic回归分析其流行现状和影响因素。
    结果  有效调查182 616名中小学生,超重肥胖率为23.0%;血压偏高检出率为13.9%;超重肥胖且血压偏高共病率为4.4%,其中经济差片区共病率(4.6%)高于中片区(4.3%)、好片区(4.1%)(χ2 = 23.679,P < 0.001),男生(4.7%)高于女生(4.0%)(χ2 = 55.967,P < 0.001),高中生(5.1%)高于初中生(4.8%)、小学生(3.9%)(χ2 = 118.414,P < 0.001)。多因素logistic回归分析结果显示,住校学生发生超重肥胖和血压偏高的风险是非住校生的0.773倍(P < 0.05),每天进行 ≥ 60 min中高强度运动组是未每天运动组的0.765倍(P < 0.05),每天放学后做作业/读书写字时长 < 1 h、1 h~分别是 ≥ 3 h组的0.833倍、0.894倍(P < 0.05),睡眠充足学生发生超重肥胖和血压偏高的风险是睡眠不足学生的0.912倍(P < 0.05)。
    结论 贵州省中小学生超重肥胖和血压偏高情况不容乐观,尤其是经济较差的地区,男生、高中生是超重肥胖和血压偏高共病防控的重点人群。住校、每天进行 ≥ 60 min中高强度运动、睡眠充足是超重肥胖和血压偏高的保护因素,放学后写作业时间 ≥ 3 h是危险因素。

     

    Abstract:
    Objective To analyze the prevalence and determinants of overweight/obesity and elevated blood pressure among primary and secondary school students aged 7 – 18 years in Guizhou province to provide evidence for the development of effective interventions.
    Methods Measurements of height, weight, and blood pressure and a survey of health and related factors using a questionnaire used in the National Surveillance of Common Diseases and Health-Related Factors among Students were conducted from September 2022 to March 2023 among 187 674 students aged 7 to 18 years recruited using stratified multistage cluster sampling from 2 primary schools and 2 junior high schools in each district/county and 2 senior high schools in each district and one senior high school in for all districts/counties of Guizhou province. Overweight/obesity, elevated blood pressure, and inadequate sleep were assessed according to national references including Screening for Overweight and Obesity in School-Aged Children and Adolescents: WS/T 586 – 2018, Screening Threshold for High Blood Pressure in Children and Adolescents Aged 7 – 18: WS/T 610 – 2018, and Hygiene Requirements for Daily Study Time of Primary and Secondary School Students: GB/T 17223 – 2012. Chi-square test and multivariate logistic regression analysis were used to analyze the prevalence and determinants of the two disorders and their comorbidity.
    Results Among the 182 616 students effectively surveyed, the prevalence of overweight/obesity was 23.0%, the detection rate of elevated blood pressure was 13.9%, and the comorbidity of both conditions was 4.4%. The comorbidity rate of overweight/obesity and elevated blood pressure among students differed significantly by economic development region (4.6%, 4.3%, and 4.1% for those from undeveloped, moderately developed, and highly developed regions, respectively; χ2 = 23.679, P < 0.001), gender (4.7% for males and 4.0% for females; χ2 = 55.967, P < 0.001), and educational level (5.1% for senior high school students, 4.8% for junior high school students, and 3.9% for primary school students; χ2 = 118.414, P < 0.001). Multivariate logistic regression analysis revealed that students with the following characteristics had a significantly reduced risk of developing the comorbidity of overweight/obesity and elevated blood pressure: school boarding (odds ratio OR = 0.773) compared with non-boarding, 60 minutes or more of moderate-to-vigorous physical activity daily (OR = 0.773) compared with no 60 minutes of moderate-to-vigorous physical activity, spending < 1 hour or 1 – 2.9 hours per day studying after school (OR = 0.833 or OR = 0.894), and having adequate daily sleep (OR = 0.912) compared with inadequate daily sleep (P < 0.05 for all).
    Conclusion Among primary and high school students in Guizhou province, the prevalence of overweight/obesity and elevated blood pressure should be of concern, especially among those in economically underdeveloped regions; males and high school students are key groups for preventing the comorbidity of overweight/obesity and elevated blood pressure; school boarding, with 60 minutes or more of moderate-to-vigorous physical activity daily and adequate daily sleep are protective factors, but spending ≥ 3 hours per day studying after school is a risk factor for the comorbidity of overweight/obesity and elevated blood pressure.

     

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