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中国职业人群肥胖强化健走处方干预效果评价

郭凯明 赵一凡 赵平平 刘芳 徐溪 张朝 林永青 周脉耕 姜莹莹 蒋炜

郭凯明, 赵一凡, 赵平平, 刘芳, 徐溪, 张朝, 林永青, 周脉耕, 姜莹莹, 蒋炜. 中国职业人群肥胖强化健走处方干预效果评价[J]. 中国公共卫生. doi: 10.11847/zgggws1139360
引用本文: 郭凯明, 赵一凡, 赵平平, 刘芳, 徐溪, 张朝, 林永青, 周脉耕, 姜莹莹, 蒋炜. 中国职业人群肥胖强化健走处方干预效果评价[J]. 中国公共卫生. doi: 10.11847/zgggws1139360
GUO Kai-ming, ZHAO Yi-fan, ZHAO Ping-ping, LIN Yong-qing, . Effect of short-term intensive brisk walking prescription on obesity in Chinese occupational population: a pair matched-control study[J]. Chinese Journal of Public Health. doi: 10.11847/zgggws1139360
Citation: GUO Kai-ming, ZHAO Yi-fan, ZHAO Ping-ping, LIN Yong-qing, . Effect of short-term intensive brisk walking prescription on obesity in Chinese occupational population: a pair matched-control study[J]. Chinese Journal of Public Health. doi: 10.11847/zgggws1139360

中国职业人群肥胖强化健走处方干预效果评价

doi: 10.11847/zgggws1139360
详细信息
    作者简介:

    郭凯明(1996 – ),男,山西运城人,硕士在读,研究方向:慢性病流行病学

    通讯作者:

    蒋炜,E-mail:jiangwei1980@163.com

  • 中图分类号: R 161

Effect of short-term intensive brisk walking prescription on obesity in Chinese occupational population: a pair matched-control study

  • 摘要:   目的  评价中国职业人群肥胖强化健走处方干预效果,为推广适合中国职业人群适宜的体重控制方案提供借鉴。  方法  基于2021年5 — 8月中国职业人群健走项目,招募来自全国12个省份的31528名在职人员进行为期100 d的健走干预,根据是否接受强化干预分为强化干预组和阳性对照组(强化干预组实施4个健走处方,阳性对照组实行3个健走处方),对完成基线问卷调查和体格检查且健走数据完整的28285名在职人员采用倾向得分匹配,共得到5208对10416名研究对象,比较2组职业人群干预前后体重、体质指数、腰围、臀围和体脂率的变化情况以对中国职业人群肥胖强化健走处方的干预效果进行评价。  结果  强化干预组职业人群万步率、集中健走率、4个处方完成率、体重监测完成率及阳性对照组万步率、集中健走率、3个处方完成率P25值和平均值均 > 85 %,2组职业人群的干预依从性均较好;强化干预组和阳性对照组职业人群的体重、体质指数、腰围、臀围、体脂率在干预前分别为(65.98 ± 11.86)cm和(65.23 ± 11.87)kg、(23.77 ± 3.29)和(23.78 ± 3.30)、(82.75 ± 10.25)cm和(82.54 ± 10.14)cm、(96.15 ± 7.37)kg和(96.06 ± 7.17)cm、(27.92 ± 6.18)%和(27.75 ± 6.37)%,在干预后分别为(64.18 ± 11.50)kg和(63.86 ± 11.58)kg、(23.18 ± 3.16)和(23.31 ± 3.19)、(81.33 ± 10.05)kg和(81.09 ± 9.99)cm、(95.16 ± 6.88)kg和(94.97 ± 6.70)cm、(26.89 ± 6.11)%和(27.00 ± 6.29)%;干预前后强化干预组和阳性对照组职业人群分别比较,干预前、后2组职业人群的体重、体质指数、腰围、臀围和体脂率差异均有统计学意义(均P < 0.01);干预前、后2组职业人群比较,干预前强化干预组职业人群的体重高于阳性对照组职业人群(t = – 3.25,P = 0.001);协方差分析结果显示,干预后强化干预组职业人群的体重、体质指数和体脂率均低于阳性对照组职业人群(均P < 0.01)。通过多水平模型结合倍差法校正性别、年龄、文化程度、职业、居住地、是否患慢性病、慢性病知识得分、心理量表得分和睡眠时间等混杂因素后结果显示,干预后强化干预组职业人群体脂率较阳性对照组多下降了0.29 %(t = – 2.05,P = 0.04);进一步进行亚组分析结果显示,干预前体质指数水平为超重的职业人群通过强化干预可促进体重、体质指数和体脂率的下降,干预前体质指数水平为肥胖的职业人群通过强化干预可促进体质指数和体脂率的下降,干预前体脂率水平为超重和肥胖的职业人群通过强化干预可促进体脂率的下降。  结论  4个健走处方的强化干预模式可进一步降低中国超重和肥胖职业人群的肥胖程度,对体脂率的健康受益更大。
  • 表  1  中国职业人群干预前、后肥胖相关指标比较($\bar x \pm s$

    肥胖相关指标干预前干预后
    强化干预组阳性对照组强化干预组阳性对照组
    体重(kg)65.98 ± 11.86 b65.23 ± 11.8764.18 ± 11.50 ac63.86 ± 11.58 a
    体质指数23.77 ± 3.2923.78 ± 3.3023.18 ± 3.16 ac23.31 ± 3.19 a
    腰围(cm)82.75 ± 10.2582.54 ± 10.1481.33 ± 10.05a81.09 ± 9.99 a
    臀围(cm)96.15 ± 7.3796.06 ± 7.1795.16 ± 6.88 a94.97 ± 6.70 a
    体脂率(%)27.92 ± 6.1827.75 ± 6.3726.89 ± 6.11 ac27.00 ± 6.29 a
      注:干预后与干预前同组别比较,a P < 0.01;与干预前阳性对照组比较,b P < 0.01;与干预后阳性对照组比较,c P < 0.01。
    下载: 导出CSV

    表  2  强化干预对中国职业人群肥胖相关指标效应的亚组分析

    亚组体重体质指数腰围臀围体脂率
    性别 男性 – 0.53( – 1.35~0.30) – 0.16( – 0.42~0.10) 0.11( – 0.62~0.84) 0.07( – 0.52~0.65) – 0.28( – 0.64~0.09)
    女性 – 0.37( – 0.93~0.19) – 0.12( – 0.32~0.08) – 0.02( – 0.58~0.55) – 0.02( – 0.49~0.44) – 0.33( – 0.68~0.03)
    年龄(岁) 20~29 – 0.11( – 1.30~1.09) – 0.01( – 0.43~0.40) 0.03( – 1.09~1.15) – 0.14( – 1.05~0.77) – 0.02( – 0.75~0.70)
    30~39 – 0.62( – 1.56~0.32) – 0.23( – 0.55~0.09) 0.07( – 0.83~0.96) – 0.10( – 0.83~0.64) – 0.49( – 1.01~0.03)
    40~49 – 0.59( – 1.32~0.15) – 0.18( – 0.43~0.06) 0.07( – 0.62~0.76) 0.15( – 0.42~0.72) – 0.38( – 0.77~0.01)
    50~65 – 0.12( – 1.18~0.94) – 0.02( – 0.35~0.32) – 0.11( – 1.10~0.87) 0.03( – 0.76~0.83) – 0.15( – 0.68~0.38)
    干预前体质指数水平 正常 – 0.23( – 0.64~0.18) – 0.06( – 0.18~0.07) 0.13( – 0.32~0.59) 0.11( – 0.28~0.51) – 0.25( – 0.52~0.01)
    超重 – 0.61( – 1.15~ – 0.07) a – 0.20( – 0.33~ – 0.06) b – 0.14( – 0.75~0.46) – 0.09( – 0.61~0.44) – 0.29( – 0.51~ – 0.07) a
    肥胖 – 1.08( – 2.18~0.03) – 0.41( – 0.74~ – 0.07) a 0.45( – 0.78~1.68) 0.11( – 0.96~1.18) – 0.65( – 1.05~ – 0.25) b
    干预前腰围水平 正常 – 0.35( – 0.85~0.15) – 0.10( – 0.27~0.07) – 0.02( – 0.40~0.37) 0.15( – 0.27~0.58) – 0.28( – 0.60~0.05)
    中心性肥胖前期 – 0.42( – 1.13~0.30) – 0.14( – 0.39~0.11) – 0.02( – 0.35~0.31) – 0.04( – 0.61~0.53) – 0.25( – 0.68~0.17)
    中心性肥胖 – 0.57( – 1.37~0.23) – 0.16( – 0.42~0.11) 0.16( – 0.42~0.74) – 0.13( – 0.71~0.45) – 0.34( – 0.72~0.03)
    干预前体脂率水平 正常 – 0.29( – 0.96~0.37) – 0.05( – 0.24~0.14) 0.14( – 0.53~0.81) 0.04( – 0.52~0.61) 0.06( – 0.27~0.39)
    超重 – 0.42( – 0.95~0.11) – 0.10( – 0.24~0.04) 0.17( – 0.44~0.77) 0.16( – 0.36~0.68) – 0.36( – 0.57~ – 0.16) b
    肥胖 – 0.53( – 1.19~0.13) – 0.20( – 0.42~0.02) – 0.22( – 0.90~0.47) – 0.19( – 0.76~0.39) – 0.49( – 0.81~ – 0.16) b
      注:a P < 0.05;b P < 0.01。
    下载: 导出CSV
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  • 收稿日期:  2022-06-02
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