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1991—2015年中国9个省份儿童青少年超重和肥胖率的变化趋势分析
作者:马淑婧 张艳青 羊柳 赵敏 席波

摘要:

目的  分析1991—2015年中国9个省份儿童青少年超重和肥胖率的变化趋势。方法  采用1991—2015年9次"中国健康与营养调查"数据,选取资料完整的14 888名6~17岁儿童青少年为研究对象。超重和肥胖分别采用2000年国际肥胖工作组(IOTF)制定的全球儿童超重和肥胖标准(IOTF标准)、2007年世界卫生组织(WHO)制定的学龄儿童青少年生长参照标准(WHO标准)、2009年李辉等制定的儿童超重肥胖筛查体重指数界值(专家标准)及2018年原国家卫生和计划生育委员会发布的学龄儿童青少年超重与肥胖筛查界值(行业标准)进行判定。采用多元线性回归模型分析1991—2015年儿童青少年体重指数变化趋势,采用logistics回归模型分析1991—2015年超重和肥胖率的变化趋势。结果  调整年龄、性别和地区后,体重指数由1991年(2 363名)的17.26 kg/m2上升至2015年(1 060名)的18.72 kg/m2P趋势<0.001)。根据IOTF标准、WHO标准、专家标准和行业标准,超重率分别由1991年的4.06%、5.37%、5.16%、4.27%增长至2015年的13.58%、16.23%、13.30%、11.70% (P趋势<0.001),肥胖率分别由1991年的1.02%、1.86%、2.24%、2.41%增长至2015年的7.45%、10.75%、12.08%、12.74%(P趋势<0.001)。结论  1991—2015年,我国9个省份儿童青少年体重指数水平、超重和肥胖率均呈逐年增加趋势。

关键词:超重;肥胖症;儿童;青少年;横断面研究

Abstract:

Objective  To analyze the trends of overweight and obesity of children and adolescents in 9 provinces of China from 1991 to 2015.Methods  A total of 14 888 children and adolescents aged 6-17 years with complete data were selected from the China Health and Nutrition Survey from 1991 to 2015. The definitions of overweight and obesity were defined using the international body mass index (BMI) cut-offs for child overweight and obesity established by the International Obesity Task Force in 2000 (hereinafter referred to as 'IOTF Standard’), the growth reference for school-aged children and adolescents established by the World Health Organization in 2007 (hereinafter referred to as 'WHO Standard’), the BMI cut-offs for screening overweight and obesity in Chinese children established by Li Hui et al. in 2009 (hereinafter referred to as 'Expert Standard’), and the screening thresholds for overweight and obesity in Chinese school-age children and adolescents released by the National Health and Family Planning Commission in 2018 (hereinafter referred to as 'Industry Standard’). Multivariable linear regression model was used to examine the trends in BMI values from 1991 to 2015, and multivariable logistic regression model was used to examine the trends in the prevalence of overweight and obesity from 1991 to 2015.Results  After adjusting for the age, sex and region, BMI values increased from 17.26 kg/m2 in 1991 to 18.72 kg/m2 in 2015 (P value for trend <0.001). The prevalence of overweight defined by the IOTF Standard, WHO Standard, Expert Standard, and Industry Standard increased from 4.06%, 5.37%, 5.16%, and 4.27% in 1991 to 13.58%, 16.23%, 13.30%, and 11.70% in 2015, respectively (all P values for trend <0.001), and the prevalence of obesity increased from 1.02%, 1.86%, 2.24%, and 2.41% in 1991 to 7.45%, 10.75%, 12.08%, and 12.74% in 2015, respectively (all P values for trend <0.001).Conclusion  The BMI values and prevalence of overweight and obesity increased significantly in Chinese children and adolescents from nine provinces from1991 to 2015.

Key words: Overweight;Obesity;Child;Adolescent;Cross-sectional studies

发表日期:2020/2

引用本文:

图/表:

  • 10.3760/cma.j.issn.0253-9624.2020.02.004.T001:表1 1991—2015年中国9个省份6~17岁儿童青少年基本特征比较

    10.3760/cma.j.issn.0253-9624.2020.02.004.T001:表1 1991—2015年中国9个省份6~17岁儿童青少年基本特征比较

  • 10.3760/cma.j.issn.0253-9624.2020.02.004.T002:表2 1991—2015年中国9个省份6~17岁儿童青少年体重指数情况(kg/m3,±s)

    10.3760/cma.j.issn.0253-9624.2020.02.004.T002:表2 1991—2015年中国9个省份6~17岁儿童青少年体重指数情况(kg/m3,±s)

  • 10.3760/cma.j.issn.0253-9624.2020.02.004.T003:表3 采用四类标准判定的1991—2015年中国9个省份6~17岁儿童青少年超重和肥胖率(%)

    10.3760/cma.j.issn.0253-9624.2020.02.004.T003:表3 采用四类标准判定的1991—2015年中国9个省份6~17岁儿童青少年超重和肥胖率(%)

  • 10.3760/cma.j.issn.0253-9624.2020.02.004.T004:表4 采用行业标准判定的1991—2015年中国9个省份6~17岁儿童青少年超重和肥胖率(%)

    10.3760/cma.j.issn.0253-9624.2020.02.004.T004:表4 采用行业标准判定的1991—2015年中国9个省份6~17岁儿童青少年超重和肥胖率(%)

  • 10.3760/cma.j.issn.0253-9624.2020.02.004.T005:表5 采用专家标准判定的1991—2015年中国9个省份6~17岁儿童青少年超重和肥胖率(%)

    10.3760/cma.j.issn.0253-9624.2020.02.004.T005:表5 采用专家标准判定的1991—2015年中国9个省份6~17岁儿童青少年超重和肥胖率(%)

参考文献:

[1]DongY, JanC, MaY, et al. Economic development and the nutritional status of Chinese school-aged children and adolescents from 1995 to 2014: an analysis of five successive national surveys[J]. Lancet Diabetes Endocrinol, 2019, 7(4): 288-299. DOI: 10.1016/S2213-8587(19)30075-0.
[2]SkinnerAC, PerrinEM, MossLA, et al. Cardiometabolic risks and severity of obesity in children and young adults[J]. N Engl J Med, 2015, 373(14): 1307-1317. DOI: 10.1056/NEJMoa1502821.
[3]杨丽丽,席波.儿童期肥胖与靶器官损害关系的研究进展[J].中华预防医学杂志,2019,53(7):731-736. DOI: 10.3760/cma.j.issn.0253-9624.2019.07.014
[4]SinghAS, MulderC, TwiskJW, et al. Tracking of childhood overweight into adulthood: a systematic review of the literature[J]. Obes Rev, 2008, 9(5): 474-488. DOI: 10.1111/j.1467-789X.2008.00475.x.
[5]侯冬青,赵小元,刘军廷,等.儿童青少年肥胖与成年后糖尿病的关联分析[J].中华预防医学杂志, 2016, 50(1): 23-27. DOI: 10.3760/cma.j.issn.0253-9624.2016.01.005.
[6]闫银坤,侯冬青,刘军廷,等.儿童期超重肥胖对成年期动脉粥样硬化及动脉僵硬的长期影响[J].中华预防医学杂志, 2016, 50(1): 28-33. DOI: 10.3760/cma.j.issn.0253-9624.2016.01.006.
[7]ParkMH, FalconerC, VinerRM, et al. The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review [J]. Obes Rev, 2012, 13(11): 985-1000. DOI: 10.1111/j.1467-789X.2012.01015.x.
[8]ColeTJ, BellizziMC, FlegalKM, et al. Establishing a standard definition for child overweight and obesity worldwide: international survey[J]. BMJ, 2000, 320(7244): 1240-1243. DOI: 10.1136/bmj.320.7244.1240.
[9]De OnisM. Development of a WHO growth reference for school-aged children and adolescents[J]. Bull World Health Organ, 2007, 85(9): 660-667. DOI: 10.2471/blt.07.043497.
[10]李辉,季成叶,宗心南,等.中国0~18岁儿童、青少年体块指数的生长曲线[J].中华儿科杂志, 2009, 47(7): 493-498.
[11]中华人民共和国国家卫生和计划生育委员会. WS/T 586-2018学龄儿童青少年超重与肥胖筛查[S].北京:中国标准出版社, 2018.
[12]中国健康与营养调查项目组. 1989—2009年中国九省区居民膳食营养素摄入状况及变化趋势(一)健康与营养调查项目总体方案[J].营养学报, 2011, 33(3):234-236.
[13]ZhaiL, DongY, BaiY, et al. Trends in obesity, overweight, and malnutrition among children and adolescents in Shenyang, China in 2010 and 2014: a multiple cross-sectional study[J]. BMC Public Health, 2017, 17(1): 151. DOI: 10.1186/s12889-017-4072-7.
[14]王烁,董彦会,王政和,等. 1985—2014年中国7~ 18岁学生超重与肥胖流行趋势[J].中华预防医学杂志, 2017, 51(4): 300-305. DOI: 10.3760/cma.j.issn.0253-9624.2017.04.005.
[15]WangH, XueH, DuS, et al. Time trends and factors in body mass index and obesity among children in China: 1997-2011[J]. Int J Obes (Lond), 2017, 41(6): 964-970. DOI: 10.1038/ijo.2017.53.
[16]SongY, AgardhA, MaJ, et al. National trends in stunting, thinness and overweight among Chinese school-aged children, 1985-2014[J]. Int J Obes (Lond), 2019, 43(2): 402-411. DOI: 10.1038/s41366-018-0129-7.
[17]NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2 416 population-based measurement studies in 128.9 million children, adolescents, and adults[J]. Lancet, 2017, 390(10113): 2627-2642. DOI: 10.1016/S0140-6736(17)32129-3.
[18]UijtdewilligenL, WatersCN, Muller-RiemenschneiderF, et al. Preventing childhood obesity in Asia: an overview of intervention programmes[J]. Obes Rev, 2016, 17(11):1103-1115. DOI: 10.1111/obr.12435.
[19]NCD Risk Factor Collaboration (NCD-risC). Rising rural body-mass index is the main driver of the global obesity epidemic in adults [J]. Nature, 2019, 569(7755): 260-264. DOI: 10.1038/s41586-019-1171-x.
[20]席波.预防成年期心血管疾病应始于儿童期[J].中华预防医学杂志,2019,53(7): 657-660. DOI:10.3760/cma.j.issn.0253-9624.2019.07.001.

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