中国9个城市学龄前儿童单纯性肥胖的影响因素研究  

Risk factors of simple obesity in preschool children in nine cities of China

作　　者：宗心南[1] 李辉[1] 张亚钦[1] 九市儿童体格发育调查协作组 Zong Xinnan;Li Hui;Zhang Yaqin;The Coordinating Study Group on the Physical Growth and Development of Children of Nine Cities(Department of Growth and Development,Capital Institute of Pediatrics,Beijing 100020,China;不详)

机构地区：[1]首都儿科研究所生长发育研究室,北京100020 [2]不详

出　　处：《中华流行病学杂志》2022年第1期50-57,共8页Chinese Journal of Epidemiology

基　　金：国家卫生健康委员会委托项目(2015-42)

摘　　要：目的分析我国学龄前儿童单纯性肥胖的影响因素及其交互作用。方法采用整群随机抽样方法,于2016年6-11月调查北京、哈尔滨、西安、上海、南京、武汉、广州、福州、昆明9个城市3~7岁儿童63292名。基于中国2~18岁儿童青少年超重和肥胖筛查BMI界值点筛检出肥胖儿童1522名(男童1006名、女童516名),采用病例对照研究方法,按“同性别、年龄相差≤6个月、身高相差≤5 cm”随机选择同一调查区域内体重正常儿童与肥胖儿童进行配对。影响因素及交互作用分析采用条件logistic回归模型。结果①单因素条件logistic回归模型筛选出17个肥胖影响因素有统计学意义(P<0.001),包括出生体重≥4.0 kg、剖宫产、妊娠期糖尿病、妊娠期高血压、出生后前6个月人工喂养、食欲强、进食速度快或慢、户外活动强度较低、每日户外活动时间<1 h、每日视屏时间<1 h或≥2 h、每日夜间睡眠时间<9 h、母亲超重、父亲超重、母亲文化程度高中及以下、父亲文化程度高中及以下、非核心家庭、孩子日常生活主要照护人为(外)祖父母和/或保姆。②多因素条件logistic回归模型筛选出12个影响因素有统计学意义,包括出生体重≥4.0 kg(OR=1.83,95%CI:1.29~2.61,P<0.001)、剖宫产(OR=1.22,95%CI:1.07~1.39,P=0.003)、妊娠期糖尿病(OR=4.57,95%CI:2.13~9.79,P<0.001)、母亲文化程度高中及以下(OR=1.52,95%CI:1.11~2.07,P=0.008)、单亲家庭(OR=4.79,95%CI:1.44~15.88,P=0.010)、母亲超重(OR=2.58,95%CI:1.93~3.46,P<0.001)、父亲超重(OR=2.40,95%CI:1.86~3.10,P<0.001)、食欲强(OR=7.78,95%CI:5.38~11.27,P<0.001)、进食速度快(OR=6.59,95%CI:4.86~8.94,P<0.001)、每日户外活动时间<1 h(OR=1.42,95%CI:1.09~1.85,P=0.009)、每日夜间睡眠时间<9 h(OR=1.59,95%CI:1.13~2.23,P=0.007)、每日视屏时间≥2 h(OR=1.69,95%CI:1.27~2.24,P<0.001)。③交互作用分析显示4组影响因素之间存在较强交互作用,包括母亲超重和父亲超重(Objective To examine risk factors of simple obesity and their interaction in preschool children in China.Methods A total of 63292 preschool children aged 3-7 years selected by cluster random sampling in 9 cities of China,including Beijing,Harbin,Xi'an,Shanghai,Nanjing,Wuhan,Guangzhou,Fuzhou and Kunming,were investigated from June to November in 2016.Based on the BMI-for-age cut off points of overweight and obesity for Chinese children aged 2-18 years,a total of 1522 obese children(1006 boys and 516 girls)were screened.By population-based matched case-control design,a normal weight child was randomly selected to match with an obese child by sex,age(difference≤6 months)and body height(difference≤5 cm)from the survey area.Conditional logistic regression model was used to analyze association of risk factors with obesity and the interaction of risk factors.Results①Univariate conditional logistic regression model showed that 17 risk factors of simple obesity had statistical significance(P<0.001),including high birth weight,cesarean section,gestational diabetes,gestational hypertension,formula feeding in the first 6 months after birth,strong appetite,fast or slow eating speed,low intensity of outdoor activities,daily outdoor activity time<1 hour,daily screen viewing time<1 hour or≥2 hours,daily night sleep time<9 hours,mother overweight,father overweight,mother's low educational level,father's low educational level,non-nuclear family structure,and parents not being the primary caregivers of children.②Multivariate conditional logistic regression model showed that 12 risk factors had statistical significance,including high birth weight(OR=1.83,95%CI:1.29-2.61,P<0.001),cesarean section(OR=1.22,95%CI:1.07-1.39,P=0.003),gestational diabetes(OR=4.57,95%CI:2.13-9.79,P<0.001),mother's low educational level(OR=1.52,95%CI:1.11-2.07,P=0.008),single parent family(OR=4.79,95%CI:1.44-15.88,P=0.010),mother overweight(OR=2.58,95%CI:1.93-3.46,P<0.001),father overweight(OR=2.40,95%CI:1.86-3.10,P<0.001),strong appetite(OR=7.78,9

关 键 词：肥胖 儿童 危险因素 流行病学研究 

分 类 号：R723.14[医药卫生—儿科]