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目的探讨中国城市化水平对儿童青少年体质指数(BMI)和超重肥胖的影响。方法采用分层多阶段整群随机抽样方法,选择“中国健康与营养调查”中1997—2011年中国九省儿童青少年作为研究对象,利用城市化指数测量方法,将城市化水平分为低、中、高三类,采用多水平模型分析城市化水平对儿童青少年BMI和超重肥胖的影响。结果在多水平随机截距线性模型中,控制年龄、总能量摄入、膳食脂肪供能比、身体活动量和静坐时间、家庭收入、父母受教育水平和父母超重肥胖情况等变量后,高城市化水平社区男孩BMI均值相对低城市化水平社区男孩增加了0.61(95%CI 0.03~1.19,P<0.05),城市化水平对女孩BMI的影响无统计学意义(P=0.59);在多水平随机截距Logistic回归模型中,控制年龄、基线BMI、总能量摄入、膳食脂肪供能比、身体活动量和静坐时间、家庭收入、父母受教育水平和父母超重肥胖情况等变量后,不同城市化水平社区男、女发生超重肥胖的危险性差异均没有统计学意义(男:P=0.17,女:P=0.57)。结论高城市化水平社区男孩BMI高于低城市化水平社区男孩,城市化水平对女孩BMI没有影响,城市化水平与儿童青少年超重肥胖无显著相关性,说明社区本身城市化水平的高低可能不是影响超重肥胖的直接因素,其主要通过对儿童青少年生活方式和家庭因素的影响,间接影响儿童青少年超重和肥胖。
Objective To explore the impact of urbanization on body mass index (BMI) and overweight and obesity in children and adolescents in China. Methods A stratified and multistage cluster random sampling method was used to select children and adolescents in nine provinces of China from 1997 to 2011 in China Health and Nutrition Survey. The urbanization index was used to divide the urbanization level into two categories: low , Middle and high categories, the use of multi-level model to analyze the impact of urbanization on children and adolescents BMI and overweight and obesity. Results After adjusting for variables such as age, total energy intake, dietary fat to energy ratio, physical activity and sit-in time, family income, education level of parents and overweight and obesity among parents in a multi-level random intercept model, Boys with average level of urban boys had a mean increase of 0.61 (95% CI 0.03-1.19, P <0.05), and urbanized boys had no significant effect on BMI (P = 0.59) Random intercept Logistic regression model, the control of age, baseline BMI, total energy intake, dietary fat to energy ratio, physical activity and sit-in time, family income, education level of parents and overweight and obesity in parents and other variables, different cities There were no significant differences in the risk of overweight and obesity between men and women in the standardized community (male: P = 0.17, female: P = 0.57). Conclusions Boys in urban areas with high urbanization level are higher than urban boys with low urbanization level. Urbanization level has no effect on BMI in urban areas. There is no significant correlation between urbanization level and overweight and obesity in children and adolescents, indicating that the level of urbanization may not be affected The direct cause of overweight and obesity, which indirectly affects children and adolescents overweight and obesity indirectly through their influence on lifestyle and family factors in children and adolescents.