目的 分析中国汉族学生贫血状况的动态变化及营养状况与贫血的关联,为贫血的防治提供参考指标。方法 比较2000年、2005年和2010年全国学生体质与健康调研资料中贫血状况,对象为7、9、12、14、17岁汉族学生。利用世界卫生组织(WHO)2001年标准筛查贫血,营养状况分别使用体质指数(BMI)和皮褶厚度之和进行评价。分析比较2000-2010年间贫血患病率的变化,使用Logistic回归分析营养状况对学生贫血的影响。结果 10年来,中国学生贫血患病率整体大幅度下降(P<0.001)。2010年我国学生贫血患病率女生高于男生,乡村高于城市,城男、城女、乡男、乡女4类学生患病率分别为6.9%、11.2%、8.8%、12.7%。7~9岁无论男、女、城、乡均呈下降趋势。9~17岁男性学生各年龄段贫血患病率无趋势性变化,但女性学生,随年龄的增加,贫血患病率呈逐步增高趋势。Logistic回归结果显示,低皮褶厚度组与正常组相比具有更高的罹患贫血的风险(OR=1.18,95%CI:1.09~1.26),性别分层后该因素仍然显著。而以BMI作为营养状况分类方法,贫血患病率在消瘦组与正常组之间差异无统计学意义(OR=0.95,95%CI:0.88~1.03)。结论 我国汉族学生贫血防治正进入“瓶颈”阶段。贫血状况随着营养状况的提高而改善,“皮褶厚度之和”比BMI在预测是否存在贫血方面更为敏感。

Objectives To analyze the secular trend of the anemia in Chinese Han students and to examine the associations between nutritional status and anemia,hoping to provide parameter for the prevention of anemia. Methods Subjects were Han students aged 7,9,12,14 and 17 years old sampled from 2000,2005 and 2010 Chinese National Surveys on Students' Constitution and Health.World Health Organization (WHO) criteria for screening anemia (2001) was used.Nutritional status was defined according to body mass index (BMI) and skinfold thickness respectively.The changes of prevalence of anemia were analyzed,and logistic regression was used to assess the associations between anemia and nutritional status. Results During the past 10 years,prevalence of anemia had declined significantly (P<0.001).In 2010,prevalence of anemia among Chinese students maintained the trends that prevalence among girls was higher than that among boys,and prevalence among students in rural area exceeded that in urban area.Specifically,prevalences of anemia among four groups of students (urban boys,urban girls,rural boys and rural girls) were 6.9%,11.2%,8.8% and 12.7%,respectively.From 7 to 9 years old,the prevalence of anemia among girls and boys in both areas dropped.From 9 to 17 years old,the prevalence of anemia among boys showed no significant trend,while that among girls showed an upward trend with the increase of age.Logistic regression analysis confirmed that students with low skinfold thickness gained a higher risk of anemia than those with normal skinfold thickness (OR=1.18,95%CI:1.09~1.26),and this trend was also significant when stratified by sex.However,when nutritional status was classified by using BMI,there was no significant difference between the thinness group and the normal group in prevalence of anemia. Conclusions The prevention and treatment of anemia among Han students is entering the "bottleneck" stage.Anemia status is improved with the enhancement of nutritional status,and the sum of skinfold thickness is more sensitive to predict the presence of anemia than BMI.