目的 了解苏州市学龄前儿童超重与肥胖的流行现况,分析儿童肥胖的影响因素。方法 采用分层整群随机抽样的方法,于2021年12月—2022年6月抽取苏州市各区域共24 452名3～6岁儿童进行体格测量,分析超重与肥胖检出率。采用病例对照研究问卷调查3 786例(肥胖组与对照组各1 893例)儿童的基本信息、饮食、运动、睡眠等情况,分析学龄前儿童肥胖的影响因素。结果 1)苏州市学龄前儿童超重总检出率为14.8%(男14.6%、女15.0%);肥胖总检出率为7.9%(男8.7%、女7.1%),男女肥胖检出率差异有统计学意义(χ2=19.828,P<0.01)。2)各年龄组肥胖检出率差异有统计学意义(χ2=98.415,P<0.01),3~<4岁组最低(5.8%),6~<7岁组最高(11.8%)。3)轻度、中度、重度肥胖总检出率分别为4.8%、2.6%、0.5%。在各年龄组中,中重度肥胖构成比随年龄增长而显著增加(χ2=57.275,P<0.05)。4)出生体重>4 000g、剖宫产、父母超重/肥胖、儿童食欲旺盛、吃饭速度快(<10min/正餐)、油炸食物频率高(>1周/次)、看电视就餐、喜好静坐(>2h/d)、运动耐力不足、屏幕暴露时间长(>1h/d)、睡觉时间晚(21∶30后)是学龄前儿童肥胖的危险因素(P<0.05);早餐食量最大、蔬果作为常吃零食、饭后活动是学龄前儿童肥胖的保护因素(P<0.05)。5)学龄前儿童肥胖程度的影响因素:父亲超重(OR=1.33,95%CI:1.06~1.65)、父亲肥胖(OR=1.91,95%CI:1.46~2.49)、母亲超重(OR=1.25,95%CI:1.01~1.54)、母亲肥胖(OR=1.94,95%CI:1.40~2.69)、父亲学历低(初中及以下)(OR=1.57,95%CI:1.25~1.96)、儿童食欲旺盛(OR=1.72,95%CI:1.41~2.11)、吃饭速度快(<10min/正餐)(OR=1.29,95%CI:1.05~1.57)、喜好静坐(静坐>2h/d)(OR=1.51,95%CI:1.24~1.85)、运动耐力不足(OR=1.56,95%CI:1.12~2.19)、屏幕暴露时间长(>1h/d)(OR=1.42,95%CI:1.16~1.75)。结论 苏州市学龄前儿童超重与肥胖检出率较高,肥胖检出率与严重程度均随着儿童年龄增长而增加。除了遗传因素外,学龄前儿童肥胖还与孕产史及出生后不良的生活方式相关。
Abstract
Objective To investigate the prevalence and influencing factors of overweight and obesity among preschool children in Suzhou. Methods A stratified cluster random sampling method was used to select 24 452 children aged 3 - 6 years in different districts of Suzhou from December 2021 to June 2022. Then the prevalence rate of overweight and obesity was determined by physical measurements. A case-control study was conducted with a questionnaire survey of 3 786 children(1 893 in the obesity group and 1 893 in the control group) to analyze the factors influencing preschool obesity. Results 1) The overall detection rates of overweight among preschool children in Suzhou was 14.8%(boys 14.6%, girls 15.0%). The overall detection rates of obesity was 7.9%(boys 8.7%, girls 7.1%), with a statistically significant difference between boys and girls(χ2=19.828, P<0.01). 2) There was statistically significant difference in the detection rates of obesity among different age groups(χ2=98.415, P<0.01), with the lowest rate in the 3 - 4 years old group(5.8%) and the highest rate in the 6 - 7 years old group(11.8%). 3) The overall detection rates of mild, moderate and severe obesity was 4.8%, 2.6% and 0.5%, respectively. The proportion of moderate and severe obesity significantly increased with age(χ2=57.275,P<0.01). 4) Risk factors for preschool obesity included birth weight >4 000g, cesarean section, parental overweight/obesity, strong appetite of children, eating speed <10min/meal, high frequency of fried food consumption(>1time/week), eating while watching television, sedentary behavior >2h/d, insufficient exercise endurance, screen time >1h/d, and late bedtime(after 21∶30)(P<0.05). Protective factors for preschool obesity included larger breakfast consumption, fruits and vegetables as regular snacks, and physical activity after meals(P<0.05). 5) Factors influencing the degree of preschool obesity included paternal overweight(OR=1.33, 95%CI:1.06 - 1.65), paternal obesity(OR=1.91, 95%CI:1.46 - 2.49), maternal overweight(OR=1.25, 95%CI:1.01 - 1.54), maternal obesity(OR=1.94, 95%CI:1.40 - 2.69), low education level of father(junior high school or below)(OR=1.57, 95%CI:1.25 - 1.96), strong appetite of children(OR=1.72, 95%CI:1.41 - 2.11), eating speed <10min/meal(OR=1.29, 95%CI:1.05 - 1.57), sedentary behavior >2h/d(OR=1.51, 95%CI:1.24 - 1.85), insufficient exercise endurance(OR=1.56, 95%CI:1.12 - 2.19), and screen time>1h/d(OR=1.42, 95%CI:1.16 - 1.75). Conclusions The detection rates of overweight and obesity among preschool children in Suzhou are relatively high, and the detection rate and severity of obesity increase with age. In addition to genetic factors, preschool obesity are also associated with pregnancy and birth history, as well as unhealthy lifestyle after birth.
关键词
学龄前儿童 /
超重 /
肥胖 /
流行病学
Key words
preschool children /
overweight /
obesity /
epidemiology
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