Correlation between sleep duration and overweight/obesity among children and adolescents aged 7-18 in Henan Province
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摘要:
目的 分析河南省7~18岁儿童青少年睡眠时长与超重肥胖的关系，为有效控制超重肥胖提供支持。 方法 采用分层整群随机抽样方法，于2019年随机抽取河南省内8个市18 823名学生为研究对象，进行问卷调查和体格检查。采用χ2检验、秩和检验、单因素方差分析及Logistic回归分析模型进行数据分析。 结果 本次调查对象中，正常组有11 185人，超重有4 415人，肥胖有3 223人。男生有10 073人，女生有8 750人，调查对象的平均年龄(11.6±4.1)岁，平均睡眠时长为(8.19±1.27)h/d，不同体重3组之间的性别、年龄及睡眠时长的差异均有统计学意义(均有P＜0.001)。男生和女生的超重和肥胖检出率随着睡眠时长的减少而增加(均有P趋势＜0.05)，且在不同睡眠时长下男生的超重和肥胖检出率高于女生(均有P＜0.05)。在小学、初中及高中人群分别进行多变量Logistic回归分析模型分析，结果发现随着睡眠时间的减少，儿童青少年发生超重肥胖的风险增加(均有P＜0.05)。 结论 睡眠不足是河南省儿童青少年超重肥胖的危险因素，保证充足的睡眠时长有利于减少超重肥胖的发生。 Abstract:Objective To analyze the relationship between sleep duration and overweight/obesity among children and adolescents aged 7-18 in Henan Province, in order to provide support for effective control of overweight and obesity. Methods Questionnaire survey and physical examination were conducted among 18 823 students with a stratified cluster sampling method in eight cities of Henan Province in 2019. Chi-square test, rank sum test, One-way Analysis of Variance and Logistic regression model were used for data analysis. Results Among the respondents, 11 185 were with normal weight, 4 415 were with overweight and 3 223 were with obesity. There were 10 073 boys and 8 750 girls. The average age of the respondents was (11.6±4.1) years old and the average sleep time was (8.19±1.27) h/d. The difference in gender, age and sleep duration among the three groups were statistically significant (all P < 0.001). The detection of overweight and obesity among boys and girls increased with the decrease of sleep duration (all Ptrend < 0.05), and the detection of overweight and obesity in boys was higher than that of girls under different sleep duration (all P < 0.05). Multivariate Logistic regression analysis was performed on the population of elementary school, junior high school and high school population respectively, the results showed that with the decrease of sleep time, the risk of overweight and obesity in children and adolescents increased (all P < 0.05). Conclusions Insufficient sleep is a risk factor of overweight and obesity among children and adolescents in Henan Province. Adequate sleep duration can reduce the incidence of overweight and obesity. -
Key words:
- Sleep duration /
- Overweight obesity /
- Children and adolescents
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表 1 研究对象的一般情况描述[n(%)]
Table 1. General description of the research object [n(%)]
特征 总人数 正常组 超重组 肥胖组 χ2/Z/F值 P值 性别 22.486 ＜0.001 男 10 073(53.5) 5 722(51.2) 2 504(56.7) 1 847(57.3) 女 8 750(46.5) 5 463(48.8) 1 911(43.3) 1 376(42.7) 年龄(岁) 97.563 ＜0.001 7~ 8 983(47.7) 5 419(48.4) 2 123(48.1) 1 441(44.7) 13~ 6 179(32.8) 3 608(32.3) 1 584(35.9) 987(30.6) 16~18 3 661(19.5) 2 158(19.3) 708(16.0) 795(24.7) 学段 2 831.160 ＜0.001 小学 8 882(47.2) 4 527(40.5) 2 531(57.3) 1 824(56.6) 初中 6 275(33.3) 4 566(40.8) 1 011(22.9) 698(21.7) 高中 3 666(19.5) 2 092(18.7) 873(19.8) 701(21.7) 身高(x±s, cm) 166.3±4.4 166.3±4.3 166.1±4.2 166.9±4.6 43.095 ＜0.001 体重(x±s, kg) 59.4±4.1 59.3±3.7 59.6±4.2 59.5±4.8 8.778 ＜0.001 BMI(x±s, kg/m2) 25.4±2.9 22.3±1.6 24.4±3.7 26.7±1.6 628.992 ＜0.001 睡眠时长(h/d) 1 635.398 ＜0.001 ＜8 7 104(37.7) 3 046(27.2) 2 157(48.8) 1 901(59.0) 8~ 5 288(28.1) 3 405(30.5) 1 332(30.2) 551(17.1) 9~ 4 307(22.9) 3 204(28.6) 697(15.8) 406(12.6) ≥10 2 124(11.3) 1 530(13.7) 229(5.2) 365(11.3) 父亲文化程度 115.088 ＜0.001 初中及以下 5 246(27.9) 3 278(29.3) 1 006(22.8) 962(29.9) 高中 5 187(27.5) 3 179(28.4) 1 160(26.3) 848(26.3) 大专及以上 8 390(44.6) 4 728(42.3) 2 249(50.9) 1 413(43.8) 父亲BMI(kg/m2) 328.237 ＜0.001 正常 1 0698(56.8) 6 698(59.9) 2 358(53.4) 1 642(51.0) 超重 5 302(28.2) 3 045(27.2) 1 460(33.1) 797(24.7) 肥胖 2 823(15.0) 1 442(12.9) 597(13.5) 784(24.3) 母亲文化程度 170.051 ＜0.001 初中及以下 5 619(29.8) 3 537(31.6) 1 066(24.1) 1 016(31.5) 高中 5 245(27.9) 3 279(29.3) 1 155(26.2) 811(25.2) 大专及以上 7 959(42.3) 4 369(39.1) 2 194(49.7) 1 396(43.3) 母亲BMI(kg/m2) 77.087 ＜0.001 正常 10 792(57.3) 6 529(58.4) 2 334(52.9) 1 929(59.9) 超重 5 715(30.4) 3 338(29.8) 1 532(34.7) 845(26.2) 肥胖 2 316(12.3) 1 318(11.8) 549(12.4) 449(13.9) 家庭年收入水平(万元) 47.256 ＜0.001 ≤10 9 045(48.1) 5 542(49.5) 2 058(46.6) 1 445(44.8) 11~ 7 172(38.1) 4 224(37.8) 1 709(38.7) 1 239(38.5) 21~30 2 606(13.8) 1 419(12.7) 648(14.7) 539(16.7) 
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表 2 不同特征儿童青少年不同睡眠时长的超重肥胖检出情况[n(%)]
Table 2. Detection of overweight and obesity in children and adolescents of different characteristics and different sleep time [n(%)]
分组 男生 女生 Z值 P值 总人数 正常 超重 肥胖 总人数 正常 超重 肥胖 小学(h/d) 35.263 0.013 ＜8 1 407 365(25.9) 617(43.9) 425(30.2) 1 240 473(38.1) 446(36.0) 321(25.9) 8~ 1 015 572(56.3) 287(28.3) 156(15.4) 886 609(68.7) 159(18.0) 118(13.3) 9~ 986 723(73.3) 156(15.8) 107(10.9) 854 639(74.8) 129(15.1) 86(10.1) ≥10 480 402(83.7) 45(9.4) 33(6.9) 444 398(89.6) 29(6.5) 17(3.9) P趋势a 0.035 0.017 0.029 0.042 0.031 0.025 初中(h/d) 28.521 0.019 ＜8 1 322 579(43.8) 392(29.7) 351(26.6) 1 159 528(45.6) 339(29.2) 292(25.2) 8~ 1 024 658(64.2) 231(22.6) 135(13.2) 869 576(66.3) 201(23.1) 92(10.6) 9~ 733 546(74.5) 98(13.4) 89(12.1) 679 527(77.6) 107(15.7) 45(6.7) ≥10 411 317(77.1) 53(12.9) 41(10.0) 342 287(84.0) 32(9.4) 23(6.6) P趋势a 0.152 0.042 0.037 0.119 0.018 0.026 高中(h/d) 19.567 0.028 ＜8 1 103 510(46.2) 279(25.3) 314(28.5) 873 480(55.0) 195(22.3) 198(22.7) 8~ 774 478(61.8) 190(24.5) 106(13.7) 720 443(61.5) 163(22.7) 114(15.8) 9~ 544 356(65.4) 119(21.9) 69(12.7) 511 372(72.8) 81(21.8) 58(11.4) ≥10 274 216(78.9) 37(13.5) 21(5.6) 173 131(75.7) 30(17.3) 12(7.0) P趋势a 0.265 0.023 0.045 0.063 0.027 0.032 合计(h/d) 3.895 0.032 ＜8 3 832 1 454(38.0) 1 288(33.6) 1 090(28.4) 3272 1 481(45.2) 980(30.0) 811(24.8) 8~ 2 813 1 708(60.7) 708(25.2) 397(14.1) 2475 1 628(65.8) 523(21.1) 324(13.1) 9~ 2 263 1 625(71.8) 373(16.5) 265(11.7) 2044 1 538(75.3) 317(15.5) 189(9.2) ≥10 1 165 935(80.2) 135(11.6) 95(8.2) 959 816(85.1) 91(9.5) 52(5.4) P趋势a 0.024 0.015 0.033 0.026 0.032 0.028 注：a表示男生、女生的超重和肥胖检出率随着睡眠时长变化的趋势性检验结果。
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表 3 河南省7~18岁儿童青少年睡眠时长与超重肥胖发生风险的Logistic回归分析模型分析
Table 3. Logistic regression analysis of sleep duration and risk of overweight and obesity among children and adolescents aged 7-18 in Henan Province
学段 模型1 模型2 OR(95% CI)值 P值 OR调整(95% CI)值 P值 小学(h/d) ＜8 1.079(1.125~3.082) 0.022 3.112(1.097~5.473) 0.036 8~ 1.153(1.066~4.031) 0.013 2.562(1.157~4.389) 0.019 9~ 2.062(1.234~2.987) 0.037 1.965(1.085~3.758) 0.028 ≥10a 1.000 1.000 初中(h/d) ＜8 1.168(1.025~2.152) ＜0.001 2.529(1.196~3.807) 0.023 8~ 2.523(1.173~4.069) 0.032 3.016(1.242~3.986) 0.045 9~a 1.000 1.000 ≥10 0.321(0.198~0.817) 0.017 0.529(0.167~0.955) 0.024 高中(h/d) ＜8a 1.000 1.000 8~ 0.432(0.246~0.678) ＜0.001 0.626(0.201~0.793) 0.015 9~ 0.617(0.181~0.936) 0.026 0.768(0.322~0.851) 0.033 ≥10 0.536(0.217~0.685) ＜0.001 0.699(0.203~0.919) 0.008 注：a表示基于我国标准化管理委员会制订的不同学段的睡眠时长推荐而选择的参照组；模型1未调整任何因素，模型2调整了儿童青少年的性别、年龄、身高、体重、BMI、父母亲文化程度、父母亲BMI及家庭年收入水平；变量之间已排除共线性的影响。
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