湖南省学生营养健康状况监测地区中小学生铁缺乏和贫血患病现状及影响因素

唐嘉鹏; 谭雅卿; 陈艳华; 王非; 李开宇; 孙梦婷; 罗曼君; 魏剑晖; 阮霄睿; 秦家碧

doi:10.16462/j.cnki.zhjbkz.2025.02.008

文章导航 > 中华疾病控制杂志 > 2025 > 29(2): 171-177

唐嘉鹏, 谭雅卿, 陈艳华, 王非, 李开宇, 孙梦婷, 罗曼君, 魏剑晖, 阮霄睿, 秦家碧. 湖南省学生营养健康状况监测地区中小学生铁缺乏和贫血患病现状及影响因素[J]. 中华疾病控制杂志, 2025, 29(2): 171-177. doi: 10.16462/j.cnki.zhjbkz.2025.02.008

引用本文:

TANG Jiapeng, TAN Yaqing, CHEN Yanhua, WANG Fei, LI Kaiyu, SUN Mengting, LUO Manjun, WEI Jianhui, RUAN Xiaorui, QIN Jiabi. Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(2): 171-177. doi: 10.16462/j.cnki.zhjbkz.2025.02.008

Citation:

TANG Jiapeng, TAN Yaqing, CHEN Yanhua, WANG Fei, LI Kaiyu, SUN Mengting, LUO Manjun, WEI Jianhui, RUAN Xiaorui, QIN Jiabi. Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(2): 171-177. doi: 10.16462/j.cnki.zhjbkz.2025.02.008

引用本文:

Citation:

TANG Jiapeng, TAN Yaqing, CHEN Yanhua, WANG Fei, LI Kaiyu, SUN Mengting, LUO Manjun, WEI Jianhui, RUAN Xiaorui, QIN Jiabi. Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2025, 29(2): 171-177. doi: 10.16462/j.cnki.zhjbkz.2025.02.008

湖南省学生营养健康状况监测地区中小学生铁缺乏和贫血患病现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2025.02.008

唐嘉鹏²,
谭雅卿^1, ,,
陈艳华¹,
王非¹,
李开宇¹,
孙梦婷²,
罗曼君²,
魏剑晖²,
阮霄睿²,
秦家碧^{2, 3, ,}

1.
湖南省疾病预防控制中心学校卫生科, 长沙 410153
2.
中南大学湘雅公共卫生学院流行病与卫生统计学系, 长沙 410013
3.
昆明医科大学公共卫生学院流行病与卫生统计学系, 昆明 650500

基金项目:

国家自然科学基金 82073653

国家自然科学基金 81803313

湖南省杰出青年基金 2022JJ10087

湖南省卫生健康委科研计划项目 20221203326

详细信息

通讯作者:
谭雅卿, E-mail: yaqing998@163.com

秦家碧, E-mail: qinjiabi123@163.com

中图分类号: R181;G479
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- 文章访问数: 32
- HTML全文浏览量: 10
- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2024-07-17
- 修回日期: 2024-11-14
- 网络出版日期: 2025-03-08
- 刊出日期: 2025-02-10

Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province

1.
Department of School Health, Hunan Prouincial Center for Disease Control and Prevention, Changsha 410153, China
2.
Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha 410013, China
3.
Department of Epidemiology and Health Statistics, School of Public Health, Kunming Medical University, Kunming 650500, China

Funds:

The National Natural Science Foundation Program of China 82073653

The National Natural Science Foundation Program of China 81803313

Hunan Outstanding Youth Fund 2022JJ10087

Project of Scientific Research Program of Hunan Provincial Health and Wellness Commission 20221203326

More Information

Corresponding author: TAN Yaqing, E-mail: yaqing998@163.com; QIN Jiabi, E-mail: qinjiabi123@163.com

摘要

摘要: 目的了解湖南省2023年农村义务教育学生营养改善计划(简称营养改善计划)地区中小学生铁缺乏(iron deficiency, ID)及贫血患病现状, 并探索潜在影响因素。方法 2023年10―12月采用多阶段分层整群随机抽样的方法, 纳入4 652名中小学生, 其中1 108名中小学生进行了血清铁蛋白(serum ferritin, SF)检测。采用logistic回归分析模型分析贫血、ID以及缺铁性贫血(iron deficiency anemia, IDA)的影响因素。结果湖南省2023年营养改善计划地区中小学生血红蛋白(hemoglobin, Hb)均值为(131.49±12.92) g/L, 贫血率为11.54%(95% CI: 10.62~12.46);SF平均水平为53.47(34.53, 81.35) μg/L, ID患病率为5.23%(95% CI: 3.92~6.55), IDA患病率为1.35%(95% CI: 0.67~2.04)。多因素分析显示, 女性(OR=1.482, 95% CI：1.125~1.778)、学校所在地为乡镇/村(OR=1.420, 95% CI：1.138~1.771)的中小学生贫血的风险更高, 而10~15岁组中小学生的贫血风险较6~10岁组低。在ID和IDA中, 女性和学段为初中者的患病风险更高(ID：OR_女性=3.523, 95% CI: 1.898~6.542, OR_初中=4.120, 95% CI: 2.251~7.541; IDA：OR_女性=6.933, 95% CI: 1.551~130.984, OR_初中=8.837, 95% CI: 1.979~39.462)。结论湖南省营养改善计划地区仍需进一步加大中小学生ID和贫血的防控力度, 加强营养监测, 关注重点人群健康, 给予针对性的膳食指导和健康教育。
- 贫血 /
- 铁缺乏 /
- 中小学生 /
- 营养改善计划 /
- 回归分析
Abstract: Objective To investigate the current status of iron deficiency(ID) and anemia among students in the nutrition improvement programme areas of Hunan Province in 2023, and to explore the the potential factors. Methods During the period October-December 2023, a total of 4 652 students were included in this study using a multistage stratified whole cluster random sampling method, out of which 1 108 students were tested for serum ferritin (SF). Logistic regression was used to analyze the factors influencing anemia, ID and iron deficiency anemia (IDA). Results The average hemoglobin (Hb) level of students in the 2023 nutrition improvement program area of Hunan Province was (131.49±12.92) g/L, and the prevalence of anemia was 11.54% (95% CI: 10.62-12.46); the average SF level was 53.47 (34.53, 81.35) μg/L, and the prevalence of ID and IDA was 5.23% (95% CI: 3.92-6.55) and 1.35% (95% CI: 0.67-2.04), respectively. Multifactorial analysis showed that girls (OR=1.482, 95% CI: 1.125-1.778) and students whose school location was a township or village (OR=1.420, 95% CI: 1.138-1.771) had a higher risk of anemia, while students aged 10-15 years had a lower risk of anemia compared to those aged 6-10 years (OR=0.806, 95% CI: 0.656-0.992). In the analysis of ID and IDA, girls and junior high school students had a higher risk of the diseases (ID: OR_female=3.523, 95% CI: 1.898-6.542, OR_{junior high school}=4.120, 95% CI: 2.251-7.541; IDA: OR_female=6.933, 95% CI: 1.551-130.984, OR_{junior high school}=8.837, 95% CI: 1.979-39.462). Conclusions Nutrition Improvement Program areas in Hunan Province still need to further increase the prevention and control of ID and IDA among students, strengthen nutritional monitoring, pay attention to the health of key populations, and give targeted dietary guidance and health education.
- Anemia /
- Iron deficiency /
- Students /
- Nutrition improvement programme /
- Regression analysis

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图 1 中小学生贫血、铁缺乏及缺铁性贫血状况多因素分析

Figure 1. Visualization of the results of multifactorial logistic regression analyses using forest plots for the three disorders of anemia, iron deficiency, and iron-deficiency anemia in students

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表 1 贫血和铁缺乏监测数据基本特征

Table 1. Description of the number of people characterized by different sexes, ethnicities, school segments, school locations, age groups and nutritional status, as well as hemoglobin or serum ferritin levels, in the anemia and iron deficiency surveillance data

特征	贫血监测数据		铁缺乏监测数据		特征	贫血监测数据		铁缺乏监测数据
特征	人数(构成比/%)	血红蛋白/(g·L^-1)^①	人数(构成比/%)	血清铁蛋白/(μg·L^-1)^②	特征	人数(构成比/%)	血红蛋白/(g·L^-1)^①	人数(构成比/%)	血清铁蛋白/(μg·L^-1)^②
合计	4 652(100.00)	131.49±12.92	1 108(100.00)	53.47(34.53, 81.35)	年龄组/岁
性别					6~10	1 097(23.58)	127.51±11.25	205(18.50)	62.20(44.24, 92.17)
男	2 353(50.58)	133.76±13.36	564(50.90)	59.54(37.70, 84.08)	>10~15	3 393(72.94)	132.46±13.02	828(74.73)	51.25(33.56, 77.17)
女	2 299(49.42)	129.17±12.03	544(49.10)	48.65(30.90, 79.13)	>15	162(3.48)	138.24±14.81	75(6.77)	45.20(27.90, 80.70)
F/Z值		-11.539		-4.197	F/H值		162.902		25.187
P值		< 0.001		< 0.001	P值		< 0.001		< 0.001
民族					营养状况
汉族	3 699(79.51)	131.37±13.00	876(79.06)	49.57(32.51, 74.50)	生长迟缓	30(0.64)	129.40±11.78	3(0.27)	―
少数民族	953(20.49)	131.96±12.61	232(20.94)	70.70(45.70, 107.75)	消瘦	315(6.77)	129.37±12.83	51(4.60)	53.47(34.53, 81.54)
F/Z值		1.606		-6.935	正常	3 270(70.29)	131.28±12.78	789(71.21)	52.90(34.51, 80.70)
P值		0.205		< 0.001	超重	566(12.17)	132.70±13.52	134(12.10)	45.34(28.89, 75.23)
学段					肥胖	471(10.12)	133.06±13.06	131(11.82)	59.60(36.90, 86.70)
小学	2 609(56.08)	128.79±11.74	478(43.14)	57.90(38.55, 84.46)	F/H值		5.507		10.302
初中	2 043(43.92)	134.95±13.53	630(56.86)	47.31(29.09, 75.49)	P值		< 0.001		0.036
F/Z值		-16.166		-4.558
P值		< 0.001		< 0.001
学校所在地
县城	1 213(26.07)	133.97±13.29	562(50.72)	54.52(35.51, 84.46)
乡镇/村	3 439(73.94)	130.62±12.68	546(49.28)	51.90(32.50, 79.65)
F/Z值		61.117		-1.53
P值		< 0.001		0.126
注：“―”因人数太少未能计算。 ①以x±s表示; ②以M(P₂₅, P₇₅)表示。

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表 2 中小学生贫血、铁缺乏及缺铁性贫血单因素分析

Table 2. A univariate analysis was carried out using logistic regression to investigate the factors influencing the three disorders of anemia, iron deficiency, and iron-deficiency anemia in students

因素	贫血^①	铁缺乏 ^①	缺铁性贫血^①
性别
男	1.000	1.000	1.000
女	1.472(1.227~1.766)^②	3.457(1.872~6.385)^②	6.879(1.545~30.629)^②
民族
汉族	1.000	1.000	1.000
少数民族	0.949(0.757~1.189)	0.503(0.225~1.124)	1.907(0.646~5.636)
学段
小学	1.000	1.000	1.000
初中	0.951(0.793~1.141)	4.053(2.223~7.388)^②	8.778(1.971~39.088)^②
学校所在地
县城	1.000	1.000	1.000
乡镇/村	1.422(1.140~1.772)^②	1.193(0.702~2.026)	1.553(0.549~4.393)
年龄组/岁
6~10	1.000	1.000
>10~15	0.800(0.651~0.983)^②	12.832(1.761~93.483)^②	―
>15	1.324(0.845~2.073)	24.358(2.991~198.336)^②	―
营养状况
正常	1.000	1.000
生长迟缓	1.143(0.397~3.292)	9.362(0.831~105.441)	―
营养状况
消瘦	1.270(0.913~1.767)	1.170(0.349~3.921)	―
超重	0.751(0.554~1.019)	1.510(0.736~3.098)	1.620(0.446~5.884)
肥胖	0.823(0.598~1.133)	0.590(0.207~1.677)	0.544(0.070~4.250)
父母是否在外地工作
父母都没有在外地打工	1.000	1.000	1.000
父亲在外地打工	0.989(0.789~1.241)	0.709(0.388~1.293)	0.799(0.232~2.752)
父母都在外地打工	1.131(0.906~1.412)	0.280(0.098~0.802)^②	0.691(0.142~3.357)
母亲在外地打工	0.881(0.594~1.306)	0.910(0.312~2.657)	2.195(0.446~10.799)
是否知道如何正确预防缺铁性贫血
是	1.000	1.000	1.000
否	1.096(0.902~1.331)	0.666(0.341~1.303)	0.204(0.027~1.562)
食堂学生餐食谱制作者
其他部门提供, 如配餐中心等	1.000	1.000	1.000
学校食堂管理员	1.138(0.636~2.035)	0.586(0.225~1.525)	0.799(0.103~6.178)
是否使用过配餐软件
是	1.000
否	0.758(0.483~1.191)	―	―
学校是否开展过健康宣传教育
是	1.000
否	1.068(0.671~1.702)	―	―
每周吃肉情况
每天都吃	1.000	1.000	1.000
未能每天吃	1.138(0.944~1.371)	1.253(0.718~2.186)	1.282(0.453~3.627)
几乎不吃	1.342(0.819~2.199)	2.861(0.926~8.833)	―
每次吃肉情况/乒乓球大小
≥3	1.000	1.000	1.000
1~ < 3	0.890(0.724~1.093)	1.876(0.938~3.755)	2.380(0.502~11.274)
< 1	1.006(0.780~1.297)	2.060(0.905~4.691)	4.295(0.825~22.348)
每周喝奶情况
每天都喝	1.000	1.000	1.000
未能每天喝	1.094(0.881~1.359)	1.211(0.662~2.216)	1.971(0.546~7.114)
几乎不喝	1.176(0.865~1.598)	0.954(0.365~2.492)	0.848(0.087~8.230)
每周吃鸡蛋情况
每天都吃	1.000	1.000	1.000
未能每天吃	1.209(0.940~1.555)	1.762(0.782~3.973)	1.835(0.411~8.191)
几乎不吃	0.796(0.516~1.228)	3.048(1.071~8.674)^②	―
每天吃新鲜蔬菜种类/种
≥3	1.000	1.000	1.000
< 3	1.226(0.967~1.555)	3.258(1.165~9.115)^②	3.400(0.444~26.002)
基本不吃	1.173(0.754~1.826)	1.923(0.343~10.789)	―
每次吃蔬菜量/乒乓球大小
≥3	1.000	1.000	1.000
1~ < 3	1.070(0.877~1.305)	1.284(0.706~2.333)	1.382(0.449~4.258)
< 1	1.084(0.830~1.416)	1.303(0.607~2.794)	0.887(0.171~4.612)
每周吃水果情况
每天都吃	1.000	1.000	1.000
未能每天吃	1.125(0.899~1.407)	1.236(0.665~2.298)	1.502(0.416~5.422)
几乎不吃	1.008(0.650~1.564)	0.910(0.200~4.135)	2.156(0.220~21.162)
每次吃水果情况/乒乓球大小
≥3	1.000	1.000	1.000
1~ < 3	1.092(0.903~1.321)	0.675(0.381~1.197)	0.488(0.146~1.631)
< 1	1.003(0.734~1.372)	1.053(0.450~2.464)	1.707(0.445~6.540)
注：“―”因人数太少未能计算。 ①以OR值(95% CI)表示; ②表示P < 0.05。

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湖南省学生营养健康状况监测地区中小学生铁缺乏和贫血患病现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2025.02.008

通讯作者:
谭雅卿, E-mail: yaqing998@163.com

秦家碧, E-mail: qinjiabi123@163.com

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Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province

Corresponding author: TAN Yaqing, E-mail: yaqing998@163.com; QIN Jiabi, E-mail: qinjiabi123@163.com

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湖南省学生营养健康状况监测地区中小学生铁缺乏和贫血患病现状及影响因素

doi: 10.16462/j.cnki.zhjbkz.2025.02.008

通讯作者: 谭雅卿, E-mail: yaqing998@163.com 秦家碧, E-mail: qinjiabi123@163.com

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Analysis of the prevalence and influencing factors of iron deficiency and anemia among students in monitoring area of the nutritional health status of students in Hunan Province

Corresponding author: TAN Yaqing, E-mail: yaqing998@163.com; QIN Jiabi, E-mail: qinjiabi123@163.com

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目录

通讯作者:
谭雅卿, E-mail: yaqing998@163.com

秦家碧, E-mail: qinjiabi123@163.com