广州小学生体重状况与健康相关生活质量的关系：一项横断面研究。
Relationship between weight status and health-related quality of life in Chinese primary school children in Guangzhou: a cross-sectional study.
作者信息
Liu Wei, Lin Rong, Liu Weijia, Guo Zhongshan, Xiong Lihua, Li Bai, Cheng K K, Adab Peymane, Pallan Miranda
机构信息
Faculty of School Health, Guangzhou Centre for Disease Control and Prevention, Guangzhou, China.
Public Health, Epidemiology and Biostatistics, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
出版信息
Health Qual Life Outcomes. 2016 Dec 3;14(1):166. doi: 10.1186/s12955-016-0567-7.
BACKGROUND
To investigate the association between weight status and health-related quality of life (HRQOL) among pupils in Guangzhou, China.
METHODS
The study comprised 5781 children aged 8-12 years from 29 schools. Height and weight were objectively measured using standardized methods, and BMI z-score derived using the age and sex specific WHO reference 2007 for 5-19 years. Weight status was classified as underweight (<-2SD), healthy weight (between -2SD and 1SD), overweight/obesity (>1SD). HRQOL was measured by the self-report version of the Pediatric Quality of Life Inventory 4.0.
RESULTS
After controlling for gender, age, school type, parental education, and family income, HRQOL scores were significantly lower in overweight/obese compared with healthy weight children only in the social functioning domain (β = -1.93, p = 0.001). Compared with healthy weight children, underweight children had significantly lower total (β = -1.47, p = 0.05) and physical summary scores (β = -2.18, p = 0.02). Subgroup analysis for gender indicated that compared to healthy weight, total (β = -1.96, p = 0.02), psychosocial (β = -2.40, p = 0.01), social functioning (β = -3.36, p = 0.001), and school functioning (β = -2.19, p = 0.03) scores were lower in overweight/obese girls, but not boys. On the other hand, being underweight was associated with lower physical functioning (β = -2.27, p = 0.047) in girls, and lower social functioning (β = -3.63, p = 0.01) in boys. The associations were mainly observed in children aged 10 and over, but were not significant in younger children. Children from private schools had generally lower HRQOL compared to those in public schools, but the associations with weight status were similar in both groups.
CONCLUSIONS
The relationship between overweight/obesity and HRQOL in children in China is not as prominent as that seen in children in western or high-income countries. However, there appears to be gender and age differences, with more of an impact of overweight on HRQOL in girls and older children compared with boys and younger children. Underweight is also associated with lower HRQOL. Future intervention to prevent both obesity and undernutrition may have a positive impact on the HRQOL in children in China.
背景
调查中国广州小学生的体重状况与健康相关生活质量（HRQOL）之间的关联。
方法
该研究纳入了来自29所学校的5781名8至12岁儿童。使用标准化方法客观测量身高和体重，并根据世界卫生组织2007年针对5至19岁人群的年龄和性别特异性参考标准得出BMI z评分。体重状况分为体重过轻（<-2SD）、健康体重（-2SD至1SD之间）、超重/肥胖（>1SD）。HRQOL通过儿童生活质量量表4.0的自我报告版本进行测量。
结果
在控制了性别、年龄、学校类型、父母教育程度和家庭收入后，仅在社会功能领域，超重/肥胖儿童的HRQOL得分显著低于健康体重儿童（β=-1.93，p=0.001）。与健康体重儿童相比，体重过轻的儿童总得分（β=-1.47，p=0.05）和身体总结得分（β=-2.18，p=0.02）显著更低。按性别进行的亚组分析表明，与健康体重相比，超重/肥胖女孩的总得分（β=-1.96，p=0.02）、心理社会得分（β=-2.40，p=0.01）、社会功能得分（β=-3.36，p=0.001）和学校功能得分（β=-2.19，p=0.03）更低，而男孩则不然。另一方面，体重过轻与女孩的身体功能较低（β=-2.27，p=0.047）以及男孩的社会功能较低（β=-3.63，p=0.01）相关。这些关联主要在10岁及以上的儿童中观察到，而在年龄较小的儿童中不显著。与公立学校的儿童相比，私立学校的儿童HRQOL总体较低，但两组中体重状况与HRQOL的关联相似。
结论
中国儿童超重/肥胖与HRQOL之间的关系不如西方或高收入国家儿童那样突出。然而，似乎存在性别和年龄差异，与男孩和年幼儿童相比，超重对女孩和年长儿童的HRQOL影响更大。体重过轻也与较低的HRQOL相关。未来预防肥胖和营养不良的干预措施可能会对中国儿童的HRQOL产生积极影响。
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