一项在中国评估儿童肥胖干预可持续长期效果的队列研究。

A cohort study assessing the sustainable long-term effectiveness of a childhood-obesity intervention in China.

机构信息

Department of Women and Children's Health Care, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.

Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China.

出版信息

Int J Epidemiol. 2019 Feb 1;48(1):108-115. doi: 10.1093/ije/dyy145.

DOI:10.1093/ije/dyy145

PMID:30357404

Abstract

BACKGROUND

Obesity has become a global epidemic, with substantial impacts on children's health. Numerous intervention studies for the prevention of obesity in children have been conducted during the most recent decade, but very few have evaluated the long-term and sustainable effectiveness of such prevention efforts.

METHODS

We conducted a follow-up study during September 2015 and September 2017, based upon a previous 3-year cluster randomized-controlled study (RCT) for a comprehensive childhood-obesity intervention in 14 primary schools in Shanghai, China. A total of 929 students were enrolled in the study. Generalized estimating equation approaches were applied to analyse student's body mass index (BMI), BMI z-score at baseline and three annual long-term follow-ups.

RESULTS

Three years after the end of the RCT study, the odds of developing obesity and the odds of developing obesity or overweight in the intervention group were both lower than in the control group among girls [OR(obesity) = 0.299, p = 0.010 and OR (overweight/obesity) = 0.493, p = 0.013]; the odds of developing obesity or overweight in the intervention group was lower than in the control group among boys (OR = 0.369, p = 0.017). Compared with the baseline, the BMI z-scores in the intervention group were lower than those in the control group for both normal-weight students (-0.027) and overweight or obese students (-0.074).

CONCLUSIONS

The 3-year RCT showed significant and reliable long-term effects on preventing childhood obesity, particularly among girls.

摘要

背景

肥胖已成为全球性问题，对儿童健康造成了重大影响。在最近十年中，已经开展了许多针对儿童肥胖预防的干预研究，但很少有研究评估这些预防措施的长期可持续效果。

方法

我们基于先前在中国上海的 14 所小学开展的为期 3 年的综合儿童肥胖干预的群组随机对照研究（RCT），于 2015 年 9 月和 2017 年 9 月进行了随访研究。共纳入 929 名学生。采用广义估计方程方法分析学生的体重指数（BMI）、基线时的 BMI z 评分以及 3 年的长期随访结果。

结果

在 RCT 研究结束 3 年后，与对照组相比，干预组女孩肥胖和超重/肥胖的发病几率均较低[肥胖的比值比（OR）=0.299，p=0.010；超重/肥胖的 OR=0.493，p=0.013]；与对照组相比，干预组男孩超重/肥胖的发病几率较低（OR=0.369，p=0.017）。与基线相比，干预组的正常体重学生（-0.027）和超重或肥胖学生（-0.074）的 BMI z 评分均低于对照组。