Yuan J N, Jin B H, Si S T, Yu Y X, Liang L, Wang C L, Gong C X, Liu G L, Chen S K, Fu J F
Department of Endocrinology , the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
Department of Epidemiology and Health Statistics, School of Public Health, Zhejiang University, Hangzhou 310058, China.
Zhonghua Er Ke Za Zhi. 2021 Nov 2;59(11):935-941. doi: 10.3760/cma.j.cn112140-20210523-00441.
To analyze the trends of overweight and obesity prevalence in Chinese children, aged from 6 to 15 years old among 4 provinces and cities from 2009 to 2019. Reviewed the national multi-center epidemiological survey data of children from the National Key Technology R&D Program of China during the Eleventh Five-Year Plan (2009 to 2010) and the National Key Research and Development Program of China during the Thirteenth Five-Year Plan (2017 to 2019). The participants' data were selected from four provinces,municipalities and autonomous region,including Beijing, Tianjin (Northern region), Zhejiang (Eastern region), and Guangxi (Southern region). Totally 14 597 pairs of 6-15 year-old children were surveyed. According to the body mass index (BMI) and standard deviation score (SDS) of children among different genders, ages, and regions, test or chi-square test was used to evaluate the changes in overweight and obesity over a 10-year span. Totally 7 721 pairs of boys and 6 876 pairs of girls were collectted in this study, whose mean age was (10.7±2.5) years. In the past 10 years, the overall BMISDS were 0.39±1.24 and 0.36±1.31 and the overall obesity rate were 11.8% (=1 773) anel 12.5% (=1 813) of children in the 4 administrative regions did not have statistically significant differences (all >0.05). However, the overall overweight rate rose from 17.1% (=2 496) to 19.1% (=2 781) (χ²=18.657, <0.01), and the average annual growth rate was 0.20%. The BMISDS in the Eastern region increased from 0.10±1.07 to 0.19±1.22 (=-4.095, <0.01), and the overweight rate and obesity rate increased by 3.8% (=202) and 3.1% (=169) respectively (both <0.01); the BMISDS in the Northern region and the obesity rate did not have statistically significant differences(all >0.05), but the overweight rate rose from 20.5% (1 233) to 22.8% (=1 365) significantly (χ²=7.431, <0.01); BMISDS in the Southern region was significantly decreased from 0.30±1.19 to 0.09±1.25 (=1.426, <0.01), and the rate of obesity decreased from 9.8% (=315) to7.9% (=256) (χ²=6.46, <0.05), the overweight rate was not stafistically significant (=0.10), respectively. The obesity rate of boys had risen from 16.4% (=1 265) to 18.2% (1 407) (χ²=8.997, <0.01) in the past 10 years, and the overweight rate had risen from 18.0% (=1 393) to 20.5% (=1 579) (χ²=14.26, <0.01). The overweight+obesity rate rose from 34.4% (=2 658) to 38.7% (=2 986) (χ²=29.859, <0.01), and the weight problem in the age group of 8 to 11 years was particularly severe (all <0.01). The obesity rate of girls dropped from 6.8% (=468) to 5.9% (=406) (χ²=4.546, <0.05), the overweight rate rose from 16.0% (=1 103) to 17.5% (=1 202) (χ²=5.006, <0.05), and the overall overweight+obesity rate rose from 22.8% (=1 571) to 23.4% (=1 608) (χ²=0.53, >0.05). The growth rate of obesity among children in China had slowed down from 2009 to 2019, but the overweight rate was still on the rise. The overall base of overweight and obesity population continued to expand. The weight problem of peri-adolescent boys was particularly prominent. The current status of obesity epidemics in different regions, ages, and genders are significantly different and had their own characteristics. It is necessary to establish a personalized prevention and control strategy.
分析2009年至2019年中国4个省市6至15岁儿童超重和肥胖患病率的趋势。回顾了中国国家科技支撑计划(2009年至2010年)和国家重点研发计划(2017年至2019年)期间全国多中心儿童流行病学调查数据。参与者的数据来自4个省、直辖市和自治区,包括北京、天津(北方地区)、浙江(东部地区)和广西(南方地区)。共调查了14597对6至15岁儿童。根据不同性别、年龄和地区儿童的体重指数(BMI)和标准差评分(SDS),采用检验或卡方检验评估10年间超重和肥胖的变化。本研究共收集了7721对男孩和6876对女孩,平均年龄为(10.7±2.5)岁。在过去10年中,4个行政区儿童的总体BMISDS分别为0.39±1.24和0.36±1.31,总体肥胖率分别为11.8%(=1773)和12.5%(=1813),差异无统计学意义(均>0.05)。然而,总体超重率从17.1%(=2496)上升至19.1%(=2781)(χ²=18.657,P<0.01),年均增长率为0.20%。东部地区的BMISDS从0.10±1.07增加到0.19±1.22(Z=-4.095,P<0.01),超重率和肥胖率分别增加了3.8%(=202)和3.1%(=169)(均P<0.01);北方地区的BMISDS和肥胖率差异无统计学意义(均>0.05),但超重率从20.5%(1233)显著上升至22.8%(=1365)(χ²=7.431,P<0.01);南方地区的BMISDS从0.30±1.19显著下降至0.09±1.25(Z=1.426,P<0.01),肥胖率从9.8%(=315)降至7.9%(=256)(χ²=6.46,P<0.05),超重率差异无统计学意义(P=0.10)。在过去10年中,男孩的肥胖率从16.4%(=1265)上升至18.2%(1407)(χ²=8.997,P<0.01),超重率从18.0%(=1393)上升至20.5%(=1579)(χ²=14.26,P<0.01)。超重+肥胖率从34.4%(=2658)上升至38.7%(=2986)(χ²=29.859,P<0.01),8至11岁年龄组的体重问题尤为严重(均P<0.01)。女孩的肥胖率从6.8%(=468)降至5.9%(=406)(χ²=4.546,P<0.05),超重率从16.0%(=1103)上升至17.5%(=1202)(χ²=5.006,P<0.05),总体超重+肥胖率从22.8%(=1571)上升至23.4%(=1608)(χ²=0.53,P>0.05)。2009年至2019年中国儿童肥胖增长率有所放缓,但超重率仍在上升。超重和肥胖人群的总体基数持续扩大。青春期前后男孩的体重问题尤为突出。不同地区、年龄和性别的肥胖流行现状存在显著差异且各有特点。有必要制定个性化的防控策略。