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[中国7-17岁儿童青少年体重指数环境因素的多水平扫描]

[Multi-level scanning of environmental factors of body mass index of children and adolescents aged 7-17 years in China].

作者信息

Guan F X, Hu X, Hu H J, Ouyang Y F, Wang L S, Li Y, Yang C, Guo C L, Wang H J, Zhang B

机构信息

National Institute for Nutrition and Health,Chinese Center for Disease Control and Prevention, Beijing 100050, China.

George Institute for Global Health (Australia) Beijing Representative Office, Beijing 100600, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Oct 10;42(10):1790-1796. doi: 10.3760/cma.j.cn112338-20210303-00168.

Abstract

To investigate the influence of environmental factors on body mass index of children and adolescents in China. Using data from the China Health and Nutrition Survey, the research object to 7 - 17 years old children and adolescents who participated in 2000, 2006, 2011, and 2015 round of survey with complete data, a total of 6 626 children and adolescents (male 3 473, female 3 153) were investigated under univariate analysis for each environmental factor variable before using Partial Least Square Regression fitting a linear model for further screening. Finally, we fitted a three-level linear mixed-effects model distinct by urban and rural area for analysis. The three-level null model, log likelihood=-17 034.68, =483.06, <0.001. Intern-class correlation coefficient () showed that community-level was 9.97%, and both community and individual were 39.38%. The three-level model also showed that urban model's urbanization index (=-0.05, 95%: -0.09--0.01, <0.05), the park location (=-0.88, 95%: -1.72 - -0.04, <0.05), 15 - 17 age group (=-1.04, 95%:-1.78 - -0.30, <0.05) were negatively correlated with BMI. The distance to the gym (=0.12, 95%: 0.02 - 0.22, <0.05), the number of home TV sets (=0.50, 95%: 0.08 - 0.92, <0.05) and the frequency of parents' alarm of fiction TV program contents (=1.85, 95%: 0.70 - 3.00, <0.05) were correlated with BMI. Rural urbanization index (=-0.04, 95%:-0.07 - -0.01, <0.05). Rural per capita income (=-7.29e, 95%:-1.00e - -6.77e, <0.05), parents' restricted frequency of watching TV (=-1.29, 95%:-2.36 - -0.21, <0.05), adipo-energy ratio (=-0.03, 95%:-0.06 - -1.00e, <0.05) were negatively correlated with the BMI. Factors as the frequency of parents' alarm of fiction TV program contents (=3.01, 95%: 0.03 - 6.00, <0.05), the survey time was 2015 (=4.83, 95%: 1.96 - 7.69, <0.05) were correlated with BMI. Environmental factors could indirectly influence the change of BMI of children and adolescents to different degrees and various aspects. Urbanization index and rural per capita income had a slight protective effect on increasing BMI of children and adolescents. At the community level, attention should be paid to the setting of activity places around the living environment of children and adolescents. Family members should also guide their children and adolescents to develop nice behavior in watching TV.

摘要

为探讨环境因素对中国儿童青少年体重指数的影响。利用中国健康与营养调查的数据,研究对象为参加2000年、2006年、2011年和2015年四轮调查且数据完整的7至17岁儿童青少年,在对各环境因素变量进行单因素分析前,共调查了6626名儿童青少年(男3473名,女3153名),之后采用偏最小二乘回归拟合线性模型进行进一步筛选。最后,我们拟合了一个按城乡区分的三级线性混合效应模型进行分析。三级空模型,对数似然=-17034.68,=483.06,<0.001。组内相关系数()显示社区水平为9.97%,社区和个体两者为39.38%。三级模型还显示城市模型的城市化指数(=-0.05,95%置信区间:-0.09--0.01,<0.05)、公园位置(=-0.88,95%置信区间:-1.72--0.04,<0.05)、15至17岁年龄组(=-1.04,95%置信区间:-1.78--0.30,<0.05)与体重指数呈负相关。到健身房的距离(=0.12,95%置信区间:0.02-0.22,<0.05)、家中电视机数量(=0.50,95%置信区间:0.08-0.92,<0.05)以及父母对虚构电视节目内容的警示频率(=1.85,95%置信区间:0.70-3.00,<0.05)与体重指数相关。农村城市化指数(=-0.04,95%置信区间:-0.07--0.01,<0.05)。农村人均收入(=-7.29e,95%置信区间:-1.00e--6.77e,<0.05)、父母限制看电视的频率(=-1.29,95%置信区间:-2.36--0.21,<0.05)、脂肪能量比(=-0.03,95%置信区间:-0.06--1.00e,<0.05)与体重指数呈负相关。父母对虚构电视节目内容的警示频率(=3.01,95%置信区间:0.03-6.00,<0.05)、调查时间为2015年(=4.83,95%置信区间:1.96-7.69,<0.05)等因素与体重指数相关。环境因素可在不同程度和多个方面间接影响儿童青少年体重指数的变化。城市化指数和农村人均收入对儿童青少年体重指数增加有轻微保护作用。在社区层面,应关注儿童青少年生活环境周边活动场所的设置。家庭成员也应引导儿童青少年养成良好的看电视行为习惯。

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