Cai Shan, Zhang Yihang, Chen Ziyue, Liu Yunfei, Dang Jiajia, Li Jiaxin, Huang Tianyu, Sun Ziyue, Dong Yanhui, Ma Jun, Song Yi
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, 100191, China.
National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
Lancet Reg Health West Pac. 2025 Apr 23;58:101560. doi: 10.1016/j.lanwpc.2025.101560. eCollection 2025 May.
With increasing concerns about early-onset cardiovascular diseases, it is essential to understand the distribution of cardiovascular health among young adults. This study aimed to characterize trends in physical fitness and the prevalence of overweight/obesity (OWOB), elevated blood pressure (EBP), and their comorbidity among Chinese college students from 2000 to 2019 and to analyze the changes in their associations and subgroup differences.
Data were extracted from five cycles of the Chinese National Survey on Students' Constitution and Health (2000-2019), including 241,710 college students aged 19-22. Physical fitness indicator (PFI) was computed using standardized z-scores of forced vital capacity, sit-and-reach, 50-m dash, standing long jump, muscle strength, and endurance running. OWOB was defined as a body mass index ≥25 kg/m, and EBP as systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg. Comorbidity was defined as the co-occurrence of OWOB and EBP. Mixed-effects logistic regression was used to analyze associations, and generalized linear mixed-effects models were applied to examine dose-response relationships.
The median of college students' PFI deteriorated continuously from -0.16 in 2000 to -1.99 in 2019, with boys experiencing a faster decline than girls. The prevalence of OWOB, EBP, and comorbidity increased significantly from 3.7%, 2.2%, and 0.3% in 2000 to 14.0%, 5.2%, and 1.8% in 2019, respectively, with boys exhibiting higher prevalence than girls. Decreasing PFI levels were significantly associated with the increasing prevalence of OWOB, EBP, and comorbidity, and such associations were strongest in 2019. L-shaped curves were observed for the relationships between PFI and the prevalence of OWOB, EBP, and comorbidity, with stronger associations in boys. Provincial population attributable fraction showed that when improving the PFI levels from low to middle-low or above, college students in Guizhou, Sichuan, and Yunnan provinces exhibited the most reductions in OWOB, EBP, and comorbidity.
Physical fitness among Chinese college students has significantly declined over the past two decades, accompanied by marked increases in the burden of cardiovascular risks. There is an urgent need to increase the focus on college students' health and establish a college-based physical examination system to assess their long-term cardiovascular function.
The present study was funded by National Key R&D Program of China (Grant No. 2024YFC2707901 to Yi Song), National Natural Science Foundation of China (Grant No. 82273654 to Yi Song), and Beijing Office for Education Sciences Planning (Grant No. BBAA22027 to Yi Song).
随着对早发性心血管疾病的关注日益增加，了解年轻成年人的心血管健康分布至关重要。本研究旨在描述2000年至2019年中国大学生的身体素质趋势、超重/肥胖（OWOB）、血压升高（EBP）的患病率及其合并症情况，并分析它们之间关联的变化和亚组差异。
数据来自中国国家学生体质与健康调查的五个周期（2000 - 2019年），包括241,710名年龄在19 - 22岁的大学生。身体素质指标（PFI）使用用力肺活量、坐位体前屈、50米短跑、立定跳远、肌肉力量和耐力跑的标准化z分数计算得出。OWOB定义为体重指数≥25 kg/m²，EBP定义为收缩压≥140 mmHg和/或舒张压≥90 mmHg。合并症定义为OWOB和EBP同时出现。采用混合效应逻辑回归分析关联，并应用广义线性混合效应模型检验剂量反应关系。
大学生的PFI中位数从2000年的 - 0.16持续恶化至2019年的 - 1.99，男生下降速度比女生快。OWOB、EBP和合并症的患病率分别从2000年的3.7%、2.2%和0.3%显著增加至2019年的14.0%、5.2%和1.8%，男生的患病率高于女生。PFI水平下降与OWOB、EBP和合并症患病率增加显著相关，且这种关联在2019年最为强烈。观察到PFI与OWOB、EBP和合并症患病率之间呈L形曲线关系，男生的关联更强。省级人群归因分数显示，当将PFI水平从低提高到中低或以上时，贵州、四川和云南省的大学生在OWOB、EBP和合并症方面的减少最为明显。
在过去二十年中，中国大学生的身体素质显著下降，同时心血管风险负担显著增加。迫切需要更加关注大学生健康，并建立基于大学的体检系统以评估他们的长期心血管功能。
本研究由中国国家重点研发计划（授予宋毅的项目编号2024YFC2707901）、国家自然科学基金（授予宋毅的项目编号82273654）和北京市教育科学规划办公室（授予宋毅的项目编号BBAA22027）资助。
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