Dang Jiajia, Zhang Yihang, Liu Yunfei, Shi Di, Cai Shan, Chen Ziyue, Li Jiaxin, Huang Tianyu, Sun Ziyue, Li Xi, Ma Jun, Zhang Zilong, Song Yi
Institute of Child and Adolescent Health, School of Public Health, Peking University, Beijing, China.
National Health Commission Key Laboratory of Reproductive Health, Peking University, Beijing, China.
Obesity (Silver Spring). 2025 Jul;33(7):1344-1354. doi: 10.1002/oby.24303. Epub 2025 May 16.
We characterized the spatial-temporal trends of obesity among Chinese children and adolescents from 1985 to 2019 and examined the impact of social determinants of health (SDOH) patterns.
Using data from the Chinese National Survey on Students' Constitution and Health (CNSSCH) conducted between 1985 and 2019, featuring seven cross-sectional surveys, we employed spatial-temporal analysis methods and collected 23 obesity-related variables to identify SDOH patterns. A general linear regression model investigated associations between SDOH patterns and obesity prevalence.
Obesity prevalence rose from 0.1% to 8.1%. Northern regions formed a high-obesity cluster, whereas Southern regions were low-obesity clusters. The following four SDOH patterns emerged: Western Resource-Limited Frontier, Coastal-Central Development Belt, Inland Agricultural Heartland, and Metropolitan Resource-Rich Hubs. Prevalence was 5.7%, 5.8%, 10.2%, and 11.3% for Patterns 1 through 4, respectively. Compared with Pattern 2, Patterns 3 and 4 showed higher obesity risks.
Childhood obesity prevalence in China increased with regional disparities from 1985 to 2019, with higher prevalence in the North and lower prevalence in the South. SDOH patterns were linked to spatial clusters, suggesting that regions characterized by advanced urbanization, abundant resources (Pattern 4), and a dietary profile heavy in carbohydrates and low in protein (Pattern 3) potentially contributed to increased obesity risk.
我们描述了1985年至2019年中国儿童和青少年肥胖的时空趋势，并研究了健康的社会决定因素（SDOH）模式的影响。
利用1985年至2019年期间进行的中国学生体质与健康调研（CNSSCH）的数据，该调研包含七次横断面调查，我们采用时空分析方法并收集了23个与肥胖相关的变量，以确定SDOH模式。一个一般线性回归模型研究了SDOH模式与肥胖患病率之间的关联。
肥胖患病率从0.1%上升至8.1%。北方地区形成了一个高肥胖集群，而南方地区是低肥胖集群。出现了以下四种SDOH模式：西部资源有限前沿地区、沿海-中部发展带、内陆农业中心地带和大都市资源丰富枢纽地区。模式1至4的患病率分别为5.7%、5.8%、10.2%和11.3%。与模式2相比，模式3和4显示出更高的肥胖风险。
1985年至2019年期间，中国儿童肥胖患病率随地区差异而增加，北方患病率较高，南方患病率较低。SDOH模式与空间集群相关，这表明以城市化进程先进、资源丰富（模式4）以及碳水化合物含量高而蛋白质含量低的饮食结构（模式3）为特征的地区可能导致肥胖风险增加。
