2015年山东省6～18岁儿童青少年超重肥胖流行现况
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摘要
目的分析山东省学龄期儿童青少年超重肥胖流行现况,为儿童青少年肥胖防治策略和措施的制定提供基础数据。方法利用2015年山东省中小学生体检数据,共纳入9 583 576名6～18岁儿童青少年。利用国内外四种儿童青少年超重肥胖标准分析山东省学龄期儿童超重肥胖性别、年龄、城乡分布特征,并比较国内标准与国外标准间的一致程度。结果基于中国肥胖问题工作组(中国标准)、国际肥胖问题工作组(IOTF标准)、美国疾病预防控制中心(CDC标准)和世界卫生组织(WHO标准)推荐的儿童青少年超重肥胖体重指数(BMI)筛查标准,山东省6～18岁儿童青少年总体超重检出率分别为17.5%、16.6%、13.9%和17.6%,肥胖检出率分别为13.1%、7.2%、11.4%、10.8%。男生超重肥胖检出率高于女生,城市高于农村。在6～11岁年龄组随年龄增长超重肥胖检出率呈平稳上升趋势,12～18岁年龄组呈迅速下降趋势。中国标准与其他三种国际标准之间一致性较好,加权Kappa值分别为0.82(中国标准vs.CDC标准)、0.70(中国标准vs.IOTF标准)和0.83(中国标准vs.WHO标准)。结论儿童青少年肥胖已成为山东省重要的公共卫生问题,需引起全社会的重点关注。
Objective To investigate the prevalence of overweight and obesity among children and adolescents aged 6-18 years in Shandong province,in order to provide basis for the development of strategies and measures for the prevention and control of overweight and obesity in children and adolescents. Methods Data were extracted from physical examinations of primary and secondary school students of Shandong province in 2015.A total of 9 583 576 children aged 6-18 years were included in this study.The prevalence of overweight and obesity among school-age children in Shandong province was examined by age,gender and region,based on four national and international criteria.The agreement between the national criteria and the international one was also analyzed. Results Based on the national,international obesity task force(IOTF),centers for disease control and prevention(CDC)and world health organization(WHO)standard criteria,the prevalence rate of overweight in the above criteria was 17.5%,16.6%,13.9%and 17.6%,respectively;and the prevalence rate of obesity in the above criteria was 13.1%,7.2%,11.4%and 10.8%,respectively.The prevalence rates of overweight and obesity in boys were higher than those in girls,and higher in urban areas than those in rural areas.The prevalence rates of overweight and obesity kept stable rising with age in children aged 6-11 years,but the rates decreased rapidly in adolescents aged 12-18 years.There was high agreement among the national criteria and the three international criterias,with the corresponding weighted kappa values of 0.82(China vs.CDC),0.70(China vs.IOTF)and 0.83(China vs.WHO),respectively. Conclusion Childhood obesity has become an important public health issue in Shandong Province,more attention should be paid by the whole society.
Objective To investigate the prevalence of overweight and obesity among children and adolescents aged 6-18 years in Shandong province,in order to provide basis for the development of strategies and measures for the prevention and control of overweight and obesity in children and adolescents. Methods Data were extracted from physical examinations of primary and secondary school students of Shandong province in 2015.A total of 9 583 576 children aged 6-18 years were included in this study.The prevalence of overweight and obesity among school-age children in Shandong province was examined by age,gender and region,based on four national and international criteria.The agreement between the national criteria and the international one was also analyzed. Results Based on the national,international obesity task force(IOTF),centers for disease control and prevention(CDC)and world health organization(WHO)standard criteria,the prevalence rate of overweight in the above criteria was 17.5%,16.6%,13.9%and 17.6%,respectively;and the prevalence rate of obesity in the above criteria was 13.1%,7.2%,11.4%and 10.8%,respectively.The prevalence rates of overweight and obesity in boys were higher than those in girls,and higher in urban areas than those in rural areas.The prevalence rates of overweight and obesity kept stable rising with age in children aged 6-11 years,but the rates decreased rapidly in adolescents aged 12-18 years.There was high agreement among the national criteria and the three international criterias,with the corresponding weighted kappa values of 0.82(China vs.CDC),0.70(China vs.IOTF)and 0.83(China vs.WHO),respectively. Conclusion Childhood obesity has become an important public health issue in Shandong Province,more attention should be paid by the whole society.
引文
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[14] Zhang YX.Changes in the nutritional status of children and adolescents in Shandong,China[J].Public Health Nutr,2016,19(15):2708-2711.
[15] Ogden CL,Carroll MD,Kit BK,et al.Prevalence of childhood and adult obesity in the United States,2011-2012[J].Jama,2014,311(8):806-814.
[16] Li L,Shen T,Wen L,et al.Lifestyle factors associated with childhood obesity:a cross-sectional study in Shanghai,China[J].Bmc Research Notes,2015,8(1):1-8.
[17] Hye LH,Ah PH,Kang JH,et al.Factors related to body mass index and body mass index change in korean children:preliminary results from the obesity and metabolic disorders cohort in childhood[J].Korean J Fam Med,2012,33(3):134-143.
[18]孔国书,齐亚强.影响居民肥胖的社会经济因素:性别与城乡差异[J].社会学评论,2017,5(5):79-96.
[19] Khasnutdinova SL,Grjibovski AM.Prevalence of stunting,underweight,overweight and obesity in adolescents in Velsk district,north-west Russia:a cross-sectional study using both international and Russian growth references[J].Public Health,2010,124(7):392-397.
[20] Mira EG,Shurooq B,David Y,et al.Impact of using national v.international definitions of underweight,overweight and obesity:an example from Kuwait[J].Public Health Nutr,2011,14(11):2074-2078.
[21]杨丽丽,席波.济南市城区6~17岁儿童青少年超重和肥胖流行现状[J].中国儿童保健杂志,2017,25(11):1108-1112.
[2] World Health Organization(WHO).Obesity and overweight[EB/OL].http://www.who.int/mediacentre/factsheets/fs311/en/,2017-09-21.html.
[3]王烁,董彦会,王政和,等.1985—2014年中国7~18岁学生超重与肥胖流行趋势[J].中华预防医学杂志,2017,51(4):300-305.
[4] Yu Z,Han S,Chu J,et al.Trends in overweight and obesity among children and adolescents in China from 1981to 2010:A Meta-Analysis[J].PloS One,2012,7(12):e51949.
[5] Yi S,Wang H J,Ma J,et al.Secular trends of obesity prevalence in Urban Chinese children from 1985to 2010:gender disparity[J].PloS One,2013,8(1):e53069.
[6] Ajala O,Mold F,Boughton C,et al.Childhood predictors of cardiovascular disease in adulthood:a systematic review and meta-analysis[J].Obes Rev,2017,18(9):1061-1070.
[7] Llewellyn A,Simmonds M,Owen CG,et al.Childhood obesity as a predictor of morbidity in adulthood:a systematic review and meta-analysis[J].Obes Rev,2016,17(1):56-57.
[8] Kuczmarski RJ,Ogden CL,Guo SS,et al.2000CDC Growth Charts for the United States:methods and development[J].Vital Health Stat,2002,11(246):1-190.
[9] Cole TJ,Bellizzi MC,Flegal KM,et al.Establishing a standard definition for child overweight and obesity worldwide:international survey[J].BMJ,2000,320(7244):1240-1243.
[10] De OM,Onyango AW,Borghi E,et al.Development of a WHO growth reference for school-aged children and adolescents[J].Bull World Health Organ,2007,85(9):660-667.
[11]李辉,宗心南,季成叶,等.中国2~18岁儿童青少年超重和肥胖筛查体重指数界值点的研究[J].中华流行病学杂志,2010,31(6):616-620.
[12]王烁,董彦会,王政和,等.1985—2014年中国7~18岁学生超重与肥胖流行趋势[J].中华预防医学杂志,2017,51(4):300-305.
[13]田甜,薛建,王硕,等.山东省7~18岁儿童青少年营养状况与体能相关性分析[J].中国儿童保健杂志,2014,22(8):813-815.
[14] Zhang YX.Changes in the nutritional status of children and adolescents in Shandong,China[J].Public Health Nutr,2016,19(15):2708-2711.
[15] Ogden CL,Carroll MD,Kit BK,et al.Prevalence of childhood and adult obesity in the United States,2011-2012[J].Jama,2014,311(8):806-814.
[16] Li L,Shen T,Wen L,et al.Lifestyle factors associated with childhood obesity:a cross-sectional study in Shanghai,China[J].Bmc Research Notes,2015,8(1):1-8.
[17] Hye LH,Ah PH,Kang JH,et al.Factors related to body mass index and body mass index change in korean children:preliminary results from the obesity and metabolic disorders cohort in childhood[J].Korean J Fam Med,2012,33(3):134-143.
[18]孔国书,齐亚强.影响居民肥胖的社会经济因素:性别与城乡差异[J].社会学评论,2017,5(5):79-96.
[19] Khasnutdinova SL,Grjibovski AM.Prevalence of stunting,underweight,overweight and obesity in adolescents in Velsk district,north-west Russia:a cross-sectional study using both international and Russian growth references[J].Public Health,2010,124(7):392-397.
[20] Mira EG,Shurooq B,David Y,et al.Impact of using national v.international definitions of underweight,overweight and obesity:an example from Kuwait[J].Public Health Nutr,2011,14(11):2074-2078.
[21]杨丽丽,席波.济南市城区6~17岁儿童青少年超重和肥胖流行现状[J].中国儿童保健杂志,2017,25(11):1108-1112.