生活方式对大学生超重肥胖与血压偏高及其共病的影响

Influence of lifestyle on overweight and obesity,abnormally high blood pressure and their morbidity among college students in northern China

目的了解2021年我国内蒙古大学生中肥胖、血压偏高及其共病的发病情况,并分析生活方式因素对疾病发生的影响,为当地高校慢性病防治工作提供科学依据。方法2021年10—11月,通过体格检查收集内蒙古自治区大学生的体格数据,并结合问卷调查了解其生活方式。采用描述性统计方法分析学生的体重、血压和共病情况,并利用χ^(2)检验比较其在不同性别、年级间的差异。通过相关性分析和单因素Logistic回归,筛选出影响超重肥胖、血压偏高及共病的主要生活方式因素,进而统计这些生活方式在学生中的分布情况,并应用多因素Logistic回归模型,调整性别、年级、学校等因素,精确计算各因素对患病风险的影响。结果共调查2337名学生,发现正常高值血压者占比25.9%(605/2337),血压偏高者占比8.3%(195/2337),肥胖者占比13.7%(319/2337),共病患者占比8.0%(186/2337)。男生肥胖(22.4%vs.9.9%)、血压偏高(18.3%vs.4.0%)及其共病(17.1%vs.4.0%)的检出率显著高于女生(χ^(2)=89.60、218.93、116.40,P<0.001)。高年级学生血压偏高的比例高于低年级(χ^(2)=6.45,P<0.05),而超重肥胖和共病在不同年级间的分布差异无统计学意义(P>0.05)。在学校类型上,专科院校学生的超重肥胖、血压偏高和共病报告率均高于本科院校(χ^(2)=24.10、14.30、4.94,P<0.05)。在这些方式中,男生除运动更充分外,其他生活习惯均差于女生,各年级大学生在生活习惯上的差异不显著,而在学校中,专科学校学生不如本科院校学生睡眠充足,但是专科学校中学生运动更加充分,且短时间内大量饮酒的报告率较低。充足睡眠、充分运动是超重肥胖与血压偏高共病发生的保护因素(充足睡眠:OR=0.67,95%CI:0.48~0.94,P=0.019;充分运动:OR=0.63,95%CI:0.40~0.97,P=0.042);吸烟和饮酒是共病发生的危险因素(吸烟>1支/d:OR=1.59,95%CI:1.03~2.42,P=0.033;1个月内有酗酒行为:OR=1.60,95%CI:1.02~2.46,P=0.033)。结论睡眠充足是超重肥胖、血压偏高及共病的保护因素,而吸烟和饮酒则是危险因素。建议高校调整熄灯时间,保障学生充足的睡眠;加强健康教育,积极劝阻学生的吸烟和饮酒行为;并组织开展校园体育活动,提高学生参与体育锻炼的积极性,以促进身心健康。

Objective To understand the prevalence of obesity,elevated blood pressure,and comorbidities among college students in Inner Mongolia in 2021,and to analyze the influence of lifestyle factors on disease occurrence,so as to provide scientific evidence for chronic disease prevention and control in local universities.Methods From October to November 2021,physical examination data were collected from college students in Inner Mongolia Autonomous Region,and questionnaires were used to understand their lifestyles.Descriptive statistical methods were used to analyze body weight,blood pressure,and comorbidity conditions,andχ^(2) tests were used to compare differences across genders and grades.Correlation analysis and univariate Logistic regression were used to identify the main lifestyle factors affecting overweight/obesity,elevated blood pressure,and comorbidities.The distribution of these lifestyles among students was then statistically analyzed,and multivariate Logistic regression models were applied to precisely calculate the impact of each factor on the risk of disease after adjusting for gender,grade,and school factors.Results A total of 2337students were surveyed,with 25.9%(605/2337)having elevated normal blood pressure,8.3%(195/2337)having high blood pressure,13.7%(319/2337)being obese,and 8.0%(186/2337)having comorbidities.Male students had significantly higher detection rates for obesity(22.4%vs.9.9%),high blood pressure(18.3%vs.4.0%),and comorbidities(17.1%vs.4.0%)compared to female students(χ^(2)=89.60,218.93,116.40,P<0.001).Senior students had a higher proportion of elevated blood pressure than junior students(χ^(2)=6.45,P<0.05),while there were no significant differences in overweight/obesity and comorbidities across grades(P>0.05).In terms of school type,the reported rates of overweight/obesity,high blood pressure,and comorbidities were higher in vocational colleges than in undergraduate institutions(χ^(2)=24.10,14.30,4.94,P<0.05).Among lifestyle factors,male students tended to exercise more but had poorer habits overall compared to female students,and there were no significant differences in lifestyle habits across grades(P>0.05).Students in vocational colleges reported less adequate sleep but more exercise and lower rates of binge drinking compared to students in undergraduate institutions.Adequate sleep and regular exercise were protective factors against overweight/obesity and high blood pressure(adequate sleep:OR=0.67,95%CI:0.48-0.94,P=0.019;regular exercise:OR=0.63,95%CI:0.40-0.97,P=0.042).Smoking and alcohol consumption were risk factors for comorbidities(smoking:OR=1.59,95%CI:1.03-2.42,P=0.033;alcohol consumption:OR=1.60,95%CI:1.02-2.46,P=0.033).Conclusions Adequate sleep and regular weekly exercise are protective factors against overweight/obesity,high blood pressure,and comorbidities,while smoking and alcohol consumption are risk factors.It is recommend that universities adjust the lights-out time to ensure students get adequate sleep,strengthen health education to discourage smoking and alcohol consumption,and organize campus sports activities to improve students′enthusiasm in participating in physical exercise,so as to promote overall health and well-being.