上海市区小学1999-2004年超重肥胖流行趋势及对策探讨

5-year Trend in Overweight and Obesity Prevalence in Primary Schools of Shanghai Urban

目的了解上海市区小学5年来超重肥胖流行变化趋势。方法①采用分层整群抽样方法,采集1999年全市小学25981例(男性13220,女性12761)和2004年全市小学21730例(男性11271,女性10459)学生的性别、出生年月、身高和体重资料。②超重或肥胖分别定义为同性别身高别理想体重的110%～120%或≥120%。采用上海标准以及WHO标准,评估超重和肥胖流行率。③按公式:体质指数Z分=[(体质指数测量值/M)L-1]/(L.S),计算出每一样本的体质指数(BMI)的Z分值(BMI-Z)。其中L、M和S值来自上海市0～18岁BMI标准。④采用t检验,比较1999年和2004年各年龄段学生的身高、体重、BMI和BMI-Z分的均值。结果①5年前后各年龄段男女生平均身高变化不大。各年龄段男女性平均体重及BMI均有增加。男生体重除6岁年龄段外均有统计学意义,女生体重大年龄段差异有统计学意义。男女生BMI除6岁年龄段外,其余各年龄段差异均有统计学意义。②使用上海标准评估,男生超重和肥胖从1999年的13.1%和14.0%,上升至2004年的14.5%和17.0%;女生则从13.3%和11.2%,分别上升至14.1%和12.7%。男女生所有年龄段的超重与肥胖发生率都有增加。③各年龄段男女生的BMI-Z分均值从1999年的基本上接近于0,上升到2004年的0.1左右。除6岁年龄段外,其余男女各年龄段BMI-Z分均值差异均有统计学意义。5年前后男女生BMI-Z分值的频数分布均出现了右移现象,男生更为明显。结论1999-2004年上海小学超重肥胖流行趋势明显上升,处于高流行水平,且进展迅速。

Objective To detect the prevalence trend of children＇s overweight and obesity during 1999 -2004 in primary schools of Shanghai urban. Methods ①Data of gender, birthday, height and weight were collected for 25 981 chidren （ 13 220 boys and 12 761 girls） in 1999, and 21 730 children （ 11 271 boys and 10 459 girls） in 2004 from primary schools of Shanghai. ②Overweight and obesity are respectively defined as 110% - 120% and ≥ 120% of P50 of weight -for- height. The prevalence of overweight and obesity is analyzed by Shanghai references and WHO references as well. ③BMI Z score （ BMI - Z） of every case was calculated by the formula z score = [ （BMI/M）^ L - 1 ]/（ L · S）. The L, M and S values are from Shanghai BMI references for age 0 -18 years. ④The means of height, weight, BMI and BMI -Z of children in 1999 and in 2004 for every age interval were compared by t - test. Results ①The mean heights of boys and girls changed little during the 5 years. Mean weights of boys and girls increased during the 5 years. There was statistic difference for weight in every age interval of boys except in age 6, and statistic diffrence in higher age intervals for girls. Mean BMIs of children also increased and there was statistic difference in every age interval except in age 6. ②By Shanghai references, the prevalence rates of overweight and obesity of boys increased from 13. 1% and 14.0% of 1999 to 14.5% and 17.0% of 2005, and those of girls increased from 13.3% and 11.2% of 1999 to 14. 1% and 12.7% of 2004. The prevalence rates of overweight and obesity for boys and girls in every age interval have increased. ③The mean BMI - Z scores increased from about zero in 1999 to about 0. 1 in 2004. There was statistic difference in every age interval except for age of 6. Distribution frequency curve of BMI Z score has markedly shift to right during 5 years, especially for boys. Conclusion The secular increase in the prevalence of overweight and obesity in primary schools is remarkble from 1999 to 2004, and at a high level with rapid progress.