儿童肥胖的综合干预效果评价与成本效益分析

EVALUATION OF THE EFFECT OF COMPREHENSIVE INTERVENTION AND ITS COST-BENEFIT ANALYSIS IN CHILDREN WITH OBESITY

目的探讨儿童肥胖营养健康教育+运动综合干预的效果,并进行成本效益分析。方法 8所学校1507名小学生分为干预组(n=749)和对照组(n=758),干预措施为营养健康教育+运动的综合方法,干预1年后比较干预前后学生的肥胖相关形态学指标和血生化指标的变化,并进行干预成本效果和成本效益分析。结果干预后干预组男生肥胖检出率较干预前显著下降,干预组腰围、腰围身高比(WHR)、低密度脂蛋白水平显著低于对照组(均P<0.05),超重肥胖学生干预前的腰高比、低密度脂蛋白显著高于正常体重组学生(P<0.05),干预后无统计学差异。成本效益分析表明每下降1kg/m2(BMI)的成本为每人245.01元。结论营养健康教育和增加学生身体活动的综合干预方法可显著降低少年儿童肥胖的发生率,并获得收益。

Objective To investigate the effect of nutrition and health education combined with exercises, comprehensive intervention and its cost-benefit in children with obesity. Methods One thousand five hundred and seven pupils from 8 schools were divided into intervention group （n=749） and control group （n=758）. An integrated approach of nutrition and health education combined with exercises was undertaken for one year. Obesity-related morphological and blood biochemical indices were measured before and after intervention, and the cost-benefit was analysed. Results The prevalence of obesity in males in intervention group was significantly decreased. Waist circumference, waist-high ratio （WHR）, low density lipoprotein （LDL） were significantly lower in the intervention group＇than in the control group （P 〈0.05）. At baseline, WHR and LDL level were significantly higher in overweight and obese children than in normal weight children （P〈0.05）. There was no statistically significant difference after intervention. It cost RMB 245.01 yuan to reduce 1 BMI. Conclusion Both education and exercises could significantly reduce the incidence of obesity and cost little for their benefits.