小学生童年期不良经历与超重肥胖的关联

Associations between adverse childhood experiences with overweight / obesity and possible gender difference

目的探讨童年期不良经历与超重、肥胖的关联及其可能的性别差异,为在童年期进行超重肥胖的有效干预提供参考依据。方法整群选取安徽省蚌埠市某中心小学三-五年级学生1 770名,对自愿参加的所有学生进行问卷调查和体格检查。问卷调查主要包括童年期不良经历（adverse childhood experiences,ACEs）和视频时间、体力活动情况,根据体质量指数（body mass index,BMI）判定超重、肥胖。结果不同性别学生超重（男生19.4%,女生19.5%）和肥胖检出率（男生17.7%,女生15.9%）差异均无统计学意义（χ2值分别为0.001,0.993,P值均〉0.05）。肥胖男童ACEs、同伴欺侮、家庭不良事件报告率高于正常体重男童。多元Logistic回归分析表明,控制积极出行方式、户外活动30 min/d、高周末视频、独生子女等协变量,总体童年期不良经历（OR=1.801,95%CI=1.055-3.074）和高家庭不良事件（OR=2.003,95%CI=1.252-3.206）是男生肥胖的危险因素,而与女童超重、肥胖关联无统计学意义。结论儿童青少年超重、肥胖受到童年期不良经历的影响。

Objective To test the association of life events in childhood with overweight risk and possible gender differences. Methods Questionnaire survey and physical examination were implemented with informed consent among boys and girls in grade 3 to grade 5 from a large-scale primary school. Information regarding adverse childhood experiences（ ACEs）,screen time and physical activity were included in the questionnaire. Body mass index was calculated and was used to classify overweight and obesity in each gender. Results Among 1 770 children aged 6. 9- 12. 3 years old（ 968 boys）,there was no gender differences in prevalence of overweight（ boys： 19. 4%; girls： 19. 5%） and obesity（ boys： 17. 7%; girls： 15. 9%）. Obese boys were more likely to report high total ACEs,high peer bullying and high family life events. No such association was found in girls. High ACEs（ OR =1. 801,95% CI = 1. 055- 3. 074） and high family life events（ OR = 2. 003,95% CI = 1. 252- 3. 206） was associated with a higher risk of obesity. No such association was found for the girls. Conclusion Children who experience many adverse childhood life events are at higher risk of being obese.