中国9-11岁小学生体育锻炼、静态行为和超重与肥胖的关系

Association of physical activities,sedentary behaviors with overweight / obesity in 9-11 year-old Chinese primary school students

目的：研究全国9-11岁小学生体育锻炼、静态行为和超重与肥胖的关系,并探索是否存在性别差异以及各省的异质性,为预防和控制超重与肥胖提供科学依据。方法：选取2010年全国学生体质健康调研资料中40 692名9-11岁汉族小学生,利用学生的身高、体重数据以及体育锻炼、视屏行为以及做家庭作业的时间数据,在不同性别的学生中分析体育锻炼、静态行为与超重与肥胖的关系,并采用Meta分析检验这些相关性在各省之间的异质性。结果：男生的超重与肥胖检出率高于女生（分别为27.1%和12.9%）,城市学生的超重与肥胖检出率高于农村学生（分别为23.8%和15.6%）,学生超重与肥胖检出率在＂好＂、＂中＂、＂差＂3类经济片区中分别为22.6%,19.2%和17.5%。男生每天体育锻炼时间≤1 h的学生的超重与肥胖率高于每天体育锻炼时间〉1 h的学生,OR值为1.09（95%CI：1.02,1.17）。女生每天视屏行为时间〉1 h、每天做家庭作业的时间〉2 h是超重与肥胖的危险因素,OR值分别为1.13（95%CI：1.02,1.26）、1.18（95%CI：1.03,1.35）,女生每天静态行为时间〉135 min的学生超重与肥胖率较高,OR值为1.19（95%CI：1.08,1.33）。男生每天体育锻炼时间≤1 h、女生每天静态行为时间〉135 min对超重与肥胖的OR值在各省之间的异质性差异均没有统计学意义（P〉0.05）。结论：小学生体育锻炼、静态行为时间和超重与肥胖有关,其关联存在性别差异,没有发现各省之间的异质性,未来应该针对不同性别的特点开展肥胖防控工作。

Objective： To explore the association of physical activities,sedentary behaviors with overweight / obesity in Chinese children aged 9- 11 years,analyze the gender difference and heterogeneity of the association across different provinces,and provide evidence for prevention and control of overweight and obesity. Methods： Using the data of 40 692 children aged 9- 11 years from Chinese National Survey on Students＇ Constitution and Health in 2010,the height and weight were measured and the time spent in physical activities,screen behaviors and homework were collected. We analyzed the associations among physical activities,sedentary behaviors and overweight / obesity in boys and girls separately,and assessed the heterogeneity of associations across different provinces with Meta-analysis. Results： The prevalence of overweight / obesity of the boys（ 27. 1%） was higher than that of the girls（ 12. 9%）,compared with the rural students（ 15. 6%）,the situation of overweight / obesity of the urban students（ 23. 8%） was more serious,the prevalences of overweight / obesity were separately 22. 6%,19. 2% and 17. 5% among developed,middle-developed and undeveloped social economic status subgroups. The boys with physical activities no more than 1 hour per day were more likely to be overweight / obese,with the OR of 1. 09（ 95% CI： 1. 02,1. 17）. The girls with screen time more than 1 hour per day or homework time more than 2 hours per day were more likely to be overweight / obese,with the ORs of 1. 13（ 95% CI： 1. 02,1. 26） and 1. 18（ 95% CI： 1. 03,1. 35） respectively. The high level of sedentary behaviors（ more than135 min per day） was associated with overweight / obese in the girls,and the OR was 1. 19（ 95% CI：1. 08,1. 33）. There was no significant heterogeneity of effect values between physical activities and overweight / obesity in the boys and between sedentary behaviors and overweight / obesity in the girls across the different provinces（ P〈0. 05）. Conclusion： The associations among physical activities,sedentary behaviors and overweight / obesity existed in Chinese children aged 9- 11 years,which were different in boys and girls. There was no statistically significant heterogeneity across different provinces. The strategies to prevent and control overweight / obesity in primary school students should focus on gender-specific needs.