重庆市某主城区中小学生体型自我评价及影响因素分析

Weight perception and associated factors among primary and middle school students in urban Chongqing

目的了解重庆市某主城区中小学生体型自我评价与实际体质量指数(body mass index,BMI)评价的一致性及其影响因素,为有效实施儿童青少年肥胖健康教育及心理干预,预防和控制青少年肥胖提供科学依据。方法采用分层整群抽样的方法,抽取重庆市某主城区8所中小学共2 798名学生进行中小学生肥胖相关KAP问卷调查和体格检查。结果该区中小学生的超重肥胖检出率为22.9%,男生超重肥胖检出率(27.6%)明显高于女生(17.8%)(χ~2=24.210,P<0.01)。30.5%的中小学生不能正确评价自己的体型,小学生(Kappa=0.418)和中学生(Kappa=0.403)体型自我评价与实际BMI的一致性均较差。多因素Logistic回归分析显示,男生(OR=1.497,95%CI=1.239~1.809)、父亲文化程度高(OR=2.855,95%CI=1.053~7.741)和家庭经济差(OR=1.827,95%CI=1.340~2.492)是学生低估自我体型的危险因素;中学(OR=1.932,95%CI=1.411~2.646)、女生(OR=2.558,95%CI=1.854~3.531)、家庭经济状况差(OR=1.967,95%CI=1.131~3.422)、家庭关系差(OR=2.468,95%CI=1.324~4.600)与一般(OR=1.378,95%CI=1.003~1.894)是学生自我体型高估的危险因素。结论重庆市某主城区学生超重肥胖检出率较高,且学生对自我体型存在低估或高估,性别和家庭经济状况是可能导致体型评价错误的影响因素。

Objective To investigate weight perception and associated factors among primary and middle school students in urban Chongqing,and to provide scientific basis for obesity related health education and psychological intervention. Methods Stratified cluster sampling method was used to select 2 798 primary and middle school students in urban Chongqing. Questionnaire survey and anthropometric measurements（ height and weight） were conducted. Results The prevalence of overweight and obesity of the primary and middle school students was 22.9%,boys（ 27.6%） was significantly higher than girls（ 17.8%）（ χ^2= 24.210,P0.01）. More than a quarter of students（ 30.5%） showed discordance between weight perception and actual BMI. Low consistency was found between body self-perception and BMI,kappa was 0.418 and 0.403 for primary and middle school students,respectively.Multi-logistic regression analysis showed that boys（ OR = 1.497,95%CI = 1.239-1.809）,students with low family economic status（ OR= 1.827,95%CI： 1.340,2.492） and high paternal education level（ OR= 2.855,95%CI= 1.053-7.741） were more likely to underestimate body weight than peers. Middle school students（ OR = 1.932,95% CI = 1.411-2.646）,girls（ OR = 2.558,95% CI =1.854-3.531）,poor family relations（ OR = 2.468,95%CI = 1.324-4.600）,and those from low-income households（ OR = 1.967,95%CI = 1.131-3. 422） were more likely to overestimate. Conclusion Obesity is prevalent among students in urban Chongqing.Monitoring adolescents＇ perceived weight in addition to their BMI is critical to understanding the challenge we face with childhood obesity.