北京市东城区儿童抑郁症状与肥胖的相关性研究

Study on the association between depressive symptoms and obesity among children in Dongcheng district,Beijing

目的研究儿童抑郁症状与肥胖的相关性,为儿童肥胖及心理干预提供科学依据。方法 2013年9月方便抽取北京市东城区12所小学的1 412名三~五年级学生,通过儿童抑郁量表(CDI)调查学生的抑郁水平。根据'中国学龄儿童青少年BMI超重、肥胖筛查标准'判定学生是否超重/肥胖。通过t检验、χ~2检验和混合线性模型分析抑郁评分与体重指数(BMI)和BMI-Z评分的关系,抑郁症状与肥胖的关系,抑郁症状与性别的交互作用对肥胖的发生是否有影响。结果 1 412名7~11岁学生平均抑郁评分为(9.75±6.38)分。13.1%男生和6.7%女生有抑郁症状。有抑郁症状学生中28.6%为肥胖,无抑郁症状学生中18.7%为肥胖,差异有统计学意义(P<0.05)。控制学校、年龄和性别因素后,学生抑郁评分每增加1分,BMI增加0.04(95%CI:0.01~0.07)kg/m^2,BMI-Z评分增加0.01(95%CI:0.001~0.020)。与无抑郁症状学生相比,有抑郁症状学生发生肥胖的风险显著增加(OR=1.54,95%CI:1.03~2.29)。抑郁症状与性别对肥胖的发生存在相加交互作用。结论儿童抑郁症状与肥胖相关,应多加关注肥胖儿童心理问题,及时进行心理干预。

Objective To study the association between depressive symptoms and obesity among primary school students,in order to provide evidence for interventions on childhood obesity and mental health.Methods A cross-sectional survey was conducted in 12 primary schools of Dongcheng district in Beijing.A total of 1 412 students in Grade 3 to 5 were selected to self-report depressive symptoms through Childhood Depression′s Inventory(CDI).Students′nutritional status was classified based on Chinese standards.The t tests,Pearson chi-square tests and linear mixed model were used to analyze the relationship between depression scores,body mass index(BMI)and BMI-Z,depressive symptoms and obesity,and to know about whether gender and depressive symptoms had additive effects on obesity.Results The average score of depressive symptoms was 9.75±6.38 in 1 412 participants aged 7 to 11 years.The prevalence rates of students with depressive symptoms were 13.1%and 6.7%for boys and girls,respectively.And 28.6%of students with depressive symptoms were obese,while it was 18.7%in students without depressive symptoms,and the difference was significant(P<0.05).After adjusting school,age and gender,BMI and BMI-Z increased by 0.04(95%CI:0.01-0.07)and 0.01(95%CI:0.001-0.020)when depression scores increased by 1.Compared with students without depressive symptoms,the risk of developing obesity among students with depressive symptoms rose significantly(OR=1.54,95%CI:1.03-2.29).The combined effect of gender and depressive symptoms on obesity was found to be significant.Conclusions Depressive symptoms are associated with obesity in children.More attention should be paid to mental health in obese children,and it is suggested to give high-risk children psychological intervention.