广州市高中生代谢异常流行现状及其影响因素分析

Prevalence and impact factors of metabolic disorders among the high school students in Guangzhou

目的了解广州市高中生代谢异常患病现状及其影响因素,为防控学生代谢异常提供参考。方法采用分层整群随机抽样方法,收集广州市4 620名高中生身高、体重、腰围、血压以及空腹血糖(fasting plasma glucose,FPG)、三酰甘油(triglyceride,TG)和总胆固醇(cholesterol,TC)等,通过问卷调查了解学生的家庭基本情况、疾病史、个人饮食、运动和学习等情况。结果广州市高中生中心性肥胖、高血糖、高TG/TC血症、高血压检出率分别为11.5%,6.9%,13.4%和11.6%。多因素Logistic回归分析显示,进食速度较快与中心性肥胖(OR=1.79,95%CI=1.47～2.18)、高TG/TC血症(OR=1.27,95%CI=1.04～1.54)均呈正相关,进食速度较慢与中心性肥胖(OR=0.47,95%CI=0.33～0.68)、高TG/TC血症(OR=0.71,95%CI=0.54～0.94)和高血压(OR=0.65,95%CI=0.49～0.88)均呈负相关;喝含糖饮料每天1次及以上的学生发生中心性肥胖较1～2次/周的风险高(OR=1.60,95%CI=1.08～2.38),不喝含糖饮料的学生发生高血糖较1～2次/周的风险低(OR=0.57,95%CI=0.43～0.77);不在外就餐的学生发生高TG/TC血症较在外面就餐1～2次/周的风险低(OR=0.78,95%CI=0.62～0.98),在外午餐的学生发生高TG/TC血症较在学校饭堂午餐的风险高(OR=1.38,95%CI=1.06～1.81)。结论广州市高中生代谢异常检出率高,进食速度快、喝含糖饮料多、在外就餐多是发生代谢异常的危险因素。

Objective To investigate the prevalence of metabolic disorder among the high school students in Guangzhou. Methods A cross-sectional study among 4 620 high school students selected with stratified cluster sampling was conducted in Guangzhou. Height, weight, blood pressure, fasting plasma glucose(FPG) and serum lipid of TC, TG were measured. Household socioeconomic status, medical history, physical activities as well as personal diet and study habits were acquired with structured questionnaire. Results The prevalence of central obesity was 11.5%. The overall prevalence of IFG and DM was 6.9%. The overall prevalence of both hypercholesteremia and hypertriglyceridemia was 13.4%. The prevalence of hypertension was 11.6%. With multivariable logistic regression, the results showed that: fast eating was associated with increased risk of central obesity(OR=1.79, 95%CI=1.47-2.18) and hypercholesteremia/hypertriglyceridemia(OR=1.27,95%CI=1.04-1.54). While students who ate slow had low risk of central obesity(OR=0.47, 95%CI=0.33-0.68), hypercholesteremia/hypertriglyceridemia(OR=0.71, 95%CI=0.54-0.94) and hypertension(OR=0.65, 95%CI=0.49-0.88). Students with sugar-sweetened beverages once a day or more had higher risk of central obesity(OR=1.60, 95%CI=1.08-2.38) while students without sugar-sweetened beverages consumption had low risk of IFG/DM(OR=0.57, 95%CI= 0.43-0.77) than those who consumed 1-2 times/week. Students without eating out habit had lower risk of hypercholesteremia/hypertriglyceridemia than those with eating out for 1-2 times/week(OR=0.78, 95%CI=0.62-0.98), and students who had lunch out of home or canteen had higher risk of hypercholesteremia/hypertriglyceridemia than those who ate at canteen(OR=1.38,95%CI=1.06-1.81). Conclusion The prevalence of metabolic disorder among high school students in Guangzhou is at a relatively high level. High eating speed, heavy sugared beverages intake and frequently eating out habits are associated with risk of metabolic disorder.