中国6~18岁儿童青少年体质量指数实测及自评影响因素

Secular trend of BMI and its consistency with self-rated BMI status among Chinese children and adolescents

目的分析中国儿童青少年体质量指数(BMI)变化趋势与自评BMI的一致性及影响自评BMI的相关因素,以期为相应干预措施的制定提供科学依据。方法以"中国健康与营养调查"2000—2015年6轮调查资料中6 238名6~18岁儿童青少年作为研究对象,采用偏度-均值-变异系数(LMS)法揭示BMI变化规律,采用χ2检验和Kappa一致性检验评价其与自评体重的偏差,采用多元Logistic回归模型分析影响体型自我评价的相关因素。结果 2000—2015年儿童青少年BMI百分位数曲线P50和P85均显示增高趋势,且高百分位增幅更大。无论年龄和性别,实测BMI与自评体重一致性较差(Kappa<0.3),50%以上的消瘦和超重(除13~18岁女生)调查对象误认为自身体重正常,约1/4体重正常调查对象误以为自身体重异常。城市男生更易自评体重偏瘦[OR值(95%CI)=1.43(1.18~1.73)],喜欢流行节目[OR值(95%CI)=1.80(1.23~2.55)]和卡通/动漫[OR值(95%CI)=1.39(1.00~1.96)]的男生更易自评体重超重。高年龄组[OR值(95%CI)=2.74(2.08~3.61)]、城市[OR值(95%CI)=1.53(1.21~1.94)]、喜欢流行节目[OR值(95%CI)=1.74(1.27~2.38)]的女生更易自评体重超重;喜欢动漫/卡通节目的女生更会认为自身体重偏瘦[OR值(95%CI)=1.78(1.33~2.40)]。结论过去十多年来中国儿童青少年BMI呈现升高趋势,且与自评BMI偏差较大,年龄、现住地和喜欢视频节目类型会影响体重的自我评价。

Objective To describe the secular trend of BMI and its consistency with self-rated BMI status in Chinese children and adolescents,and to further investigate the related factors affecting self-rated BMI,so as to provide a scientific reference for interventional measures. Methods A total of 6 238 children and adolescents aged 6-18 years were selected according to date from Chinese Health and Nutrition Svrvey during 2000-2015 and the criteria from National Health Commission of China. The LambdaMu-Sigma method( LMS) and Kappa consistency test were,respectively,applied to describe the percentiles for BMI and its agreement with self-rated BMI status. Multinomial Logistic model was used to assess the related factors influencing self-rated BMI status.Results P50 and P85 percentiles showed an increasing trend,especially the increase of high percentile of BMI. Regardless of age and sex,the measured and self-rated BMI showed low agreement. More than 50% of over-weighted or underweighted children perceived themselves as normal-weight,and about 1/4 of normal weight students misclassified themselves as abnormal in weight. Urban boys were more likely to evaluate themselves as underweight [OR( 95% CI) = 1. 43( 1. 18-1. 73) ]. Boys who favored popular showed[OR( 95%CI) = 1.80( 1.23-2.55) and cartoon [OR( 95% CI) = 1.39( 1.00-1.96) ] were more likely to consider themselves as overweight. Girls in the older age group [OR( 95%CI) = 2.74( 2.08-3.61) ]and urban [1.53( 1.21-1.94) ]who favored popular programs [OR( 95%CI) = 1.74( 1.27-2.38) ] were more likely to perceived themselves as overweight. But girls who like anime/cartoons were more likely to think they were underweight [OR( 95% CI) = 1.78( 1.33-2.40) ]. Conclusion The trend of BMI has shown an increasing trend in the past decade and it demonstrated a large bias with perceived BMI. Age,area and type of video were significant factors that influenced the self-rated BMI status.