深圳市20~49岁备孕人群心理压力与体质指数关系

Association of psychological stress with body mass index among 20-49 years old persons with fertility intention in Shenzhen city

目的探讨备孕人群心理压力与体质指数的关系。方法以2013年1月—2019年12月在深圳市参加国家免费孕前优生健康检查项目的625010名备孕人群作为研究对象,通过问卷调查和体格检查收集基本人口学特征、社会心理压力、体质指数(BMI)等相关信息,使用多元logistic回归模型分析心理压力与体质指数的关系。结果体重过低(BMI<18.5)、正常(BMI=18.5~23.9)、超重(BMI=24.0~27.9)、肥胖者(BMI≥28.0)分别为77692人(12.43%)、384963人(61.59%)、130086人(20.81%)和32269人(5.16%);自报心理压力大者80892人,占12.94%。与心理压力正常者相比,心理压力大的备孕人群发生体重过低、超重和肥胖的概率分别升高4%(OR=1.04,95%CI=1.01~1.07)、7%(OR=1.07,95%CI=1.05~1.10)和18%(OR=1.18,95%CI=1.14~1.23)。年龄分层分析结果显示,与同年龄组心理压力正常者相比,20~29岁、30~39岁备孕人群心理压力大者发生体重过低、超重和肥胖的概率均有不同程度升高;而40~49岁备孕人群心理压力大者发生体重过低的概率升高,但在超重和肥胖组中,心理压力与体质指数无关。性别分层分析结果显示,与同性别心理压力正常者相比,心理压力大的女性发生肥胖和超重的概率更高,而心理压力大的男性发生肥胖和体重过轻的概率更高。结论备孕人群心理压力大者体质指数异常概率升高,在不同年龄组和不同性别间有所不同。针对备孕人群的心理健康与体重控制应制定精细化管理策略。

Objective To explore the association between psychological stress and body mass index(BMI)among the persons with fertility intention.Methods The 625010(307002 male and 318008 female)participants of the study were 20-49 years old individuals having pre-parental eugenic health examinations free of charge during the period from January 2013 to December 2019 in Shenzhen city,Guangdong province.Questionnaire interview was conducted among the participants to collect information on demographics and psychological condition.According to the Guidelines of Overweight and Obesity Prevention and Control for Chinese Adults,the BMI is less than 18.5 for underweight,18.5-23.9 for normal weight,24.0-27.9 for overweight,and more than 28.0 for obesity.Unconditional logistic regression model was used to analyze the association of psychological stress with BMI.Results Among all the participants,384963(61.59%)were with normal weight and the number(proportion)of underweight,overweight,and obesity were 77692(12.43%),130086(20.81%),and 32269(5.16%),respectively.There were 80892(12.94%)of the participants were assessed as having psychological stress.Logistic regression analysis showed that the participants with psychological stress were at increased risks of underweight(odds ratio[OR]=1.04,95%confidence interval[95%CI]:1.01-1.07),overweight(OR=1.07,95%CI:1.05-1.10),and obesity(OR=1.18,95%CI:1.14-1.23)compared to those without the stress.In age-and gender-specific subgroup analysis,the psychological stress-related risk increment of overweight and obesity were not significant for the participants aged 40-49 years;the female participants were at higher increased risks of psychological stress-related overweight and obesity than the male participants;but the male participants were at higher increased risks of psychological stress-related obesity and underweight than the female participants.Conclusion Psychological stress is associated with increased risk of abnormal BMI and there are age and gender differences for the psychological stress-related BMI abnormality among 20-49 years old people with fertility intention.