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中国循证儿科杂志

中国循证儿科杂志 ›› 2024, Vol. 19 ›› Issue (5): 355-359.DOI: 10.3969/j.issn.1673-5501.2024.05.007

• 论著 • 上一篇    下一篇

等时替代模型下身体活动与儿童青少年肌肉发育的横断面调查

黄子微，邓钰莹，梁晓潼，陈淼，潘顺，张泽辉，刘丽   

  1. 广东药科大学公共卫生学院流行病与卫生统计学系广州，510310



  • 收稿日期:2024-12-23 修回日期:2024-12-23 出版日期:2024-10-25 发布日期:2024-10-25
  • 通讯作者: 刘丽

Association analysis between physical behaviors and muscle development among children and adolescents under the iso-temporal substitution model: A cross-sectional survey

HUANG Ziwei, DENG Yuying, LIANG Xiaotong, CHEN Miao, PAN Shun, ZHANG Zehui, LIU Li   

  1. Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China
  • Received:2024-12-23 Revised:2024-12-23 Online:2024-10-25 Published:2024-10-25
  • Contact: LIU Li, email: pupuliu9191@163.com

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摘要： 背景：当前研究多在传统回归模型下探讨单一行为对肌肉健康的影响，忽略了身体活动时间变化上的联系，等时替代模型可更精准地量化身体活动时间变化对肌肉产生的综合效应。 目的：在等时替代模型下探讨广州市儿童青少年中不同身体活动与肌肉发育的关联。 设计：横断面调查。 方法：于2020年11月至2021年6月以分层整群抽样的方法选取7 767名6~17岁广州市儿童青少年进行身体活动的问卷调查，采用生物电阻抗技术测量去脂体重和四肢骨骼肌质量。基于多重线性回归，以每天30 min为替代单位，在等时替代模型下评估中高强度运动（MVPA）、低强度运动（LPA）或睡眠等时替代久坐对肌肉发育指标的效应。 主要结局指标：去脂体重指数（FFMI）、去脂体重百分比（FFM%）和四肢骨骼肌百分比（ASMM%）。 结果：每天用30 min的MVPA等时替代久坐，FFMI、FFM%和ASMM%的Z值分别增加0.08、0.04和0.07（P均<0.05）。以每天30 min睡眠等时替代久坐后，FFMI Z值降低0.04个标准差（P<0.05），FFM% Z值则上升0.03个标准差（P>0.05）。性别和小学/中学分层分析显示出类似结果，且各亚层间差异无统计学意义。 结论：每天30 min的MVPA替代久坐与FFM、ASMM增长存在关联，用每天30 min的睡眠替代久坐亦可能与全身肌肉发育存在正向关联。

关键词: 等时替代模型, 身体活动, 肌肉发育, 儿童青少年

Abstract: Background: Current research mostly explored the effect of single behavior on muscle development under traditional regression models, ignoring the temporal relationship between behavior changes. The iso-temporal substitution model can accurately quantify the comprehensive effect of all behavior changes on muscle development. Objective: To explore the association between different physical behaviors and muscle development in children and adolescents in Guangzhou based on the iso-temporal substitution model. Design: ross-sectional survey. Methods: A total of 7,767 children and adolescents aged 6-17 years were enrolled in Guangzhou between November 2020 and June 2021. Questionnaire survey was conducted to collect information on physical activity, sleep, and sedentary behaviors. Body compositions were measured using bioelectrical impedance analysis. Based on linear regression model, iso-temporal substitution model was conducted to evaluate the effect estimates for substitution of sedentary behavior with moderate-vigorous physical activity(MVPA), light physical activity(LPA), or sleep on muscle development, with 30 min·d-1 as the substitution unit. Main outcome measures: Fat-free mass index (FFMI), fat-free mass percentage (FFM%), and appendicular skeletal muscle mass percentage (ASMM%). Results: Replacing 30min of sedentary behavior with MVPA per day significantly increased the Z-scores of FFMI, FFM%, and ASMM% by 0.08, 0.04, and 0.07 units (all P<0.05), respectively. Replacing sedentary behavior with 30 min·d-1 of sleep duration was significantly associated with decrease of FFMI Z score (β=0.04, P<0.05) and increase of FFM% Z score (β=0.03, P>0.05). The stratification analysis by gender and grade level showed similar results, with no significant heterogeneity between subgroups. Conclusion: Replacing sedentary behavior with 30 min of MVPA per day is associated with the increase of FFM and ASMM. The iso-temporal substitution of sedentary behavior with sleep may also be positively associated with muscle development.

Key words: Iso-temporal substitution model, Physical activity behavior, Muscle development, Children and adolescents