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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): 385-391.DOI: 10.3969/j.issn.1673-5501.2024.05.012

• 论著 • 上一篇    下一篇

广州市儿童青少年健康生活行为指数与肥胖表型的横断面调查

邓钰莹,梁晓潼,陈淼,黄子微,纪吉婷,张泽辉,龙佳仪,潘顺,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:2024-10-25 修回日期:2024-10-25 出版日期:2024-10-25 发布日期:2024-10-25
  • 通讯作者: 刘丽

Association between healthy lifestyle behavioral index and obesity phenotypes of children and adolescents in Guangzhou: A cross-sectional survey

DENG Yuying, LIANG Xiaotong, CHEN Miao, HUANG Ziwei, JI Jiting, ZHANG Zehui, LONG Jiayi, PAN Shun, LIU Li   

  1. School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China
  • Received:2024-10-25 Revised:2024-10-25 Online:2024-10-25 Published:2024-10-25
  • Contact: LIU Li

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摘要： 背景：我国儿童青少年超重肥胖率不断升高，现有研究多探讨单一生活行为对体成分的影响，缺乏综合生活行为与儿童青少年体成分的关联情况。 目的：探讨儿童青少年健康生活行为指数与体成分的关联。 设计：横断面调查。 方法：研究对象为广州市中小学2019年4月在校的6~17岁学生。采用Hologic DiscoveryA型双能X线骨密度仪进行体成分测量，并通过自制问卷调查学生的健康生活行为，根据睡眠充足、适度静态行为时间、充足的中高强度运动、天天吃早餐、天天吃蔬菜、天天吃水果、无含糖饮料摄入7个条目评价健康生活行为指数，并根据总分（0~7分）划分等级：低（0~2分）、中（~4分）、高（~7分）。采用多重线性回归模型分析健康生活行为指数及其等级与体成分指标（Z值）的关联。 主要结局指标：全身和中心脂肪蓄积，全身和四肢肌肉水平。 结果：1 703名6~17岁学生中男生924名（54.3%），女生779名（45.7%）。调整了年龄、父母最高文化程度和家庭年收入后，在男生中，健康生活行为指数与骨骼肌质量指数（MMI）和四肢骨骼肌质量指数（ASMI）呈正关联（β均=0.07，95%CI均为0.02~0.12），以低级行为指数为对照，中、高级指数与MMI（β中级=0.22；β高级=0.30）和ASMI（β中级=0.22；β高级=0.29）的Z值增加存在关联；在女生中，健康生活行为指数与体脂率（BF%）、内脏脂肪面积（VFA）和脂肪肌肉比（FMR）的 Z值存在负关联（β均为-0.07，95%CI均为-0.12 ~-0.01），以低级健康生活行为指数为对照，高级指数与BF%、VFA和FMR 的Z值降低存在关联，β系数分别为-0.29、-0.29和-0.28。年龄分层分析显示，在青春期男生（12~17岁）和女生（10~17岁）中，以上健康生活行为指数与体成分指标的关联仍然存在。 结论：健康生活行为指数与男生肌肉质量增长及女生的全身和中心脂肪蓄积减少存在关联，且这些关联在青春期更显著。

关键词: 儿童青少年, 生活行为, 体成分

Abstract: Background: The prevalence of overweight and obesity among children and adolescents in China is increasing. Existing studies have mostly explored the effects of single lifestyle behaviors on body composition, lacking evidence about the association between integrated lifestyle behaviors and body composition. Objective: To explore the association between healthy lifestyle behavior index and body composition in children and adolescents. Design: Crosssectional survey. Methods: This study enrolled 1,703 students aged 6 to 17 years in April 2019 in a middle school and an elementary school in Guangzhou. Body composition was measured by dualenergy Xray absorptiometry, and a questionnaire survey was performed to collect information about lifestyle behaviors. The healthy lifestyle behavior index was constructed based on seven items, including adequate sleep, moderate sedentary behavioral time, adequate moderate to vigorousintensity activity, daily breakfast, daily vegetables, daily fruits, and no intake of sugarsweetened beverages. For each item meeting, one point was assigned, and the healthy lifestyle behavior index is the total sum of all points achieved, which was further divided into three levels: low (02 points), medium (4 points), and high (7 points). Multiple linear regression models were performed to analyze the association of the healthy lifestyle behavior index and its levels with body composition (Zscores). Main outcome measures: Total body and central adiposity, whole body and appendicular muscle mass. Results: Of the 1,703 students aged 617 years, 924 (54.3%) were boys and 779 (45.7%) were girls. In the statistical analysis, adjustments were made for the age of children and adolescents, the highest educational level of their parents, and annual family income. In boys, the healthy lifestyle behavior index was positively associated with the muscle mass index (MMI) and the appendicular skeletal muscle mass index (ASMI) (all βs=0.07, both 95%CI=0.02 0.12). Compared to the lowlevel behavioral index, the medium and highlevel indices were associated with increased Zscores for MMI (βmedium=0.22; βhigh=0.30) and ASMI (βmedium=0.22; βhigh=0.29). In girls, the healthy lifestyle behavior index was negatively associated with Zscores for BF%, VFA, and FMR (all β=-0.07, all 95%CI=-0.12  -0.01). Compared to the lowlevel index, there was an association between the highlevel index and lower Zscores for BF%, VFA, and FMR, with β coefficients of -0.29, -0.29, and -0.28, respectively. When stratified by age groups, the associations between the healthy lifestyle behavior index and body composition remained statistically significant in pubertal boys (1217 years old) and girls (1017 years old). Conclusion: Healthy lifestyle behavior index is associated with an increase in muscle mass in boys and decreases in total body and central adiposity in girls.

Key words: hildren and adolescents, Lifestyle behaviors, Body composition