上海市中小学生肥胖和哮喘的流行特征及其影响因素(英文)

Epidemiological characteristics and influencing factors of combination of obesity and asthma in elementary and middle school students in Shanghai

  • 摘要:
    背景 研究发现肥胖和哮喘这两种疾病存在关联,肥胖伴有哮喘的学生其健康相关行为的特征尚不明确。
    目的 调查上海市中小学生肥胖和哮喘各组合流行状况及其影响因素,为中小学生肥胖及哮喘的防治提供依据。
    方法 依托2016年在上海市开展的全国常见病和健康影响因素监测项目,采取分层随机整群抽样的方法在上海市3个中心城区和3个郊区的12所小学和12所初中开展监测。使用问卷调查收集5 911名学生的过敏性疾病、健康状况及影响因素情况。用构成比描述调查对象的一般人口学特征,采用卡方检验比较肥胖、哮喘各组合人群在一般人口学特征及生活行为特征方面的差异,用多分类logistic回归分析肥胖合并哮喘的影响因素。
    结果 肥胖和哮喘患病率分别为13.2%(779/5 911)、8.8%(519/5 911)。男生(17.9%,10.3%)均高于女生(8.3%,7.2%)(均P < 0.05)。肥胖合并哮喘患病率为1.42%(84/5 911),男生(2.1%)高于女生(0.8%)(χ2=18.42,P < 0.001),城区(1.9%)高于郊区(1.0%)(χ2=8.40,P < 0.01)。多分类logistic回归分析显示性别、地区、哮喘家族史、二手烟暴露与肥胖合并哮喘风险相关(均P < 0.05):即女生、居住在郊区可降低学生患肥胖合并哮喘的风险,OR(95% CI)分别为0.309(0.188~0.506)、0.520(0.324~0.834);而有哮喘家族史、二手烟暴露因素可增加该风险,OR(95% CI)分别为2.916(1.810~4.699)、2.122(1.237~3.640)。此外,二手烟暴露、甜食摄入也会增加肥胖的风险,其OR(95% CI)分别为1.473(1.178~1.841)、1.542(1.411~1.713)。
    结论 上海市中小学生肥胖率和哮喘率水平较高。除了性别、居住地和家族史之外,二手烟暴露也是肥胖合并哮喘潜在的影响因素。本次研究未发现肥胖合并哮喘的学生在运动、膳食等方面与正常儿童有差异。

     

    Abstract:
    Background Studies have found an association between obesity and asthma, but the characteristics of health-related behaviors in obese students with asthma are poorly understood.
    Objective This study is conducted to investigate the prevalence and influencing factors of comorbidity between obesity and asthma in elementary and middle school students in Shanghai and to provide evidence for the prevention and treatment of such disease in the students.
    Methods Based on the Chinese National Common Diseases and Health Influencing Factors Monitoring Project conducted in Shanghai in 2016, a stratified cluster random sampling method was used to select 12 elementary schools and 12 middle schools in 3 urban and 3 suburban areas in Shanghai. A questionnaire survey was conducted to collect information on allergic diseases, obesity, and related influencing factors of 5 911 students. Proportion was used to describe the distribution of selected demographic characteristics of the subjects. Chi-square test was used to compare the differences in demographic characteristics and lifestyles of the control group, the obesity group, the asthma group, and the obesity with asthma group. Multinomial logistic regression was used to analyze the influencing factors of obesity combined with asthma.
    Results The prevalence rates of obesity and asthma were 13.2% (779/5 911) and 8.8% (519/5 911), respectively. The boys (17.9%, 10.3%) showed higher prevalence rates of obesity and asthma than the girls (8.3%, 7.2%) (P < 0.05). The prevalence of obesity with asthma was 1.4%, significantly higher in the boys (2.1%) than in the girls (0.8%) (χ2=18.42, P < 0.001), and higher in the urban areas (1.9%) than in the suburban areas (1.0%) (χ2=8.40, P < 0.01). The multinomial logistic regression analysis results showed that gender, residence, family history of asthma, and secondhand smoke exposure were associated with the risk of obesity combined with asthma (P < 0.05); namely, girls and living in suburban areas reduced the risk of reporting obesity with asthma, with OR (95% CI) of 0.307 (0.188-0.506) and 0.520 (0.324-0.834), respectively, and having a family history of asthma and being exposed to secondhand smoke increased the risk of obesity with asthma, with OR(95% CI) of 2.916(1.810-4.699) and 2.122(1.237-3.640), respectively. In addition, being exposed to secondhand smoke exposure and sweet food intake increased the risk of obesity, with OR (95% CI) of 1.473 (1.178-1.841) and 1.542 (1.411-1.713), respectively.
    Conclusion High obesity rate and asthma rate of elementary and middle school students are found in Shanghai. Besides gender, residence, and family history, secondhand smoke exposure is also a potential factor affecting obesity combined with asthma. In this study, there is no significant difference in exercise and diet between students of obesity with asthma and those without the comorbid condition.

     

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