Article(id=1311350009619116066, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349984730116963, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202601069, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1767542400000, receivedDateStr=2026-01-05, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1790579805997, onlineDateStr=2026-09-28, pubDate=1784908800000, pubDateStr=2026-07-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1790579805997, onlineIssueDateStr=2026-09-28, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1790579805997, creator=13701087609, updateTime=1790579805997, updator=13701087609, issue=Issue{id=1311349984730116963, tenantId=1146029695717560320, journalId=1227665162245664772, year='2026', volume='53', issue='14', pageStart='2497', pageEnd='2688', issueExtLink='null', onlineDate='null', pubDate='1784908800000', pubDateStr='2026-07-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1790579800064, creator='13701087609', updateTime=1790588348354, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1311385838924169506, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349984730116963, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1311385838924169507, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1311349984730116963, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2531, endPage=2537, ext={EN=ArticleExt(id=1311350009833025571, articleId=1311350009619116066, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Intestinal microbial characteristics in patients with advanced diabetic nephropathy based on metagenomics, columnId=1228016567443718970, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods Advances, runingTitle=null, highlight=null, articleAbstract=
Objective To explore the differences in the composition and function of intestinal microbiota among healthy individuals, patients with diabetes, and those with diabetic nephropathy, and to analyze the characteristics of intestinal flora imbalance in patients with advanced diabetic nephropathy, providing references for the mechanism research and prevention and treatment strategy formulation of this disease.
Methods A total of 32 patients with advanced diabetic nephropathy, 79 patients with diabetes mellitus and 55 healthy controls were enrolled from the West China Fourth Hospital and Southwest China natural population cohort. Clinical data were collected and fecal samples were subjected to metagenomic sequencing. Linear discriminant analysis was used to screen for differentially abundant species and functional pathways. Linear regression analysis was performed to investigate the correlation between population phenotypes and differentially abundant species. Random forest and SPIEC-EASI algorithms were used to establish species classifiers and interaction networks, respectively.
Results There were significant differences in the β-diversity of the intestinal microbiota among the three groups, but no statistically significant differences were observed in the α-diversity. In the advanced stage of diabetic nephropathy patients, the intestines were enriched with various opportunistic pathogenic bacteria (such as Eggerthella lenta, Clostridium innocuum, Hungatella hathewayi, etc.) and harmful pathways such as anaerobic energy metabolism and L-histidine degradation, and were significantly correlated with renal function indicators. The intestines of diabetic patients were characterized by the enrichment of opportunistic pathogenic bacteria (such as Escherichia coli and Klebsiella pneumoniae) and the activation of glycolytic pathways. The random forest model performed best in differentiating the diabetic nephropathy group from the healthy control group (AUC=0.920). The co-abundance network analysis further revealed that the intestinal microbial interaction network of diabetic nephropathy patients was significantly sparser and the topological parameters changed, suggesting that there was an imbalance in the microbial ecological network during the disease process.
Conclusion From diabetes to the advanced stage of diabetic nephropathy, the intestinal microbiota shows a progressive functional disorder, with an increase in the abundance of harmful bacterial species and metabolic pathways, which is closely related to the progression of the disease.
, authors=Yi CAO, Yu-qi ZHANG, Lin DENG, Na GUO, Jin-li TUO, Lin XIONG, Pei-bin ZENG, Zhong LI, authorsList=Yi CAO, Yu-qi ZHANG, Lin DENG, Na GUO, Jin-li TUO, Lin XIONG, Pei-bin ZENG, Zhong LI, authorCompany=null, correspAuthors=Zhong LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1311350013452709944, articleId=1311350009619116066, tenantId=1146029695717560320, journalId=1227665162245664772, language=CN, title=基于宏基因组学的糖尿病肾病晚期患者肠道微生物特征分析, columnId=1228016567632462653, journalTitle=现代预防医学, columnName=流行病与统计方法, runingTitle=null, highlight=null, articleAbstract=
目的 探究健康人群、糖尿病以及糖尿病肾病患者之间的肠道微生物组成和功能差异，解析晚期糖尿病肾病患者肠道菌群失调特征，为该病的机制研究与防治策略制定提供参考。
方法 纳入来自华西第四医院和西南区域自然人群队列的32例糖尿病肾病晚期患者、79例糖尿病患者和55名健康对照，收集临床资料并进行粪便样本宏基因组测序。通过线性判别分析筛选差异物种和功能通路，使用线性回归分析人群表型与差异物种之间的相关性，并利用随机森林和SPIEC-EASI算法分别建立物种分类器和互作网络。
结果 三组间肠道菌群β多样性存在显著差异，但α多样性无统计学差异。糖尿病肾病晚期患者组肠道中富集多种机会性致病菌（如Eggerthella lenta、Clostridium innocuum、Hungatella hathewayi等）及厌氧能量代谢、L-组氨酸降解等有害通路，且与肾功能指标显著相关。糖尿病患者肠道则以条件致病菌（如Escherichia coli和Klebsiella pneumoniae）富集及糖酵解通路激活为特征。随机森林模型在区分糖尿病肾病组与健康对照组时表现最佳（AUC=0.920）。共丰度网络分析进一步揭示，糖尿病肾病患者的肠道微生物互作网络显著稀疏化，且拓扑参数发生改变，提示疾病进程中存在微生物生态网络的失调。
结论 从糖尿病到糖尿病肾病晚期，肠道菌群呈现渐进式功能失调，有害菌种及代谢通路丰度上升，与疾病进展密切相关。
, authors=曹易, 张宇骐, 邓林, 郭娜, 庹金丽, 熊琳, 曾沛斌, 李钟, authorsList=曹易, 张宇骐, 邓林, 郭娜, 庹金丽, 熊琳, 曾沛斌, 李钟, authorCompany=null, correspAuthors=李钟, authorNote=
曹易（2002—），男，硕士在读，研究方向：微生物、公众健康与检验
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本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=he55wYMIFIiy3B2vSrr5qQ==, magXml=0cDbsMvQM6U4VQYs47vbvg==, pdfUrl=null, pdf=s4JSEXp48OvuNops+RPbTw==, pdfFileSize=1763286, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=KnO39ongaKrniUnoiRWROg==, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=PrDRP2DWneHOtvu0YFYx+A==, mapNumber=null, fund=null)}, authors=[Author(id=1311350013758894141, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, orderNo=0, firstName=null, middleName=null, lastName=null, nameCn=null, orcid=null, stid=null, country=null, authorPic=null, dead=0, email=null, emailSecond=null, emailThird=null, correspondingAuthor=0, authorType=1, ext={EN=AuthorExt(id=1311350013851168831, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, authorId=1311350013758894141, language=EN, stringName=Yi CAO, firstName=Yi, middleName=null, lastName=CAO, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China, bio=null, bioImg=null, bioContent=null, aboutCorrespAuthor=null), CN=AuthorExt(id=1311350013943443520, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, authorId=1311350013758894141, language=CN, stringName=曹易, firstName=null, middleName=null, lastName=null, prefix=null, suffix=null, authorComment=null, nameInitials=null, affiliation=null, department=null, xref=null, address=四川大学华西公共卫生学院/华西第四医院，四川 成都 610041, bio={"content":"
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13(11): e0070024., articleTitle=Complete genome sequences of Chitinophaga sp. strain MM2321 and Microbacterium sp. strain MM2322, isolated from a sand sample in Harsewinkel, Germany, refAbstract=null), Reference(id=1311350020570443917, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, doi=null, pmid=null, pmcid=null, year=2015, volume=53, issue=1, pageStart=302, pageEnd=308, url=null, language=null, rfNumber=[22], rfOrder=22, authorNames=Marques AC, Paludo KS, Dallagassa CB, journalName=Journal of Clinical Microbiology, refType=null, unstructuredReference=
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53(1): 302-308., articleTitle=Biochemical characteristics, adhesion, and cytotoxicity of environmental and clinical isolates of Herbaspirillum spp, refAbstract=null), Reference(id=1311350020633358478, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, doi=null, pmid=null, pmcid=null, year=1998, volume=64, issue=8, pageStart=3110, pageEnd=3113, url=null, language=null, rfNumber=[23], rfOrder=23, authorNames=Tanner MA, Goebel BM, Dojka MA, journalName=Applied and Environment Microbiology, refType=null, unstructuredReference=
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64(8): 3110-3113., articleTitle=Specific ribosomal DNA sequences from diverse environmental settings correlate with experimental contaminants, refAbstract=null)], funds=[Fund(id=1311350018813030518, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, awardId=2024ZYD0098, language=CN, fundingSource=四川省科技厅-中央引导地方科技发展项目(2024ZYD0098), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1311350013666619449, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, xref=null, ext=[AuthorCompanyExt(id=1311350013679202362, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, companyId=1311350013666619449, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China), AuthorCompanyExt(id=1311350013687590971, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, companyId=1311350013666619449, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=四川大学华西公共卫生学院/华西第四医院，四川 成都 610041)])], figs=[ArticleFig(id=1311350016141258858, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=EN, label=Fig.1, caption=
Comparison of diversity indices (A) Shannon index (B) Simpson index (C) PCoA visualization of beta diversity, figureFileSmall=FFJ8a1JJGsOwMkzNxFnsOg==, figureFileBig=KnO39ongaKrniUnoiRWROg==, tableContent=null), ArticleFig(id=1311350016208367723, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=CN, label=图1, caption=
多样性指数比较（A）Shannon指数（B）Simpson指数（C）PCoA可视化beta多样性, figureFileSmall=FFJ8a1JJGsOwMkzNxFnsOg==, figureFileBig=KnO39ongaKrniUnoiRWROg==, tableContent=null), ArticleFig(id=1311350017974169708, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=EN, label=Fig.2, caption=
LEfSe analysis of differential species and differential pathways (A) Species-level differences (B) Metabolic pathway differences, figureFileSmall=E4wDg98Ql86hvelFiidsiA==, figureFileBig=F50qtaU+UD6MjZQPgxJirw==, tableContent=null), ArticleFig(id=1311350018066444397, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=CN, label=图2, caption=
差异物种和差异通路LEfSe分析（A）种水平差异（B）代谢通路差异, figureFileSmall=E4wDg98Ql86hvelFiidsiA==, figureFileBig=F50qtaU+UD6MjZQPgxJirw==, tableContent=null), ArticleFig(id=1311350018146136174, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=EN, label=Fig.3, caption=
Heatmap of differential species related to phenotypes calculated using linear regression, figureFileSmall=ecvQOcZZRD9Kq71HfFl/5A==, figureFileBig=P5dUPnQ+i6QbyHfW+LNMgQ==, tableContent=null), ArticleFig(id=1311350018230022255, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=CN, label=图3, caption=
利用线性回归计算与表型相关的差异物种热图注：对原始物种丰度执行中心对数比转换（CLR），校正年龄、性别、BMI及粪便性状等潜在混杂变量；并采用分层聚类，通过关联Z分数（Z-score）聚类差异物种。
, figureFileSmall=ecvQOcZZRD9Kq71HfFl/5A==, figureFileBig=P5dUPnQ+i6QbyHfW+LNMgQ==, tableContent=null), ArticleFig(id=1311350018322296944, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=EN, label=Fig.4, caption=
Intestinal microbiota network interaction graphs based on the SPIEC-EASI algorithm and differences in network topological parameters between pairwise comparison groups, figureFileSmall=eSD32ym+de/Ive0g50ILmw==, figureFileBig=TsfxEeWSQNTSEKH+i8EfoQ==, tableContent=null), ArticleFig(id=1311350018410377329, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=CN, label=图4, caption=
基于SPIEC-EASI算法的肠道菌群网络互作图及两两比较组间网络拓扑参数差异注：A，B，C分别为健康组、糖尿病组和糖尿病肾病组网络互作图；D为两两比较组间网络拓扑参数差异柱状图；n代表节点数，l代表边数；***代表P<0.001，*代表P<0.05。
, figureFileSmall=eSD32ym+de/Ive0g50ILmw==, figureFileBig=TsfxEeWSQNTSEKH+i8EfoQ==, tableContent=null), ArticleFig(id=1311350018473291890, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=EN, label=Fig.5, caption=
Boruta Feature Analysis Chart Based on Random Forest(A) and ROC curve graph(B), figureFileSmall=xKkbIX4H9QfOvpOGaXoRWg==, figureFileBig=cBNFZZqBF+FODTPClrSzsw==, tableContent=null), ArticleFig(id=1311350018532012147, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=CN, label=图5, caption=
基于随机森林的Boruta特征分析图（A）和ROC工作曲线（B）, figureFileSmall=xKkbIX4H9QfOvpOGaXoRWg==, figureFileBig=cBNFZZqBF+FODTPClrSzsw==, tableContent=null), ArticleFig(id=1311350018611703924, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=EN, label=Table 1, caption=
Basic Characteristics of the Study Subjects
, figureFileSmall=null, figureFileBig=null, tableContent=
| 基本特征 | DKD组
（n=32） | DM组
（n=79） | HC组
（n=55） | 统计量 | P值 |
|---|
| 性别［n（%）］: | | | | 6.902 | 0.032 |
| 男 | 7（21.9） | 35（44.3） | 15（27.3） | | |
| 女 | 25（78.1） | 44（55.7） | 40（72.7） | | |
年龄（岁， ） | 66.2±10.8a | 59.0±11.4b | 63.1±8.34a | 9.407 | 0.006 |
BMI（kg/m2， ） | 22.5±3.52a | 26.1±3.00b | 23.2±2.88a | 35.199 | <0.001 |
总胆固醇（mmol/L， ） | 3.46±0.90a | 5.03±1.21b | 5.07±0.83b | 46.422 | <0.001 |
| 甘油三酯（mmol/L，［M（P25, P75）］） | 1.64（1.04,2.63）a | 1.58（1.28,2.62）b | 1.29（0.93,2.03）a | 9.077 | 0.011 |
低密度脂蛋白（mmol/L， ） | 1.65±0.67a | 3.27±0.80b | 3.29±0.66a | 63.455 | <0.001 |
| 高密度脂蛋白（mmol/L，［M（P25, P75）］） | 1.02（0.80,1.26）a | 1.16（1.02,1.40）b | 1.39（1.15,1.66）c | 26.510 | <0.001 |
| 空腹血糖（mmol/L，［M（P25, P75）］） | 7.80（6.38,9.58）a | 7.31（6.30,9.03）a | 4.88（4.62,5.17）b | 93.108 | <0.001 |
| 糖化血红蛋白［n（%）］ | 6.70（5.90,7.38）a | 7.20（6.70,8.25）b | 5.40（5.20,5.50）c | 109.350 | <0.001 |
| 血清肌酐（mmol/L，［M（P25, P75）］） | 727（519,1028）a | 63.6（54.5,77.2）b | 73.2（64.6,81.3）c | 82.568 | <0.001 |
血清尿酸（mmol/L， ） | 393±119 | 345±79.1 | 347±80.1 | 5.923 | 0.118 |
| 血清尿素（mmol/L，［M（P25, P75）］） | 22.6（17.0,28.4）a | 5.54（4.62,6.39）b | 5.18（4.34,6.02）b | 77.704 | <0.001 |
| 估算肾小球滤过率（mL/min/1.73m2，［M（P25, P75）］） | 6.85（4.69,9.69）a | 102（91.2,119）b | 99.0（84.9,108）b | 80.844 | <0.001 |
| 饮酒频率［n（%）］ | | | | - | <0.001 |
| 从不或几乎不 | 30（93.8） | 41（51.9） | 25（45.5） | | |
| 仅在重要日子饮酒 | 0（0.00） | 13（16.5） | 7（12.7） | | |
| 每月喝但少于每周一次 | 2（6.25） | 5（6.33） | 4（7.27） | | |
| 大于每周一次 | 0（0.00） | 20（25.3） | 19（34.5） | | |
| 吸烟［n（%）］: | | | | 19.793 | 0.001 |
| 不吸烟 | 13（40.6） | 53（67.1） | 30（54.5） | | |
| 正在吸烟 | 5（15.6） | 18（22.8） | 17（30.9） | | |
| 已戒烟 | 14（43.8） | 8（10.1） | 8（14.5） | | |
| 每周静坐时间 | | | | | |
| （小时，［M（P25, P75）］） | 42.0（31.5,56.0） | 21.0（14.0,29.0） | 21.0（14.0,28.0） | 32.522 | <0.001 |
), ArticleFig(id=1311350018695590005, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1311350009619116066, language=CN, label=表1, caption=
研究对象基本特征
, figureFileSmall=null, figureFileBig=null, tableContent=
| 基本特征 | DKD组
（n=32） | DM组
（n=79） | HC组
（n=55） | 统计量 | P值 |
|---|
| 性别［n（%）］: | | | | 6.902 | 0.032 |
| 男 | 7（21.9） | 35（44.3） | 15（27.3） | | |
| 女 | 25（78.1） | 44（55.7） | 40（72.7） | | |
| 年龄（岁，） | 66.2±10.8a | 59.0±11.4b | 63.1±8.34a | 9.407 | 0.006 |
| BMI（kg/m2，） | 22.5±3.52a | 26.1±3.00b | 23.2±2.88a | 35.199 | <0.001 |
| 总胆固醇（mmol/L，） | 3.46±0.90a | 5.03±1.21b | 5.07±0.83b | 46.422 | <0.001 |
| 甘油三酯（mmol/L，［M（P25, P75）］） | 1.64（1.04,2.63）a | 1.58（1.28,2.62）b | 1.29（0.93,2.03）a | 9.077 | 0.011 |
| 低密度脂蛋白（mmol/L，） | 1.65±0.67a | 3.27±0.80b | 3.29±0.66a | 63.455 | <0.001 |
| 高密度脂蛋白（mmol/L，［M（P25, P75）］） | 1.02（0.80,1.26）a | 1.16（1.02,1.40）b | 1.39（1.15,1.66）c | 26.510 | <0.001 |
| 空腹血糖（mmol/L，［M（P25, P75）］） | 7.80（6.38,9.58）a | 7.31（6.30,9.03）a | 4.88（4.62,5.17）b | 93.108 | <0.001 |
| 糖化血红蛋白［n（%）］ | 6.70（5.90,7.38）a | 7.20（6.70,8.25）b | 5.40（5.20,5.50）c | 109.350 | <0.001 |
| 血清肌酐（mmol/L，［M（P25, P75）］） | 727（519,1028）a | 63.6（54.5,77.2）b | 73.2（64.6,81.3）c | 82.568 | <0.001 |
| 血清尿酸（mmol/L，） | 393±119 | 345±79.1 | 347±80.1 | 5.923 | 0.118 |
| 血清尿素（mmol/L，［M（P25, P75）］） | 22.6（17.0,28.4）a | 5.54（4.62,6.39）b | 5.18（4.34,6.02）b | 77.704 | <0.001 |
| 估算肾小球滤过率（mL/min/1.73m2，［M（P25, P75）］） | 6.85（4.69,9.69）a | 102（91.2,119）b | 99.0（84.9,108）b | 80.844 | <0.001 |
| 饮酒频率［n（%）］ | | | | - | <0.001 |
| 从不或几乎不 | 30（93.8） | 41（51.9） | 25（45.5） | | |
| 仅在重要日子饮酒 | 0（0.00） | 13（16.5） | 7（12.7） | | |
| 每月喝但少于每周一次 | 2（6.25） | 5（6.33） | 4（7.27） | | |
| 大于每周一次 | 0（0.00） | 20（25.3） | 19（34.5） | | |
| 吸烟［n（%）］: | | | | 19.793 | 0.001 |
| 不吸烟 | 13（40.6） | 53（67.1） | 30（54.5） | | |
| 正在吸烟 | 5（15.6） | 18（22.8） | 17（30.9） | | |
| 已戒烟 | 14（43.8） | 8（10.1） | 8（14.5） | | |
| 每周静坐时间 | | | | | |
| （小时，［M（P25, P75）］） | 42.0（31.5,56.0） | 21.0（14.0,29.0） | 21.0（14.0,28.0） | 32.522 | <0.001 |
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