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Article(id=1325502291020751798, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325502070660407522, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025132, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1737648000000, receivedDateStr=2025-01-24, revisedDate=1740240000000, revisedDateStr=2025-02-23, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953972821, onlineDateStr=2026-11-06, pubDate=1748102400000, pubDateStr=2025-05-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953972821, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953972821, creator=13701087609, updateTime=1793953972821, updator=13701087609, issue=Issue{id=1325502070660407522, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='5', pageStart='609', pageEnd='760', issueExtLink='null', onlineDate='null', pubDate='1748102400000', pubDateStr='2025-05-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953920283, creator='13701087609', updateTime=1793953920283, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=751, endPage=755, ext={EN=ArticleExt(id=1325502292807525303, articleId=1325502291020751798, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020, columnId=1325500884406379444, journalTitle=Chinese Journal of School Health, columnName=Disease Control, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the prevalence trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020, so as to provide evidence for developing health promotion strategies.

Methods

Data were obtained from the Macao Citizen Physical Fitness Monitoring Database for the years 2005, 2010, 2015, and 2020 for participants aged 6-22 years. The χ2 test was employed to analyze trends in detection rates, while univariate and multivariate Logistic regression analyses were conducted to identify influencing factors.

Results

The overweight rate among Macao's children and adolescents increased from 10.4% in 2005 to 14.8% in 2020. The obesity rate rose from 6.8% to 12.1%, with the total detection rate increasing from 17.2% to 26.9%, and the differences were statistically significant (χtrend2=46.7, 87.5, 145.9, P < 0.01). Notably, the overweight/obesity rate among boys showed rapid growth (χtrend2=118.6, P < 0.01), while girls exhibited a declining inflection point in 2020. Multivariate Logistic regression analysis revealed that children and adolescents with the following characteristics faced higher risks of overweight/obesity: a physical education performance score of 3 points (overweight: OR=2.34, 95%CI=1.10-4.96; obesity: OR=2.39, 95%CI=1.19-4.81), paternal obesity (overweight: OR=2.07, 95%CI=1.38-3.11; obesity: OR=1.51, 95%CI=1.01-2.27), and maternal obesity (overweight: OR=1.69, 95%CI=1.08-2.63; obesity: OR=1.77, 95%CI=1.16-2.71) (P < 0.05). Conversely, lower risks were observed in those who performed appropriate warm-up activities before exercise (obesity: OR=0.37, 95%CI=0.15-0.95), participated in two academic/non-sports extracurricular classes (obesity: OR=0.46, 95%CI=0.24-0.88), and reported moderate physical exertion during extracurricular exercise (obesity: OR=0.60, 95%CI=0.36-0.98) (P < 0.05).

Conclusions

Overweight and obesity among Macao's children and adolescents remain severe, particularly among boys, while girls show early signs of improvement. It is recommended to establish a multi-sectoral collaborative prevention and control system to reduce childhood and adolescent obesity.

, authors=Jiaxin CHEN, Deqiang ZHAO, Yibei WANG, Chunmiao WANG, Yanfeng ZHANG*, authorsList=Jiaxin CHEN, Deqiang ZHAO, Yibei WANG, Chunmiao WANG, Yanfeng ZHANG, authorCompany=null, correspAuthors=Yanfeng ZHANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., 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=1325502297287041980, articleId=1325502291020751798, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=澳门儿童青少年2005—2020年超重肥胖变化及相关因素分析, columnId=1325500884628677558, journalTitle=中国学校卫生, columnName=疾病控制, runingTitle=null, highlight=null, articleAbstract=
目的

分析2005—2020年澳门儿童青少年超重肥胖现状、流行趋势以及相关因素，为制定儿童青少年体质健康改善策略提供依据。

方法

数据来源于2005，2010，2015，2020年澳门市民体质监测数据库，以6~22岁儿童青少年为研究对象。采用χ2检验分析超重肥胖检出率变化趋势，采用单因素与多元Logistic回归分析探讨其相关因素。

结果

澳门儿童青少年超重检出率从2005年的10.4%上升至2020年的14.8%；肥胖检出率从6.8%增至12.1%；总检出率由17.2%升至26.9%，差异均有统计学意义(χ趋势2值分别为46.7，87.5，145.9，P值均 < 0.01)；其中男生超重肥胖率快速增加(χ趋势2=118.6，P < 0.01)，女生超重肥胖率在2020年出现降低的拐点。多因素Logistic回归分析结果显示，体育课表现得分3分(超重：OR=2.34，95%CI=1.10~4.96；肥胖：OR=2.39，95%CI=1.19~4.81)、父亲肥胖(超重：OR=2.07，95%CI=1.38~3.11；肥胖：OR=1.51，95%CI=1.01~2.27)及母亲肥胖(超重：OR=1.69，95%CI=1.08~2.63；肥胖：OR=1.77，95%CI=1.16~2.71)的儿童青少年发生超重肥胖的风险均较高；运动前适当做准备活动(肥胖：OR=0.37，95%CI=0.15~0.95)、参加2项补习或非体育兴趣班(肥胖：OR=0.46，95%CI=0.24~0.88)和课外体育锻炼时身体感受适中(肥胖：OR=0.60，95%CI=0.36~0.98)的儿童青少年发生超重肥胖的风险均较低(P值均 < 0.05)。

结论

澳门儿童青少年超重肥胖问题严峻，男生尤为突出，女生开始出现下降拐点。建议构建多方协同防控体系，以减少儿童青少年肥胖的发生。

, authors=陈佳鑫, 赵德强, 王艺蓓, 王春苗, 张彦峰*, authorsList=陈佳鑫, 赵德强, 王艺蓓, 王春苗, 张彦峰, authorCompany=null, correspAuthors=张彦峰, authorNote=

陈佳鑫(2001-)，男，江苏南通人，硕士，主要研究方向为体质与健康

, correspAuthorsNote=
张彦峰，E-mail:
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BMC Public Health, 2023, 23(1): 1176., articleTitle=null, refAbstract=null)], funds=[Fund(id=1325502325074306032, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, awardId=null, language=CN, fundingSource=中国澳门特别行政区政府体育局与中国国家体育总局体育科学研究所联合项目澳门市民体质监测项目(B24-25), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325502298289480637, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, xref=null, ext=[AuthorCompanyExt(id=1325502298297869246, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, companyId=1325502298289480637, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=China Institute of Sport Science, Beijing (100061), China), AuthorCompanyExt(id=1325502298545333183, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, companyId=1325502298289480637, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=国家体育总局体育科学研究所，北京 100061)])], figs=[ArticleFig(id=1325502317461644262, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, language=EN, label=Fig.1, caption=Prevalence rates of overweight and obesity among children and adolescents of all ages in Macao in 2020, figureFileSmall=vGbSgVG8mJM/9nvsk1pAjA==, figureFileBig=xmtoZ4tV9YZukxtYLVSdhw==, tableContent=null), ArticleFig(id=1325502319554601961, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, language=CN, label=图1, caption=澳门各年龄儿童青少年2020年超重肥胖检出率, figureFileSmall=vGbSgVG8mJM/9nvsk1pAjA==, figureFileBig=xmtoZ4tV9YZukxtYLVSdhw==, tableContent=null), ArticleFig(id=1325502321257489386, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, language=EN, label=Tab.1, caption=

Univariate analysis of factors related to overweight and obesity among children and adolescents in Macao

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项人数超重肥胖χ2值P值
运动前适当做准备活动是1 119148(13.2)153(13.7)10.40.04
否202(10.0)4(20.0)
不知道396(15.4)12(30.8)
体育课表现得分548949(10.0)63(12.9)34.20.03
445771(15.5)58(12.7)
320634(16.5)42(20.4)
2221(4.5)6(27.3)
151(20.0)1(20.0)
周末每天电子设备< 0.59711(11.3)11(11.3)39.1< 0.01
使用时间/h0.5~ < 124023(9.6)26(10.8)
1~ < 1.525531(12.2)46(18.0)
1.5~ < 214526(17.9)18(12.4)
2~ < 318328(15.3)29(15.8)
3~ < 411119(17.1)8(7.2)
4~ < 5595(8.5)17(28.8)
5~ < 62806(21.4)
≥64310(23.3)6(14.0)
近半年内参加补习或非没有33944(13.0)66(19.5)15.60.02
体育兴趣班1项36542(11.5)52(14.2)
2项30645(14.7)28(9.2)
≥3项16825(14.9)23(13.7)
上体育课或锻炼时身体呼吸平稳、和平常差不多、没有特别感觉24744(17.8)28(11.3)18.8< 0.01
感受微微出汗、呼吸加快、心跳有点快78992(11.7)107(13.6)
出汗较多、心跳明显加快、上气不接下气13819(13.8)33(23.9)
学校体育课外体育锻炼呼吸平稳、和平常差不多、没有特别感觉17137(21.6)18(10.5)26.1< 0.01
时身体感受微微出汗、呼吸加快、心跳有点快66473(11.0)89(13.4)
出汗较多、心跳明显加快、上气不接下气17626(14.8)40(22.7)
父亲肥胖是38969(17.7)68(17.5)17.5< 0.01
否78987(11.0)101(12.8)
母亲肥胖是27747(17.0)59(21.3)21.7< 0.01
否901109(12.1)110(12.2)
), ArticleFig(id=1325502321739834347, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, language=CN, label=表1, caption=

澳门儿童青少年超重肥胖的相关因素单因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
组别选项人数超重肥胖χ2值P值
运动前适当做准备活动是1 119148(13.2)153(13.7)10.40.04
否202(10.0)4(20.0)
不知道396(15.4)12(30.8)
体育课表现得分548949(10.0)63(12.9)34.20.03
445771(15.5)58(12.7)
320634(16.5)42(20.4)
2221(4.5)6(27.3)
151(20.0)1(20.0)
周末每天电子设备< 0.59711(11.3)11(11.3)39.1< 0.01
使用时间/h0.5~ < 124023(9.6)26(10.8)
1~ < 1.525531(12.2)46(18.0)
1.5~ < 214526(17.9)18(12.4)
2~ < 318328(15.3)29(15.8)
3~ < 411119(17.1)8(7.2)
4~ < 5595(8.5)17(28.8)
5~ < 62806(21.4)
≥64310(23.3)6(14.0)
近半年内参加补习或非没有33944(13.0)66(19.5)15.60.02
体育兴趣班1项36542(11.5)52(14.2)
2项30645(14.7)28(9.2)
≥3项16825(14.9)23(13.7)
上体育课或锻炼时身体呼吸平稳、和平常差不多、没有特别感觉24744(17.8)28(11.3)18.8< 0.01
感受微微出汗、呼吸加快、心跳有点快78992(11.7)107(13.6)
出汗较多、心跳明显加快、上气不接下气13819(13.8)33(23.9)
学校体育课外体育锻炼呼吸平稳、和平常差不多、没有特别感觉17137(21.6)18(10.5)26.1< 0.01
时身体感受微微出汗、呼吸加快、心跳有点快66473(11.0)89(13.4)
出汗较多、心跳明显加快、上气不接下气17626(14.8)40(22.7)
父亲肥胖是38969(17.7)68(17.5)17.5< 0.01
否78987(11.0)101(12.8)
母亲肥胖是27747(17.0)59(21.3)21.7< 0.01
否901109(12.1)110(12.2)
), ArticleFig(id=1325502322083767276, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, language=EN, label=Tab.2, caption=

Multivariate Logistics regression analysis of related factors of overweight and obesity in children and adolescents in Macao(n=1 178)

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项超重肥胖
OR值(95%CI)P值OR值(95%CI)P值
体育课表现得分51.001.00
41.60(0.90~2.83)0.110.92(0.52~1.64)0.78
32.34(1.10~4.96)0.032.39(1.19~4.81)0.02
21.92(0.85~4.33)0.122.49(0.45~13.78)0.30
11.18(0.12~11.32)0.884.50(0.59~34.61)0.15
父亲肥胖否1.001.00
是2.07(1.38~3.11)< 0.011.51(1.01~2.27)0.05
母亲肥胖否1.001.00
是1.69(1.08~2.63)0.021.77(1.16~2.71)0.01
运动前适当做准备活动否1.001.00
是0.63(0.23~1.73)0.370.37(0.15~0.95)0.04
不知道0.46(0.07~2.96)0.410.50(0.10~2.53)0.40
近半年内参加补习或非体育兴趣班没有1.001.00
1项0.63(0.34~1.18)0.150.81(0.45~1.45)0.50
2项0.71(0.40~1.27)0.250.46(0.24~0.88)0.02
≥3项0.86(0.48~1.53)0.601.34(0.75~2.39)0.32
上体育课或锻炼时身体感受呼吸平稳、和平常差不多、没有特别感觉1.001.00
微微出汗、呼吸加快、心跳有点快0.69(0.30~1.59)0.380.52(0.30~0.92)0.02
出汗较多、心跳明显加快、上气不接下气0.66(0.35~1.26)0.210.47(0.21~1.03)0.06
学校体育课外体育锻炼时身体感受呼吸平稳、和平常差不多、没有特别感觉1.001.00
微微出汗、呼吸加快、心跳有点快1.55(0.73~3.31)0.260.60(0.36~0.98)0.04
出汗较多、心跳明显加快、上气不接下气0.69(0.34~1.18)0.180.60(0.27~1.35)0.22
), ArticleFig(id=1325502323849569263, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325502291020751798, language=CN, label=表2, caption=

澳门儿童青少年超重肥胖相关因素的多元Logistic回归分析(n=1 178)

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自变量选项超重肥胖
OR值(95%CI)P值OR值(95%CI)P值
体育课表现得分51.001.00
41.60(0.90~2.83)0.110.92(0.52~1.64)0.78
32.34(1.10~4.96)0.032.39(1.19~4.81)0.02
21.92(0.85~4.33)0.122.49(0.45~13.78)0.30
11.18(0.12~11.32)0.884.50(0.59~34.61)0.15
父亲肥胖否1.001.00
是2.07(1.38~3.11)< 0.011.51(1.01~2.27)0.05
母亲肥胖否1.001.00
是1.69(1.08~2.63)0.021.77(1.16~2.71)0.01
运动前适当做准备活动否1.001.00
是0.63(0.23~1.73)0.370.37(0.15~0.95)0.04
不知道0.46(0.07~2.96)0.410.50(0.10~2.53)0.40
近半年内参加补习或非体育兴趣班没有1.001.00
1项0.63(0.34~1.18)0.150.81(0.45~1.45)0.50
2项0.71(0.40~1.27)0.250.46(0.24~0.88)0.02
≥3项0.86(0.48~1.53)0.601.34(0.75~2.39)0.32
上体育课或锻炼时身体感受呼吸平稳、和平常差不多、没有特别感觉1.001.00
微微出汗、呼吸加快、心跳有点快0.69(0.30~1.59)0.380.52(0.30~0.92)0.02
出汗较多、心跳明显加快、上气不接下气0.66(0.35~1.26)0.210.47(0.21~1.03)0.06
学校体育课外体育锻炼时身体感受呼吸平稳、和平常差不多、没有特别感觉1.001.00
微微出汗、呼吸加快、心跳有点快1.55(0.73~3.31)0.260.60(0.36~0.98)0.04
出汗较多、心跳明显加快、上气不接下气0.69(0.34~1.18)0.180.60(0.27~1.35)0.22
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澳门儿童青少年2005—2020年超重肥胖变化及相关因素分析
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陈佳鑫 , 赵德强 , 王艺蓓 , 王春苗 , 张彦峰 *
中国学校卫生 | 疾病控制 2025,46(5): 751-755
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中国学校卫生 |疾病控制 2025 , 46 (5) : 751 -755
澳门儿童青少年2005—2020年超重肥胖变化及相关因素分析
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陈佳鑫, 赵德强, 王艺蓓, 王春苗, 张彦峰*
作者信息
  • 国家体育总局体育科学研究所，北京 100061
通讯作者:
张彦峰，E-mail:
作者简介:

陈佳鑫(2001-)，男，江苏南通人，硕士，主要研究方向为体质与健康

Trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020
Jiaxin CHEN, Deqiang ZHAO, Yibei WANG, Chunmiao WANG, Yanfeng ZHANG*
Affiliations
  • China Institute of Sport Science, Beijing (100061), China
出版时间: 2025-05-25 doi: 10.16835/j.cnki.1000-9817.2025132
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摘要
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目的

分析2005—2020年澳门儿童青少年超重肥胖现状、流行趋势以及相关因素，为制定儿童青少年体质健康改善策略提供依据。

方法

数据来源于2005，2010，2015，2020年澳门市民体质监测数据库，以6~22岁儿童青少年为研究对象。采用χ2检验分析超重肥胖检出率变化趋势，采用单因素与多元Logistic回归分析探讨其相关因素。

结果

澳门儿童青少年超重检出率从2005年的10.4%上升至2020年的14.8%；肥胖检出率从6.8%增至12.1%；总检出率由17.2%升至26.9%，差异均有统计学意义(χ趋势2值分别为46.7，87.5，145.9，P值均 < 0.01)；其中男生超重肥胖率快速增加(χ趋势2=118.6，P < 0.01)，女生超重肥胖率在2020年出现降低的拐点。多因素Logistic回归分析结果显示，体育课表现得分3分(超重：OR=2.34，95%CI=1.10~4.96；肥胖：OR=2.39，95%CI=1.19~4.81)、父亲肥胖(超重：OR=2.07，95%CI=1.38~3.11；肥胖：OR=1.51，95%CI=1.01~2.27)及母亲肥胖(超重：OR=1.69，95%CI=1.08~2.63；肥胖：OR=1.77，95%CI=1.16~2.71)的儿童青少年发生超重肥胖的风险均较高；运动前适当做准备活动(肥胖：OR=0.37，95%CI=0.15~0.95)、参加2项补习或非体育兴趣班(肥胖：OR=0.46，95%CI=0.24~0.88)和课外体育锻炼时身体感受适中(肥胖：OR=0.60，95%CI=0.36~0.98)的儿童青少年发生超重肥胖的风险均较低(P值均 < 0.05)。

结论

澳门儿童青少年超重肥胖问题严峻，男生尤为突出，女生开始出现下降拐点。建议构建多方协同防控体系，以减少儿童青少年肥胖的发生。

超重  /  肥胖症  /  回归分析  /  儿童  /  青少年
Objective

To analyze the prevalence trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020, so as to provide evidence for developing health promotion strategies.

Methods

Data were obtained from the Macao Citizen Physical Fitness Monitoring Database for the years 2005, 2010, 2015, and 2020 for participants aged 6-22 years. The χ2 test was employed to analyze trends in detection rates, while univariate and multivariate Logistic regression analyses were conducted to identify influencing factors.

Results

The overweight rate among Macao's children and adolescents increased from 10.4% in 2005 to 14.8% in 2020. The obesity rate rose from 6.8% to 12.1%, with the total detection rate increasing from 17.2% to 26.9%, and the differences were statistically significant (χtrend2=46.7, 87.5, 145.9, P < 0.01). Notably, the overweight/obesity rate among boys showed rapid growth (χtrend2=118.6, P < 0.01), while girls exhibited a declining inflection point in 2020. Multivariate Logistic regression analysis revealed that children and adolescents with the following characteristics faced higher risks of overweight/obesity: a physical education performance score of 3 points (overweight: OR=2.34, 95%CI=1.10-4.96; obesity: OR=2.39, 95%CI=1.19-4.81), paternal obesity (overweight: OR=2.07, 95%CI=1.38-3.11; obesity: OR=1.51, 95%CI=1.01-2.27), and maternal obesity (overweight: OR=1.69, 95%CI=1.08-2.63; obesity: OR=1.77, 95%CI=1.16-2.71) (P < 0.05). Conversely, lower risks were observed in those who performed appropriate warm-up activities before exercise (obesity: OR=0.37, 95%CI=0.15-0.95), participated in two academic/non-sports extracurricular classes (obesity: OR=0.46, 95%CI=0.24-0.88), and reported moderate physical exertion during extracurricular exercise (obesity: OR=0.60, 95%CI=0.36-0.98) (P < 0.05).

Conclusions

Overweight and obesity among Macao's children and adolescents remain severe, particularly among boys, while girls show early signs of improvement. It is recommended to establish a multi-sectoral collaborative prevention and control system to reduce childhood and adolescent obesity.

Overweight  /  Obesity  /  Regression analysis  /  Child  /  Adolescent
陈佳鑫, 赵德强, 王艺蓓, 王春苗, 张彦峰. 澳门儿童青少年2005—2020年超重肥胖变化及相关因素分析. 中国学校卫生, 2025 , 46 (5) : 751 -755 . DOI: 10.16835/j.cnki.1000-9817.2025132
Jiaxin CHEN, Deqiang ZHAO, Yibei WANG, Chunmiao WANG, Yanfeng ZHANG. Trends and associated factors of overweight and obesity among children and adolescents in Macao from 2005 to 2020[J]. Chinese Journal of School Health, 2025 , 46 (5) : 751 -755 . DOI: 10.16835/j.cnki.1000-9817.2025132
正文
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随着儿童青少年的膳食结构逐渐向高能量、高脂肪以及精制碳水化合物饮食转变[1]，儿童青少年的超重、肥胖问题日益突出。研究发现，儿童青少年超重肥胖会为身体带来一系列危害，如胰岛素抵抗[2]、心脑血管疾病[3]甚至过早死亡[4]等，也是成年后患高血压[5]、糖尿病[6]等慢性疾病的重要风险因素。超重肥胖还可能导致儿童青少年的心理健康问题，如焦虑、抑郁、自卑[7]等。
澳门作为我国特别行政区之一，澳门市民的体质健康尤其是儿童青少年的体质健康，受到国家高度关注[8]。澳门在国家体育总局的支持下，于2005，2010，2015，2020年顺利开展并完成4次澳门市民体质监测工作。为精准剖析澳门市民体质健康状况筑牢数据根基，本研究基于2005—2020年澳门儿童青少年体质监测数据，分析澳门儿童青少年超重肥胖现状、发展趋势及影响因素，旨在为制定科学、高效的儿童青少年体质健康改善策略提供依据。
1　资料来源与方法
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1.1　资料来源
以2005—2020年澳门6~22周岁的儿童青少年为研究对象，研究数据来源于2005，2010，2015，2020年澳门特别行政区市民体质监测数据库，样本量共21 031人。其中男生10 543名，女生10 488名；2005，2010，2015，2020年儿童青少年分别有5 338，5 128，5 229，5 336名。超重肥胖的影响因素研究数据来源于2020年澳门市民体质监测儿童青少年中进一步分层随机抽样的精细化问卷调查，样本量共1 178人。本研究已通过国家体育总局体育科学研究所伦理委员会审查(批号：CISSLA20190607)，所有受试者及其监护人均签署知情同意书。
1.2　方法
研究问卷基于国民体质调查工作组发布的标准化工具框架，并邀请相关领域专家(含公共卫生、体育科学、儿童保健专家)对问卷内容进行修订与背对背评分，内容效度(Ave=0.92)、结构效度(KMO=0.87)及信度(Cronbach α系数为0.84)均达到心理学测量学要求，适用于大样本流行病学研究。问卷内容包括儿童青少年及家长基本信息、身体状况和儿童青少年的体育活动表现、生活习惯、心理状态，其中基本信息、身体状况、家庭体育活动表现、生活习惯, 心理状态由儿童青少年和家长共同填写，学校体育活动表现如体育课表现得分由体育教师进行综合评价。儿童青少年超重和肥胖的判定标准根据《学龄儿童青少年超重肥胖筛查：WS/T 586—2018》[9]中体质量指数(body mass index, BMI)有关超重和肥胖临界值标准。父母肥胖界定标准依据成人BMI≥28 kg/m2[10]。
1.3　质量控制
体质监测调查开展前，由国家体育总局体育科学研究所安排专家对测试人员进行专业培训及考核，测试中由专家进行全程监督，确保测试规范、数据精确。
1.4　统计学分析
采用SPSS 27.0软件进行数据处理，计量资料采用Kolmogorov-Smirnov检验进行正态性分析，数据服从正态分布，用(x±s)表示；计数资料用频数或百分率描述。超重与肥胖的影响因素单因素分析采用χ2检验，超重、肥胖及超重肥胖总检出率在2005—2020年间的随时间变化趋势采用趋势χ2分析，通过单因素分析筛选出的相关因素进行多元Logistic回归分析。检验水准α=0.05。
2　结果
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2.1　澳门儿童青少年2020年超重和肥胖现状
2020年6~22岁儿童青少年超重和肥胖的检出率分别为14.8%(788名)和12.1%(648名)，总检出率为26.9%(1 436名)。其中男生超重和肥胖检出率分别为17.6%(512名)和15.4%(450名)，女生分别为11.4%(276名)和8.2%(198名)；男生超重和肥胖检出率均高于女生，差异均有统计学意义(χ2值分别为39.8，65.2，P值均 < 0.01)。各年龄儿童青少年的超重肥胖检出率见图1，肥胖检出率在6~11岁呈上升趋势，12~18岁呈下降趋势，18岁以后呈上升趋势。
2.2　澳门儿童青少年2005—2020年超重肥胖发展趋势
2005，2010，2015，2020年澳门儿童青少年超重肥胖检出率分别为17.2%(919名)、20.7%(1 059名)、24.8%(1 297名)、26.9%(1 436名)，差异有统计学意义(χ2=182.3，P < 0.01)；各年份男生超重肥胖检出率分别为20.2%(561名)、23.8%(620名)、28.0%(803名)、33.0%(962名)，女生分别为14.0%(358名)、17.4%(439名)、20.9%(494名)、19.6%(474名)，年份间差异均有统计学意义(χ2值分别为36.9，17.6，P值均＜0.01)。2005，2010，2015，2020年澳门儿童青少年超重检出率分别为10.4%(554名)、12.1%(621名)、13.4%(703名)、14.8%(788名)，差异有统计学意义(χ2=50.8，P < 0.01)；各年份男生超重检出率分别为11.9%(330名)、14.3%(373名)、14.6%(419名)、17.6%(512名)，女生分别为8.7%(224名)、9.8(248名)、12.0(284名)、11.4%(276名)，年份间差异均有统计学意义(χ2值分别为36.9，17.6，P值均 < 0.01)。2005，2010，2015，2020年澳门儿童青少年肥胖检出率分别为6.8%(365名)、8.5%(438名)、11.4%(594名)、12.1%(648名)，差异具有统计学意义(χ2=110.3，P < 0.01)；各年份男生肥胖检出率分别为8.3%(231名)、9.5%(247名)、13.4%(384名)、15.4%(450名)，女生分别为5.2(134名)、7.6%(191名)、8.9%(210名)、8.2%(198名)，年份间差异均有统计学意义(χ2值分别为89.8，27.4，P值均＜0.01)。趋势性检验发现，超重、肥胖、超重和肥胖总体检出率均呈上升趋势(χ趋势2值分别为46.7，87.5，145.9)，其中男生超重肥胖率增加快速(χ趋势2=118.6)(P值均＜0.01)，女生超重肥胖率在2020年出现下降拐点。
2.3　澳门儿童青少年超重肥胖的单因素分析
运动前是否适当做准备活动、体育课表现得分、近半年内参加补习或非体育兴趣班的儿童青少年超重、肥胖检出率差异有统计学意义；周末电子设备使用时间、上体育课或锻炼时身体感受、学校体育课外体育锻炼时身体感受、父母是否肥胖的儿童青少年超重、肥胖检出率差异有统计学意义(P值均 < 0.05)。见表1。
2.4　澳门儿童青少年超重肥胖影响因素的多元Logistic回归分析
以儿童青少年是否超重肥胖(否=0，是=1)为因变量，将单因素分析中有统计学意义的变量纳入多元Logistic回归模型。结果显示，体育课表现得分为3分、父母肥胖的儿童青少年超重、肥胖的风险均增加；运动前适当做准备活动，体育锻炼时身体感受为“微微出汗、呼吸加快、心跳有点快”，近半年参加2项补习或非体育兴趣班的儿童青少年肥胖风险降低(P值均 < 0.05)。见表2。
3　讨论
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从年龄来看，本研究中肥胖率呈现出阶段性变化趋势，在6~11岁持续上升，12~18岁下降，18岁以后再次上升，可能是受到学业压力及生活习惯的影响。尤其是18~19岁间超重肥胖率显著上升，可能与高三步入大学的生活方式、学业压力等转变有关[11]。此外大学生可能因为学习紧张或懒惰，与高中相比明显减少体育运动的时间，从而引发体重增加[12]。提示应针对不同年龄段的特点，制定个性化的超重肥胖预防策略，特别是在关键的学业转换期，应加强对学生健康生活方式的引导和干预。
通过4次体质监测数据的对比发现，澳门儿童青少年的超重、肥胖率总体保持上升趋势。值得注意的是，澳门女生超重、肥胖检出率自2005年体质监测以来，于2020年首次均出现下降拐点。可能的原因包括女生对超重肥胖和健康问题的认知和意识提升，更加注重饮食健康和身体锻炼，对健康和体型的关注度提高，从而对超重肥胖率产生一定的抑制作用[13]。然而男生的超重、肥胖率依然在快速上升，可能与男生在食物摄入上更偏好于肉类、油炸类等高能量食物，且摄入量更多有关[14]。儿童时期肥胖率的增加，会导致成年期肥胖的累积，对我国人群健康、人力资本、医疗卫生负担造成巨大影响[15]。男生及家长应该对现状引起足够的重视，改善孩子的生活习惯、饮食习惯，减少高能量食物的摄入；同时鼓励孩子积极参与体育锻炼，促进体质健康发展。
本研究结果显示，多种因素与澳门儿童青少年的超重肥胖密切相关。首先，儿童青少年的体育课表现差会导致超重肥胖的风险增加，运动前不做准备活动和体育活动时身体感受比较强烈是肥胖的风险因素。可能是由于儿童青少年开始对于体育锻炼的认识不足，重视程度不够，导致运动能力下降、运动时身体感受吃力，最终使孩子忽视运动带来的益处，减少运动行为，陷入恶性循环[16-17]。要改善这一状况，学校应加强体育教育宣传，融入课程；家长要以身作则，与孩子制定运动计划并鼓励；政府需完善公共体育设施，媒体加强宣传，共同助力孩子养成运动习惯。
本研究还发现，肥胖儿童青少年在周末使用电子产品时间超过4 h的检出率高达64.2%，参加2项兴趣班(非体育)者肥胖发生风险较低。长时间使用电子产品不仅减少儿童青少年户外活动与身体锻炼的机会，导致能量消耗降低、加剧肥胖程度，还可能因接触不良信息影响心理健康；而未参加兴趣班则使他们在课余时间缺乏有益的活动引导，同时长时间使用电子设备，易陷入久坐不动的状态，进一步加重超重肥胖问题。因此，家庭应建立电子产品使用规则，丰富周末活动；学校要引导学生合理使用电子产品，提供多样兴趣班[18]；各方携手，引导孩子健康生活，降低超重肥胖风险。
本研究还发现，父母肥胖是儿童青少年超重肥胖的相关因素之一。从数据来看，父亲或母亲存在肥胖情况时，儿童青少年超重肥胖的风险增加。这一现象背后的原因与家庭环境和教育方式紧密相关。随着生活水平的提升，父母虽然能给孩子提供多样且充足的食物，但受我国传统育儿及饮食观念的影响，父母对孩子的饮食通常不会加以约束；且许多父母常以孩子吃饱、吃好为首要目标，忽视食物的合理搭配与适量原则，容易使孩子食物摄入量远超身体需要量，多余能量逐渐转化为脂肪堆积，进而导致肥胖的发生。同时家长作为孩子的第一影响人，其健康观念、行为会直接影响孩子的健康知识、态度、行为的养成[19]。在运动行为上，家长应该做好榜样作用，把握家庭健康教育和指导的薄弱环节，完善学生肥胖预防控制策略，共同参与学生肥胖的干预活动。
本研究还存在一定局限性：研究仅分析有限的影响因素，实际生活中可能存在其他未被纳入的重要因素影响儿童青少年超重肥胖状况，未来可进一步优化抽样方法，纳入更多影响因素，并开展纵向研究以更好地揭示因果关系。
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  • 中国澳门特别行政区政府体育局与中国国家体育总局体育科学研究所联合项目澳门市民体质监测项目(B24-25)
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2025年第46卷第5期
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doi: 10.16835/j.cnki.1000-9817.2025132
  • 接收时间：2025-01-24
  • 首发时间：2026-11-06
  • 出版时间：2025-05-25
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  • 收稿日期：2025-01-24
  • 修回日期：2025-02-23
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中国澳门特别行政区政府体育局与中国国家体育总局体育科学研究所联合项目澳门市民体质监测项目(B24-25)
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    国家体育总局体育科学研究所，北京 100061

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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