Article(id=1325501978108896166, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325501865651216714, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025108, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736092800000, receivedDateStr=2025-01-06, revisedDate=1738857600000, revisedDateStr=2025-02-07, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953898216, onlineDateStr=2026-11-06, pubDate=1745510400000, pubDateStr=2025-04-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953898216, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953898216, creator=13701087609, updateTime=1793953898216, updator=13701087609, issue=Issue{id=1325501865651216714, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='4', pageStart='457', pageEnd='572 578', issueExtLink='null', onlineDate='null', pubDate='1745510400000', pubDateStr='2025-04-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953871404, creator='13701087609', updateTime=1793953871404, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=465, endPage=469, ext={EN=ArticleExt(id=1325501979501405095, articleId=1325501978108896166, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Association between sleep status and overweight/obesity among primary school students in Bao'an District of Shenzhen, columnId=1325501866582352204, journalTitle=Chinese Journal of School Health, columnName=Column on the prevention and control of obesity in children and adolescents, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the association between different sleep statuses and overweight/obesity among primary school students, so as to provide a basis for the development of childhood overweight and obesity prevention and control strategies.

Methods

In November 2023, a total of 3 391 primary school students of grade 1-6 from seven schools in Baoan District, Shenzhen, were surveyed by questionnaires and physical examinations by using multi-stage cluster sampling. The Logistic regression analysis was used to explore the association between primary school students' sleep status and overweight/obesity.

Results

The detection rate of overweight/obesity in primary school students was 22.59%, the detection rate of overweight/obesity in boys (27.04%) was higher than that in girls (17.44%), the only child (25.81%) had higher rates than non-only child (21.76%), and the differences were statistically significant (χ2=51.48, 5.98, P<0.05). Multivariate Logistic regression analysis showed that, after controlling for confounders, primary school students' weekend nighttime sleep duration (OR=0.83, 95%CI=0.75-0.91), weekly average nighttime sleep duration (OR=0.76, 95%CI=0.64-0.89), and weekend compensated sleep duration (OR=0.89, 95%CI=0.81-0.97) were negatively associated with the risk of developing overweight/obesity (P<0.05). Compared with to primary school students with school days nap durations<0.5 h, those whose napped for 0.5-<1 h and ≥1 h on school days had a 20% (OR=1.20, 95%CI=1.02-1.42) and 37% (OR=1.37, 95%CI=1.02-1.83) increased risk of overweight/obesity, respectively (P<0.05).

Conclusions

Increasing weekend nighttime sleep duration, average weekly nighttime sleep duration, and weekend compensatory sleep duration can reduce the risk of overweight and obesity in primary school students. School days nap duration is a risk factor for overweight/obesity among primary school students.

, authors=Yun HUANG, Yanhong LIU, Li HUANG, Yanrou LI, Mingze WU, authorsList=Yun HUANG, Yanhong LIU, Li HUANG, Yanrou LI, Mingze WU, authorCompany=null, correspAuthors=null, 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=1325501981892158376, articleId=1325501978108896166, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=深圳市宝安区小学生睡眠状况及其与超重肥胖的关联, columnId=1325501866821427534, journalTitle=中国学校卫生, columnName=儿童青少年肥胖防控专栏, runingTitle=null, highlight=null, articleAbstract=
目的

分析小学生不同睡眠状况与超重肥胖的关联,为制定儿童超重肥胖防控策略提供依据。

方法

2023年11月, 采用分层整群随机抽样方法, 对深圳市宝安区7所学校一至六年级3 931名小学生进行问卷调查和体格检查, 采用Logistic回归分析探讨小学生睡眠状况与超重肥胖的关联。

结果

小学生超重肥胖检出率为22.59%, 男生超重肥胖检出率(27.04%)高于女生(17.44%), 独生子女(25.81%)高于非独生子女(21.76%), 差异均有统计学意义(χ2值分别为51.48, 5.98, P值均<0.05)。多因素Logistic回归分析结果显示, 控制混杂因素后, 小学生周末夜间睡眠时长(OR=0.83, 95%CI=0.75~0.91)、一周平均每日睡眠时长(OR=0.76, 95%CI=0.64~0.89)和周末追赶睡眠时长(OR=0.89, 95%CI=0.81~0.97)与小学生超重肥胖发生风险均呈负相关(P值均<0.05)。与上学日午睡时长<0.5 h相比, 上学日午睡时长0.5~<1 h和≥1 h的小学生发生超重肥胖的风险分别增加20%(OR=1.20, 95%CI=1.02~1.42)、37%(OR=1.37, 95%CI=1.02~1.83)(P值均<0.05)。

结论

增加周末夜间睡眠时长、一周平均每日睡眠时间和周末追赶睡眠时长有助于降低小学生超重肥胖风险, 上学日午睡时间过长是小学生超重肥胖的正性相关因素。

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黄韵(1988-), 女, 广西梧州人, 硕士, 主治医师, 主要研究方向为慢性病预防与控制

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黄韵(1988-), 女, 广西梧州人, 硕士, 主治医师, 主要研究方向为慢性病预防与控制

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黄韵(1988-), 女, 广西梧州人, 硕士, 主治医师, 主要研究方向为慢性病预防与控制

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Comparison of overweight and obesity detection rates in primary school students with different characteristics

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特征选项人数超重肥胖χ2/$X_{趋势}^2$值P值特征选项人数超重肥胖χ2/$X_{趋势}^2$值P值
性别男2 108570(27.04)51.48<0.01母亲文化程度a初中及以下20257(28.22)4.130.13
女1 823318(17.44)高中或中专675156(23.11)
年级一719128(17.80)29.98<0.01大专及以上3 019668(22.13)
二826157(19.01)上学日夜间睡眠时长/ha<91 842465(25.24)12.84<0.01
三625142(22.72)9~<101 964399(20.32)
四562145(25.80)≥1012224(19.67)
五568141(24.82)周末夜间睡眠时长/ha<9370115(31.08)21.88<0.01
六631175(27.73)9~<101 611382(23.71)
民族汉族3 772842(22.32)3.810.05≥101 936389(20.09)
其他15946(28.93)一周平均每日睡眠时长/ha<91 321359(27.18)24.54<0.01
是否独生子女是802207(25.81)5.980.019~<102 429500(20.58)
否3 129681(21.76)≥1016427(16.46)
是否与父母同住是3 705831(22.43)0.950.33上学日就寝时间a22:00前1 063220(20.70)4.730.03
否22657(25.22)22:00—23:002 570590(22.96)
中高强度活动时间/(h·d-1)<0.51 081224(20.72)10.300.0423:00后29578(26.44)
0.5~<11 582393(24.84)周末就寝时间a22:00前30261(20.20)10.50<0.01
1~<1.5782160(20.46)22:00—23:002 204462(20.96)
1.5~<228270(24.82)23:00后1 422365(25.67)
≥220441(20.10)周末追赶睡眠时长/ha<0.51 130287(25.40)8.000.01
视屏时间/(h·d-1)<13 245706(21.76)9.280.010.5~<1956217(22.70)
1~<2529134(25.33)≥11 828382(20.90)
≥215748(30.57)上学日午睡时长/h<0.51 563332(21.24)3.210.07
父亲文化程度a初中及以下18756(29.95)8.890.010.5~<12 032472(23.23)
高中或中专621154(24.80)≥133684(25.00)
大专及以上3 091671(21.71)周末午睡时长/h<0.52 717610(22.45)0.340.56
父亲是否超重肥胖a否1 884306(16.24)85.04<0.010.5~<1662146(22.05)
是1 940557(28.71)≥1552132(23.91)
母亲是否超重肥胖a否3 183644(20.23)54.56<0.01睡眠质量睡眠不良2 767621(22.44)0.120.74
是722238(32.96)睡眠良好1 164267(22.94)
), ArticleFig(id=1325501989194441680, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501978108896166, language=CN, label=表1, caption=

不同特征小学生超重肥胖检出率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
特征选项人数超重肥胖χ2/$X_{趋势}^2$值P值特征选项人数超重肥胖χ2/$X_{趋势}^2$值P值
性别男2 108570(27.04)51.48<0.01母亲文化程度a初中及以下20257(28.22)4.130.13
女1 823318(17.44)高中或中专675156(23.11)
年级一719128(17.80)29.98<0.01大专及以上3 019668(22.13)
二826157(19.01)上学日夜间睡眠时长/ha<91 842465(25.24)12.84<0.01
三625142(22.72)9~<101 964399(20.32)
四562145(25.80)≥1012224(19.67)
五568141(24.82)周末夜间睡眠时长/ha<9370115(31.08)21.88<0.01
六631175(27.73)9~<101 611382(23.71)
民族汉族3 772842(22.32)3.810.05≥101 936389(20.09)
其他15946(28.93)一周平均每日睡眠时长/ha<91 321359(27.18)24.54<0.01
是否独生子女是802207(25.81)5.980.019~<102 429500(20.58)
否3 129681(21.76)≥1016427(16.46)
是否与父母同住是3 705831(22.43)0.950.33上学日就寝时间a22:00前1 063220(20.70)4.730.03
否22657(25.22)22:00—23:002 570590(22.96)
中高强度活动时间/(h·d-1)<0.51 081224(20.72)10.300.0423:00后29578(26.44)
0.5~<11 582393(24.84)周末就寝时间a22:00前30261(20.20)10.50<0.01
1~<1.5782160(20.46)22:00—23:002 204462(20.96)
1.5~<228270(24.82)23:00后1 422365(25.67)
≥220441(20.10)周末追赶睡眠时长/ha<0.51 130287(25.40)8.000.01
视屏时间/(h·d-1)<13 245706(21.76)9.280.010.5~<1956217(22.70)
1~<2529134(25.33)≥11 828382(20.90)
≥215748(30.57)上学日午睡时长/h<0.51 563332(21.24)3.210.07
父亲文化程度a初中及以下18756(29.95)8.890.010.5~<12 032472(23.23)
高中或中专621154(24.80)≥133684(25.00)
大专及以上3 091671(21.71)周末午睡时长/h<0.52 717610(22.45)0.340.56
父亲是否超重肥胖a否1 884306(16.24)85.04<0.010.5~<1662146(22.05)
是1 940557(28.71)≥1552132(23.91)
母亲是否超重肥胖a否3 183644(20.23)54.56<0.01睡眠质量睡眠不良2 767621(22.44)0.120.74
是722238(32.96)睡眠良好1 164267(22.94)
), ArticleFig(id=1325501989500625873, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501978108896166, language=EN, label=Tab.2, caption=

Logistic regression analysis on different sleep statuses and overweight and obesity among primary school studnets(n=3 931)

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项模型1模型2
OR值(95%CI)P值OR值(95%CI)P值
上学日夜间睡眠时长a0.80(0.70~0.92)<0.010.88(0.76~1.02)0.08
上学日夜间睡眠时长/h<91.38(0.87~2.18)0.171.29(0.79~2.10)0.31
9~<101.04(0.66~1.65)0.861.03(0.64~1.68)0.89
≥101.001.00
周末夜间睡眠时长a0.78(0.71~0.86)<0.010.83(0.75~0.91)<0.01
周末夜间睡眠时长/h<91.79(1.40~2.30)<0.011.43(1.10~1.87)0.01
9~<101.24(1.05~1.45)0.011.16(0.98~1.37)0.08
≥101.001.00
一周平均每日睡眠时间a0.67(0.58~0.78)<0.010.76(0.64~0.89)<0.01
一周平均每日睡眠时间/h<91.89(1.23~2.91)<0.011.78(1.12~2.82)0.01
9~<101.32(0.86~2.01)0.211.43(0.91~2.25)0.12
≥101.001.00
周末追赶睡眠时长a0.88(0.81~0.96)<0.010.89(0.81~0.97)0.01
周末追赶睡眠时长/h<0.51.29(1.08~1.54)0.011.21(1.01~1.46)0.04
0.5~<11.11(0.92~1.34)0.271.14(0.94~1.39)0.19
≥11.001.00
上学日就寝时间22:00前0.73(0.54~0.98)0.040.90(0.65~1.24)0.51
22:00—23:000.83(0.63~1.09)0.180.99(0.74~1.33)0.96
23:00后1.001.00
周末就寝时间22:00前0.73(0.54~0.99)0.050.85(0.61~1.18)0.33
22:00—23:000.77(0.66~0.90)<0.010.92(0.78~1.09)0.33
23:00后1.001.00
上学日午睡时长/h<0.51.001.00
0.5~<11.12(0.96~1.32)0.161.20(1.02~1.42)0.03
≥11.24(0.94~1.63)0.131.37(1.02~1.83)0.04
周末午睡时长/h<0.51.001.00
0.5~<10.98(0.80~1.20)0.831.06(0.85~1.32)0.60
≥11.09(0.88~1.35)0.461.20(0.95~1.51)0.13
睡眠质量睡眠不良1.03(0.87~1.21)0.741.02(0.86~1.22)0.82
睡眠良好1.001.00
), ArticleFig(id=1325501989592900562, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325501978108896166, language=CN, label=表2, caption=

小学生不同睡眠状况与超重肥胖的Logistic回归分析(n=3 931)

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项模型1模型2
OR值(95%CI)P值OR值(95%CI)P值
上学日夜间睡眠时长a0.80(0.70~0.92)<0.010.88(0.76~1.02)0.08
上学日夜间睡眠时长/h<91.38(0.87~2.18)0.171.29(0.79~2.10)0.31
9~<101.04(0.66~1.65)0.861.03(0.64~1.68)0.89
≥101.001.00
周末夜间睡眠时长a0.78(0.71~0.86)<0.010.83(0.75~0.91)<0.01
周末夜间睡眠时长/h<91.79(1.40~2.30)<0.011.43(1.10~1.87)0.01
9~<101.24(1.05~1.45)0.011.16(0.98~1.37)0.08
≥101.001.00
一周平均每日睡眠时间a0.67(0.58~0.78)<0.010.76(0.64~0.89)<0.01
一周平均每日睡眠时间/h<91.89(1.23~2.91)<0.011.78(1.12~2.82)0.01
9~<101.32(0.86~2.01)0.211.43(0.91~2.25)0.12
≥101.001.00
周末追赶睡眠时长a0.88(0.81~0.96)<0.010.89(0.81~0.97)0.01
周末追赶睡眠时长/h<0.51.29(1.08~1.54)0.011.21(1.01~1.46)0.04
0.5~<11.11(0.92~1.34)0.271.14(0.94~1.39)0.19
≥11.001.00
上学日就寝时间22:00前0.73(0.54~0.98)0.040.90(0.65~1.24)0.51
22:00—23:000.83(0.63~1.09)0.180.99(0.74~1.33)0.96
23:00后1.001.00
周末就寝时间22:00前0.73(0.54~0.99)0.050.85(0.61~1.18)0.33
22:00—23:000.77(0.66~0.90)<0.010.92(0.78~1.09)0.33
23:00后1.001.00
上学日午睡时长/h<0.51.001.00
0.5~<11.12(0.96~1.32)0.161.20(1.02~1.42)0.03
≥11.24(0.94~1.63)0.131.37(1.02~1.83)0.04
周末午睡时长/h<0.51.001.00
0.5~<10.98(0.80~1.20)0.831.06(0.85~1.32)0.60
≥11.09(0.88~1.35)0.461.20(0.95~1.51)0.13
睡眠质量睡眠不良1.03(0.87~1.21)0.741.02(0.86~1.22)0.82
睡眠良好1.001.00
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深圳市宝安区小学生睡眠状况及其与超重肥胖的关联
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黄韵 , 刘艳红 , 黄莉 , 李彦柔 , 吴明泽
中国学校卫生 | 儿童青少年肥胖防控专栏 2025,46(4): 465-469
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中国学校卫生 |儿童青少年肥胖防控专栏 2025 , 46 (4) : 465 -469
深圳市宝安区小学生睡眠状况及其与超重肥胖的关联
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黄韵, 刘艳红, 黄莉, 李彦柔, 吴明泽
作者信息
  • 深圳市宝安区慢性病防治院健康教育与促进科, 广东 518000
作者简介:

黄韵(1988-), 女, 广西梧州人, 硕士, 主治医师, 主要研究方向为慢性病预防与控制

Association between sleep status and overweight/obesity among primary school students in Bao'an District of Shenzhen
Yun HUANG, Yanhong LIU, Li HUANG, Yanrou LI, Mingze WU
Affiliations
  • Education and Promotion Section, Shenzhen Bao'an Center for Chronic Disease Control, Shenzhen (518000), Guangdong Province, China
出版时间: 2025-04-25 doi: 10.16835/j.cnki.1000-9817.2025108
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目的

分析小学生不同睡眠状况与超重肥胖的关联,为制定儿童超重肥胖防控策略提供依据。

方法

2023年11月, 采用分层整群随机抽样方法, 对深圳市宝安区7所学校一至六年级3 931名小学生进行问卷调查和体格检查, 采用Logistic回归分析探讨小学生睡眠状况与超重肥胖的关联。

结果

小学生超重肥胖检出率为22.59%, 男生超重肥胖检出率(27.04%)高于女生(17.44%), 独生子女(25.81%)高于非独生子女(21.76%), 差异均有统计学意义(χ2值分别为51.48, 5.98, P值均<0.05)。多因素Logistic回归分析结果显示, 控制混杂因素后, 小学生周末夜间睡眠时长(OR=0.83, 95%CI=0.75~0.91)、一周平均每日睡眠时长(OR=0.76, 95%CI=0.64~0.89)和周末追赶睡眠时长(OR=0.89, 95%CI=0.81~0.97)与小学生超重肥胖发生风险均呈负相关(P值均<0.05)。与上学日午睡时长<0.5 h相比, 上学日午睡时长0.5~<1 h和≥1 h的小学生发生超重肥胖的风险分别增加20%(OR=1.20, 95%CI=1.02~1.42)、37%(OR=1.37, 95%CI=1.02~1.83)(P值均<0.05)。

结论

增加周末夜间睡眠时长、一周平均每日睡眠时间和周末追赶睡眠时长有助于降低小学生超重肥胖风险, 上学日午睡时间过长是小学生超重肥胖的正性相关因素。

睡眠  /  超重  /  肥胖症  /  回归分析  /  学生
Objective

To analyze the association between different sleep statuses and overweight/obesity among primary school students, so as to provide a basis for the development of childhood overweight and obesity prevention and control strategies.

Methods

In November 2023, a total of 3 391 primary school students of grade 1-6 from seven schools in Baoan District, Shenzhen, were surveyed by questionnaires and physical examinations by using multi-stage cluster sampling. The Logistic regression analysis was used to explore the association between primary school students' sleep status and overweight/obesity.

Results

The detection rate of overweight/obesity in primary school students was 22.59%, the detection rate of overweight/obesity in boys (27.04%) was higher than that in girls (17.44%), the only child (25.81%) had higher rates than non-only child (21.76%), and the differences were statistically significant (χ2=51.48, 5.98, P<0.05). Multivariate Logistic regression analysis showed that, after controlling for confounders, primary school students' weekend nighttime sleep duration (OR=0.83, 95%CI=0.75-0.91), weekly average nighttime sleep duration (OR=0.76, 95%CI=0.64-0.89), and weekend compensated sleep duration (OR=0.89, 95%CI=0.81-0.97) were negatively associated with the risk of developing overweight/obesity (P<0.05). Compared with to primary school students with school days nap durations<0.5 h, those whose napped for 0.5-<1 h and ≥1 h on school days had a 20% (OR=1.20, 95%CI=1.02-1.42) and 37% (OR=1.37, 95%CI=1.02-1.83) increased risk of overweight/obesity, respectively (P<0.05).

Conclusions

Increasing weekend nighttime sleep duration, average weekly nighttime sleep duration, and weekend compensatory sleep duration can reduce the risk of overweight and obesity in primary school students. School days nap duration is a risk factor for overweight/obesity among primary school students.

Sleep  /  Overweight  /  Obesity  /  Regression analysis  /  Students
黄韵, 刘艳红, 黄莉, 李彦柔, 吴明泽. 深圳市宝安区小学生睡眠状况及其与超重肥胖的关联. 中国学校卫生, 2025 , 46 (4) : 465 -469 . DOI: 10.16835/j.cnki.1000-9817.2025108
Yun HUANG, Yanhong LIU, Li HUANG, Yanrou LI, Mingze WU. Association between sleep status and overweight/obesity among primary school students in Bao'an District of Shenzhen[J]. Chinese Journal of School Health, 2025 , 46 (4) : 465 -469 . DOI: 10.16835/j.cnki.1000-9817.2025108
近年来,超重及肥胖在世界范围内呈快速增长趋势,已成为危害儿童健康的全球主要的公共卫生问题[1-3]。儿童肥胖不仅会对儿童的生理和心理健康造成严重影响,且与整个生命过程的不良健康结局相关[4-5]。研究发现,睡眠与儿童超重肥胖的发生密切相关[6-9],睡眠不足会降低瘦素水平并增加胃饥饿素分泌,通过增强食欲增加超重肥胖发生风险[10]。目前我国儿童青少年普遍存在睡眠不足问题,不同年龄呈现出不同的特点和规律[11]。本研究旨在探讨小学生不同睡眠状况与超重肥胖之间的关联,为制定儿童超重肥胖的防控措施提供依据。
于2023年11月采用分层整群随机抽样方法抽取研究对象,首先在深圳市宝安区采用随机数字表法从所有公立学校中抽取7所学校,以年级分层,采用随机数字表法从入选学校一至六年级的每个年级中抽取2个班级,共抽取84个班级,抽中班级的所有小学生作为调查对象。通过问卷星平台收集问卷,由班主任通过班级群下发问卷二维码,告知调查目的和流程,请愿意参与调查的监护人扫码填写问卷。共调查小学生4 355名,收回问卷4 212份,应答率为96.72%;剔除缺失超过10%的问卷,有效问卷3 931份,有效率为93.33%。其中男生2 108名,女生1 823名,平均年龄为(9.03±1.77)岁。本研究通过深圳市宝安区慢性病防治院伦理委员会审查(批号:No.2022-14),所有小学生监护人均签署知情同意书。
采用该问卷评价小学生睡眠状况,由小学生监护人根据过去1个月儿童的睡眠状况进行评定。CSHQ问卷分为睡眠时间和睡眠质量两部分,睡眠时间部分:上学日/周末夜间睡眠时长、一周平均每日睡眠时间、周末追赶睡眠时长,另外结合我国实际情况增加午睡时间;一周平均每日睡眠时间=(上学日睡眠时间×5+周末睡眠时间×2)/7,周末追赶睡眠时长=周末睡眠时长-上学日睡眠时长。睡眠质量部分共33题,通常(5~7次/周)、有时(2~4次/周)、偶尔(0~1次/周)分别计为1~3分,部分题目反向计分,总分≥41分被评为睡眠质量不良,<41分认为睡眠质量良好[13]。本研究中,问卷Cronbach α系数为0.73。
通过电子问卷收集小学生及父母基本情况。其中,父母的基本情况包括父、母身高、体重、文化程度等;小学生的基本情况包括性别、年龄、年级、民族、是否独生子女、是否与父母同住、中高强度活动时间、视屏时间等。
小学生的身高和体重由专业人员根据《中小学生健康体检管理办法(2021年版)》[14]进行测量,体质量指数(body mass index,BMI)=体重(kg)/[身高(m)]2。
中高强度活动时间指平均每天开展中高强度活动的时间[15]。中高强度活动指让小学生呼吸或心跳加快的运动,如跑步、篮球、足球、游泳、健身操等[15]。视屏时间指平均每天使用电子产品(如电脑、平板、手机等)的时间[16]。依据我国《中小学生一日学习时间卫生要求》(GB/T 17223—2012)[17]和美国全国睡眠基金会的推荐睡眠时长[18],本研究定义夜间睡眠时长<9 h为睡眠不足、9~<10 h为睡眠基本满足、≥10 h为睡眠充足;就寝时间分为22:00前、22:00—23:00、23:00后3组;周末追赶睡眠时长和午睡时长分为<0.5,0.5~<1和≥1 h 3组。根据《学龄儿童青少年超重与肥胖筛查》(WS/T 586—2018)[19]判定小学生超重和肥胖情况。父母的BMI情况根据《成年人体重判定》(WS/T 428—2013)[20]划分,BMI<24 kg/m2为非超重肥胖;BMI≥24 kg/m2为超重肥胖。
对参加调查的工作人员进行培训,考核合格后方可参与调查。通过问卷星制作电子问卷,根据题目内容设置填写范围、逻辑跳转,列明问卷调查中的注意事项,通过班主任下发至班级群,并解答调查对象监护人的疑问。
采用SPSS 24软件进行数据统计分析,计量资料呈正态分布,用(x ±s)表示;计数变量采用频数(率)表示,采用χ2检验分析组间率的差异,采用趋势χ2检验分析超重肥胖率随不同睡眠时长和不同就寝时间的变化趋势。采用Logistic回归分析小学生睡眠状况与超重肥胖的关联,模型1未调整混杂变量,模型2调整性别、年级、是否独生子女、中高强度活动时间、视屏时间、父母文化程度、父母营养状况等混杂变量,以P<0.05为有统计学意义。
检出小学生超重肥胖者888名,检出率为22.59%。男生超重肥胖检出率(27.04%)高于女生(17.44%),独生子女(25.81%)高于非独生子女(21.76%),且年级越高小学生超重肥胖检出率越高,父母超重肥胖的小学生超重肥胖检出率高于父母非超重肥胖的小学生,组间差异均有统计学意义(P值均<0.05)。见表1。
小学生超重肥胖率随着上学日夜间睡眠时长、周末夜间睡眠时长、一周平均每日睡眠时长、周末追赶睡眠时长的增加而降低;上学日和周末就寝时间越晚,小学生超重肥胖率越高(P值均<0.05)。上学日和周末午睡时长、睡眠质量与小学生超重肥胖均无统计学关联(P值均>0.05)。见表1。
以小学生是否超重肥胖(否=0,是=1)为因变量,分别以小学生不同睡眠状态为自变量进行多因素Logistic回归分析,结果显示,调整了性别、年级、是否独生子女、中高强度活动时间、视屏时间、父母文化程度、父母营养状况等混杂因素后,当周末夜间睡眠时长、一周平均每日睡眠时长、周末追赶睡眠时长为连续变量时,睡眠时长每增加1 h,超重肥胖的风险分别减低17%(OR=0.83,95%CI=0.75~0.91)、24%(OR=0.76,95%CI=0.64~0.89)、11%(OR=0.89,95%CI=0.81~0.97)(P值均<0.05)。当周末夜间睡眠时长、一周平均每日睡眠时长、周末追赶睡眠时长为分类变量时,与周末夜间睡眠时长≥10 h相比,周末夜间睡眠时长<9 h的小学生发生超重肥胖的风险增加43%(OR=1.43,95%CI=1.10~1.87);与一周平均每日睡眠时长≥10 h相比,一周平均每日睡眠时长<9 h的小学生发生超重肥胖的风险增加78%(OR=1.78,95%CI=1.12~2.82);与周末追赶睡眠时长≥1 h相比,周末追赶睡眠时长<0.5 h的小学生发生超重肥胖的风险增加21%(OR=1.21,95%CI=1.01~1.46)。与上学日午睡时长<0.5 h相比,上学日午睡时长0.5~<1和≥1 h的小学生发生超重肥胖的风险分别增加20%(OR=1.20,95%CI=1.02~1.42)、37%(OR=1.37,95%CI=1.02~1.83)(P值均<0.05)。见表2。
本研究结果显示,深圳市宝安区小学生超重肥胖检出率为22.59%,高于《中国居民营养与慢性病状况报告(2020年)》报道的19.0%[21],稍低于2021年深圳市的24.0%[22]。2020年国家卫生健康委员会、教育部等部门制定的《儿童青少年肥胖防控实施方案》[23]提出,2020—2030年我国儿童青少年超重率和肥胖率年均增幅需在2002—2017年基线基础上达到下降70%的目标。因此,需要及时识别小学生超重肥胖的风险因素,并制定针对性的预防控制措施。
本研究发现一周平均每日睡眠时长与小学生超重肥胖率呈负相关,睡眠不足会增加小学生超重肥胖的风险,该结果在调整混杂因素后仍成立,与既往多项研究结果一致[24-25]。一项对42个队列研究开展的Meta分析表明,婴儿、儿童和青少年睡眠时长增加1 h,BMI下降0.003 kg/m2[26]。我国河南调查172 710名9~18岁儿童青少年的横断面研究发现,睡眠不足可增加学生肥胖和中心肥胖的风险[27],但该研究仅探究学生每天睡眠时长对肥胖的影响,未区分上学日、周末和周均睡眠时长。本研究除分析一周平均每日睡眠时间,还探究上学日和周末夜间睡眠时长与超重肥胖的关联,结果显示,周末夜间睡眠时长越长,小学生超重肥胖发生风险越低,在上学日夜间睡眠时长方面没有类似发现。提示只关注小学生一周平均每日睡眠时间,可能会忽略上学日和周末之间的差异。夜间睡眠对超重肥胖作用的机制尚未明确,可能与瘦素、胃泌素等激素水平改变有关[28-29],其可能导致食欲增加,增加食物的摄入[30]。本研究从体重管理的角度为睡眠的益处提供证据,进一步支撑我国教育部“要求小学生每天睡眠时间应达到10小时”这一规定[17]。
本研究发现周末追赶睡眠可降低小学生超重肥胖的风险。韩国对1 335名中学生的调查也有相似发现,周末补充睡眠时间与青少年肥胖呈负相关[31]。学生上学日与周末的睡眠时长差值与学业压力有关,上学日小学生早上必须在规定时间到校、晚上需完成作业造成睡眠债务,周末没有时间限制。因此,小学生更倾向于在周末进行补觉,可以看作应对上学日睡眠不足的方式。
本研究还发现,上学日午睡时间过长是小学生超重肥胖的风险因素。曾祥宇等[32]在广东针对中小学生的研究也发现,午睡时间>30 min会增加肥胖的风险。可能与日间睡眠时间增加会减少学生活动时间,从而降低能量消耗有关。提示在探究睡眠时间与学生超重肥胖关联时,不仅要考虑夜间睡眠时长,还要关注日间睡眠时长与夜间睡眠时长的交互作用。
本研究也存在一定的局限性:睡眠时长为监护人主观报告,今后可采用多导睡眠记录仪或腕动计等客观指标;其次,横断面研究不能确定不同睡眠状态与小学生超重肥胖的因果关系,需前瞻性研究进一步论证。
综上所述,增加周末夜间睡眠时长、一周平均每日睡眠时间和周末追赶睡眠时长可降低小学生超重肥胖的发生风险,上学日午睡时间过长是小学生超重肥胖的风险因素。应采取有效干预措施,帮助小学生建立健康的睡眠模式,预防超重肥胖的发生,促进健康成长。
  • 深圳市宝安区科技计划项目(2024JD234)
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2025年第46卷第4期
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doi: 10.16835/j.cnki.1000-9817.2025108
  • 接收时间:2025-01-06
  • 首发时间:2026-11-06
  • 出版时间:2025-04-25
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  • 收稿日期:2025-01-06
  • 修回日期:2025-02-07
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深圳市宝安区科技计划项目(2024JD234)
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    深圳市宝安区慢性病防治院健康教育与促进科, 广东 518000
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2种不同金属材料的力学参数
科
Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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