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Objective@#To investigate the association between the combined effect of height growth and overweight/obesity with elevated blood pressure in Chinese children.@*Methods@#Based on a cohort study of puberty development in Xiamen, a cluster sampling method was used to select 1 313 children whose complete height, weight and blood pressure levels at baseline were obtained in 2017 and during a follow up in 2019. The incidence of elevated blood pressure was compared between four different subgroups, and multivariate Logistic regression was performed to analyze the combined effect in boys and girls.@*Results@#Among 1 313 children, the prevalence of elevated blood pressure at baseline was 25.2%. After 2 years of follow up, the incidence of elevated blood pressure was 19.7% and 23.4% in boys, and 16.6% in girls. After adjusting for factors including age, sex, family history of hypertension, sleep time, intake of fruits, vegetables, sugar sweetened beverages, and meat products, multivariate Logistic regression analyses showed that children in the high height growth and overweight/obesity group were more likely to exhibit a higher incidence of elevated blood pressure (overall:RR=2.41，95%CI=1.44-4.04；boys：RR=2.69，95%CI=1.45-5.02). Among girls, the risk of elevated blood pressure in the low height growth and overweight/obesity group also increased significantly (RR=4.47, 95%CI=1.45-13.75).@*Conclusion@#A large magnitude of height growth and being overweight/obesity were associated with elevated blood pressure in children, especially boys. Therefore, interventions that are targeted toward obesity prevention in children before pubertal growth spurts in height may be beneficial to reduce childhood high blood pressure.
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Objective@#To explore the relationship between nutritional status and puberty onset in boys, and to provide a reference for promoting the development of physical and mental health of boys.@*Methods@#A total of 2 724 boys aged 7 to 12 years from grade 2 to 6 were recruited from Xiamen city by cluster sampling method in 2017. The nutritional status was assessed by physical examination, pubertal developmental status was evaluated by rating scales of Tanner and Prader orchidometer, and puberty timing was determined by the P25 age of puberty onset. The association between nutritional status and puberty onset was estimated by logistic regression model.@*Results@#Pubertal onset was found in 29.0% of the boys and the incidence of early pubertal timing was 2.9%. The prevalence of puberty onset in wasting, normal weight, overweight and obesity boys was 19.6%, 28.7%, 34.4% and 31.5%, respectively. The age of puberty onset was significantly earlier in obese boys (F=3.23, P<0.05). The results of Logistic regression analysis showed that with the increase of BMI, the possibility of puberty onset and risk of early pubertal timing increased. After adjusting for confounding factors, the odds of puberty onset in boys with wasting decreased by 64.0% (OR=0.36, 95%CI=0.22-0.60), the possibility of puberty onset and risk of early pubertal timing in boys with obesity increased by 78.3% (OR=1.78, 95%CI=1.14-2.79) and 192.9% (OR=2.93, 95%CI=1.46-5.86), respectively. These relationships were more pronounced in boys of households with lower economic level (P<0.05).@*Conclusion@#BMI was positively correlated with puberty onset in boys, the odds of puberty onset and risk of early pubertal timing were significantly increased in obese boys, especially in those with low household economic level.
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Objective@#To evaluate the physical fitness and its regional distribution of students aged 13-18 years in China, using the National Standards for Students’ Physical Fitness (revised in 2014).@*Methods@#We recruited 105 834 students aged 13 to 18 years from the Chinese National Survey on Students Constitution and Health project in 2014. Related total scores, rates for qualified and for excellence (the proportions of individuals whose total score greater than or equal to 60.0 or 90.0) of these students were gathered. T test was applied to compare means of total score in different groups. χ2 test was used to compare the differences of qualified or excellence rates between different groups while Pearson correlation method was applied to test the relation of each index with per capita GDP.@*Results@#The average score was (70.1±10.7) among students aged 13 to 18 years in China. 88 805 (83.9%) students whose score exceeded 60.0 while 1 734 (1.6%) exceeded 90.0. Average score, rates of both qualified or excellence of students aged 13 to 15 appeared higher than those aged 16 to 18 but lower in males than in females. However, the rate of excellence was much higher in male students. Students living in urban areas showed both lower average score and qualified rate but higher rate of excellence than those living in rural areas. Both qualified and Excellent rates decreased with the increase of age in both sexes. We also noticed that both higher physical fitness and health status appeared in students from the east coast. Pearson correlation coefficient of each index (average score, qualified or Excellent rate) on per capital GDP appeared as 0.56, 0.43 and 0.65, respectively.@*Conclusion@#In 2014, the physical fitness of Chinese students aged 13 to 18 was not satisfactory, with older students and those living in underdeveloped areas, in particular.
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Objective@#To analyze the prevalence of physical fitness among Chinese Han students aged 13-18 years in 2014, and explore related influencing factors.@*Methods@#This study recruited 106 881 Han students aged 13-18 years who had taken physical fitness test from Chinese National Survey on Students' Constitution and Health in 2014. After the exclusion of 1 047 students without complete records of physical fitness test, 105 834 students were included in the final analysis. According to the National Student Physical Health Standard modified in 2014, seven indicators including body mass index, vital capacity, 50-m run, sit-and-reach, standing broad jump, pull-ups/curl-ups and endurance run were tested to calculate the total score of students' physical fitness. Students with score ≥60 were regarded as qualified students. Multivariate non-conditional logistic regression model was used to analyze influencing factors of physical fitness.@*Results@#Among Chinese Han students aged 13-18 years, the total score was 70.1±10.7 and the qualified rate was 83.9% (n=88 813). Boys (83.5% (44 197/52 910)) had a lower qualified rate of physical fitness than girls (84.3% (44 616/52 924)) (P<0.001), and 13-15 age group (86.5% (46 255/53 465)) was higher than the 16–18 age group (81.3% (42 558/52 369)) (P<0.001). Except for 16–18-year-old boys from central region, normal body mass index, eastern region, good socioeconomic status, enough PE class, exercise time ≥1 h/d, homework time ≥2 h/d, TV time <1 h/d were all related to high qualified rates of physical fitness (P<0.05).@*Conclusion@#Chinese Han students aged 13-18 years were in good physical condition. The qualified rates of physical fitness were significantly different by gender and age groups. Nutritional status, region, socioeconomic status, PE class, exercise time per day, homework time per day, and TV time per day were related factors of physical fitness.
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Objective@#To analyze the change in mortality and major causes of death among Chinese adolescents aged 10-19 years from 1990 to 2016.@*Methods@#Data of death for Chinese adolescents aged 10-19 years were extracted from the Global Burden of Disease Study 2016 (GBD 2016). The data was used to describe the change in mortality of Chinese adolescents from 1990 to 2016.Top 15 causes of death were compared between 1990 and 2016.@*Results@#From 1990 to 2016, the all-cause mortality of Chinese adolescents aged 10-19 years old dropped from 102.5/100 000 to 41.2/100 000, reaching about a half of the global average (78.6/100 000) but still almost twice as high as the average of high-income countries (24.3/100 000) by 2016; the reduction in mortality was higher among females than that among males (decreased 68.7% vs. 54.7%), and among adolescents aged 10-14 years than that among those aged 15-19 years (decreased 62.1% vs. 57.1%). During the 26-year period, the cause-specific mortality of all top 15 causes saw sharp decreases. Among them, communicable, maternal, and nutritional diseases saw the most significant decrease (78.1%), and its proportion in all adolescent deaths fell from 11.1% to 6.1%. Meanwhile, non-communicable diseases and injuries saw relatively small decreases (58.2% and 57.3% respectively), and their proportions rose from 33.4% and 55.6% to 34.8% and 59.1%, respectively. The top 5 causes of death changed from drowning (17.39/100 000 in mortality, 17.0% in proportion), road injuries (14.77/100 000, 14.4%), self-harm (11.44/100 000, 11.2%), leukemia (5.48/100 000, 5.4%) and interpersonal violence (3.12/100 000, 3.0%) in1990 into road injuries (9.27/100 000, 22.5%), drowning (6.83/100 000, 16.6%), leukemia(2.73/100 000, 6.6%), self-harm (2.53/100 000, 6.2%) and congenital birth defects (1.76/100 000, 4.3%) in 2016, and tuberculosis, poisonings and rheumatic heart disease had dropped out of the top 15 in 2016.@*Conclusion@#The mortality of Chinese adolescents aged 10-19 years has decreased significantly, but still higher than developed countries. Since 1990, injuries,especially for road injuries and drowning, have always been the leading causes of death among Chinese adolescents aged 10-19 years, followed by non-communicable diseases.
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Objective@#To investigate the prevalence and related factors of dyslipidemia among children and adolescents aged 6-17 years in 7 provinces in China.@*Methods@#Using the method of stratified cluster random sampling, 93 primary and secondary schools were selected from Guangdong, Hunan, Liaoning provinces, Shanghai, Chongqing, Tianjin municipalities and Ningxia Hui Autonomous Region in China, 2012. A total of 16 434 students aged 6-17 years old with completed physical and lipid profiles parameters were selected into this study from above 93 primary and secondary schools. Dyslipidemia was determined by the definition of Expert Advice on Prevention and Treatment of Dyslipidemia in Children and Adolescents in 2009. Logistic regression model was used to explore the factors related to dyslipidemia.@*Results@#The prevalence of elevated total cholesterol, elevated triglyceride, elevated low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, and dyslipidemia was 5.4% (887 cases), 15.7% (2 578 cases), 3.0% (492 cases), 13.5% (2 221 cases) and 28.5% (4 679 cases) among children and adolescents aged 6-17 years, respectively. Sugary drinks intake ≥once per week (OR=1.14; 95%CI: 1.05-1.24), sedentary time >10 hours per day (OR=1.14, 95%CI: 1.01-1.28), overweight (OR=1.50, 95%CI: 1.33-1.70), and obesity (OR=2.62, 95%CI: 2.31-2.96) were significantly associated with the prevalence of dyslipidemia.@*Conclusion@#The prevalence of dyslipidemia was high among children and adolescents aged 6-17 in 7 provinces in China, 2012. Sugary drinks intake ≥once per week, sedentary time >10 hours per day, overweight and obesity might be the risk factors of dyslipidemia among children and adolescents.
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Objective@#This study aimed to explore the association between malnutrition and the level of blood pressure (BP) as well as elevated BP (EBP) in Han students aged 7 to 18 years in China.@*Methods@#170 037 subjects with normal nutritional status and malnutrition were enrolled in this study from 2014 Chinese National Surveys on Students' Constitution and Health with a multi-stage stratified cluster random sampling framework covering 31 provinces, autonomous regions and municipalities after the exclusion of 44 317 overweight and obese students. According to the standard of "Screening Standard for Malnutrition of School-age Children and Adolescents" (WS/T456-2014), the nutritional status of children were classified into two categories, normal nutritional status and malnutrition containing stunting, mild wasting and moderate severe wasting. The level of BP and prevalence of EBP were compared between students with normal nutritional status and malnutrition. The multivariate logistic regression model was used to analyze the association between malnutrition and EBP.@*Results@#The levels of systolic BP (SBP) and diastolic BP (DBP) in Chinese Han students aged 7-18 years who were non-overweight and non-obesity status were (103.4±12.3) and (64.7±9.5) mmHg (1 mmHg=0.133 kPa), respectively. The prevalence of EBP, systolic EBP and diastolic EBP in Chinese Han malnourished students (N=21 012) were 3.1% (n=649), 1.5% (n=324) and 2.1% (n=445), respectively, which was significantly lower than those (N=148 320) with normal nutritional status (4.5% (n=6 707), 2.6% (n=3 872) and 2.7% (n=3 959)), and the corresponding differences were statistically significant (P<0.05). The OR (95%CI) between malnutrition and EBP was 0.68 (0.62-0.73), which were 0.65 (0.58-0.72) and 0.68 (0.60-0.77) for boys and girls. The OR (95%CI) between EBP and stunting as well as mild wasting and moderate severe wasting were 0.69 (0.62-0.77), 0.63 (0.55-0.72) and 0.79 (0.60-1.05), respectively.@*Conclusion@#The level of BP and prevalence of EBP in Chinese Han students with malnutrition were lower than those with normal nutritional status. The negative correlation existed between malnutrition and EBP in Chinese Han students aged 7 to 18 years.
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Objective@#To understand the nutritional status among Chinese students of five ethnic minorities aged 7-18 years.@*Methods@#Chinese National Survey on Students Constitution and Health in 2014 applied multi-stage stratified cluster random sampling, including 214 354 students from 31 province of China mainland. 73 students whose height or weight information were missing, were excluded. 25 968 minority students aged 7-18 years from Inner Mongolia Autonomous Region, Ningxia Hui Autonomous Region, Xinjiang Uygur Autonomous Region, Guangxi Zhuang Autonomous Region and Jilin Provinces were included for data analysis, including Mongolian (n=5 107), Hui (n=5 308), Uygur (n=5 740), Zhuang (n=5 267) and Korean (n=4 546) students. According to the BMI standard of Working Group on Obesity in China (WGOC) and the new students' health standard of Screening Standard for Malnutrition of School-age Children and Adolescents (WS/T 456-2014) , students were defined as wasting, normal weight, overweight and obesity groups and the nutritional status in different minorities and other characteristics was described and analyszed.@*Results@#The prevalences of wasting in Zhuang, Hui, Uygur, Korean and Mongolian students were 6.1% (318/5 267), 5.1% (266/5 308), 3.2% (187/5 740), 2.6% (116/4 546) and 1.3% (65/5 107) in descending order (χ2=212.60, P<0.001), respectively. The prevalences of overweight in Korean, Mongolian, Hui, Uygur and Zhuang students were 15.2% (686/4 546), 13.1% (669/5 107), 10.3% (549/5 308), 7.8% (446/5 740) and 7.8% (413/5 267) in descending order (χ2=220.80, P<0.001), respectively. The prevalences of obesity in Korean, Mongolian, Hui, Zhuang and Uygur students were 15.3% (695/4 546), 9.5% (488/5 107), 5.7% (304/5 308), 4.6% (242/5 267) and 3.6% (206/5 740) in descending order (χ2=647.02, P<0.001), respectively. The prevalences of wasting in Mongolian, Uygur and Korean rural students were 1.7% (44/2 623), 3.9% (113/2 868) and 3.4% (74/2 154), higher than urban students (all P values <0.05) which were 0.8% (21/2 484), 2.6% (74/2 872) and 1.8% (42/2 392) in Mongolian, Uygur and Korean students. The prevalence of obesity in Mongolian, Hui, Uygur, Zhuang and Korean urban students were 10.8% (269/2 484), 7.6% (193/2 554), 4.1% (117/2 872), 5.9% (153/2 601) and 16.6% (396/2 392), higher than rural students (all P values <0.05) which were 8.3% (219/2 623), 4.0% (111/2 754), 3.1% (89/2 868), 3.3% (89/2 666) and 13.9% (299/2 154) in Mongolian, Hui, Uygur, Zhuang and Korean students. The prevalence of obesity in Hui, Zhuang and Korean boys were 7.2% (188/2 570), 6.0% (157/2 628) and 17.2% (394/2 282), respectively, higher than that of girls which were 4.2% (116/2 738), 3.3% (85/2 639) and 13.3% (301/2 264) (all P values <0.05).@*Conclusion@#The prevalence of wasting, overweight and obesity varied by ethnic minorities in mainland China. The prevalence of overweight and obesity appears higher among mongolian and Korean students, while the prevalence of wasting was higher in Zhuang students.
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Objective To analyze the epidemiological characteristics of notifiable infectious diseases among Chinese students from 2011 to 2016 and to provide reference for the effective prevention and control programs on infectious disease among students.Methods Both morbidity and mortality of notifiable infectious diseases among Chinese students aged 6-22 years from 2011 to 2016 were analyzed,with main characteristics of the disease described.Results During 2011 to 2016,morbidities of Categories A,B and C infectious diseases among the Chinese students aged 6-22 years showed a decreasing trend,from 248.24/100 000 in 2012 to 158.57/100 000 in 2016.Mortality rates of Category A,B and C infectious diseases had also decreased from 0.12/100 000 in 2011 to 0.07/100 000 in 2016.The average morbidity of the top four diseases from Category A and B infectious diseases appeared as:tuberculosis (16.24/100 000),scarlet fever (9.39/100 000),hepatitis B (7.69/100 000) and bacillary and amebic dysentery (7.15/100 000).The average rates of mortality on the top four diseases appeared as:rabies (0.044 8/100 000),HIV/AIDS (0.027 7/100 000),tuberculosis (0.008 0/100 000) and Japanese encephalitis (0.005 9/100 000).The average rates of morbidity on the top four diseases appeared as:mumps (75.81/100 000),hand-foot-mouth disease (28.55/100 000),other infectious diarrhea (22.41/100 000) and influenza (15.67/100 000) in the Category C.Reported death cases were from hand-foot-mouth disease (11 cases),influenza (9 cases),mumps (1 case) and rubella (1 case).The prevalence rates varied among different student populations,with higher HIV/AIDS,hepatitis B and tuberculosis rates among college and senior high school students,while higher mumps,influenza and hand-foot-mouth disease rates among primary school and junior high school students.Conclusions Both morbidity and mortality of notiflable infectious diseases among Chinese students aged 6-22 years had decreased significantly in 2011-2016.However,the major infectious diseases had become new challenges among students.HIV/AIDS had become a key infectious disease among college students and the relatively high prevalence of tuberculosis was seen in college and high school students.
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Objective To analyze the epidemiological characteristics of notifiable infectious diseases among Chinese students from 2011 to 2016 and to provide reference for the effective prevention and control programs on infectious disease among students.Methods Both morbidity and mortality of notifiable infectious diseases among Chinese students aged 6-22 years from 2011 to 2016 were analyzed,with main characteristics of the disease described.Results During 2011 to 2016,morbidities of Categories A,B and C infectious diseases among the Chinese students aged 6-22 years showed a decreasing trend,from 248.24/100 000 in 2012 to 158.57/100 000 in 2016.Mortality rates of Category A,B and C infectious diseases had also decreased from 0.12/100 000 in 2011 to 0.07/100 000 in 2016.The average morbidity of the top four diseases from Category A and B infectious diseases appeared as:tuberculosis (16.24/100 000),scarlet fever (9.39/100 000),hepatitis B (7.69/100 000) and bacillary and amebic dysentery (7.15/100 000).The average rates of mortality on the top four diseases appeared as:rabies (0.044 8/100 000),HIV/AIDS (0.027 7/100 000),tuberculosis (0.008 0/100 000) and Japanese encephalitis (0.005 9/100 000).The average rates of morbidity on the top four diseases appeared as:mumps (75.81/100 000),hand-foot-mouth disease (28.55/100 000),other infectious diarrhea (22.41/100 000) and influenza (15.67/100 000) in the Category C.Reported death cases were from hand-foot-mouth disease (11 cases),influenza (9 cases),mumps (1 case) and rubella (1 case).The prevalence rates varied among different student populations,with higher HIV/AIDS,hepatitis B and tuberculosis rates among college and senior high school students,while higher mumps,influenza and hand-foot-mouth disease rates among primary school and junior high school students.Conclusions Both morbidity and mortality of notiflable infectious diseases among Chinese students aged 6-22 years had decreased significantly in 2011-2016.However,the major infectious diseases had become new challenges among students.HIV/AIDS had become a key infectious disease among college students and the relatively high prevalence of tuberculosis was seen in college and high school students.
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Objective@#To discuss the main causes and risk factors of disability and death among current Chinese adolescents.@*Methods@#Subnational data of China from Global Burden of Disease Study 2015 (GBD 2015) was used to rank the causes and risk factors leading to death and disability adjusted life years (DALY) in Chinese adolescents aged between 10 and 19 years old, and thereby to analyze the main cauese and risk factors of death and DALY among Chinese adolescents in different genders.@*Results@#In 2015, among Chinese adolescents aged 10-19 years old, the total DALY was 13 million 490 thousand years, and the total number of deaths was 63 258 cases. The top 3 causes of DALY were skin and subcutaneous diseases, iron-deficiency anemia and road injuries, resulting in DALY (constituent ratio) of 1 411 (10.5%), 1 094 (8.1%) and 1 029 (7.6%) thousand years respectively. The top 3 causes of death were road injuries, drowning and leukemia, causing 13 881 (21.9%), 9 895 (15.6%) and 4 620 (7.3%) deaths (constituent ratio) respectively. The top 3 risk factors of DALY were iron deficiency, alcohol use and drug use, causing 1 094 (8.1%), 487 (3.6%) and 220 thousand years (1.6%) DALY (constituent ratio) respectively. The top 3 risk factors of death were alcohol use, occupational injuries and drug use, causing 5 957 (9.4%), 1 523 (2.4%) and 810 (1.3%) deaths respectively.@*Conclusion@#Unintentional injury was the top cause of DALY and death in Chinese adolescents, followed by skin and subcutaneous diseases and iron-deficiency anemia. Iron deficiency and alcohol use were the top two risk factors of DALY and death.
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Objective@#To investigate the associations between the appendicular skeletal muscle mass index and main anthropometric parameters, and to provide clues for preventing the reduction of skeletal muscle mass among overweight and obese adults in China.@*Methods@#1 488 volunteered participants who resided in Beijing longer than one year, between 22 and 55 years old, with self-report BMI ≥24 kg/m2 were recruited from April to May 2014. 171 participants whose BMI ≤24 kg/m2 or with organic diseases at the first physical examination were excluded, finally 1 317 overweight/obese participants (male and female were 507, and 810, respectively) were enrolled into the present study. After measuring the anthropometric parameters and body composition by the DXA, Pearson correlation analysis and multiple linear regression models were used to analyze the associations between the appendicular skeletal muscle mass index and main anthropometric parameters.@*Results@#The average age of males and females was (35.6±8.4) and (38.2±9.4) years old, respectively. The females' mean levels of body fat percentage, BMI, waist circumference, hip circumference, and bone mineral density were (41.59±4.14)%, (29.00±3.75) kg/m2, (92.56±9.00) cm, (101.74±6.75) cm, and (1.20±0.10) g/cm2, respectively; and the males' mean levels were (34.22±4.61)%, (30.07±4.12) kg/m2, (99.63±9.49) cm, (102.93±7.28) cm, and (1.28±0.11) g/cm2, respectively. The mean level of appendicular skeletal muscle mass and skeletal muscle mass index in males were (26.98±3.88), and (8.96±1.02) kg, respectively, which were significantly higher than it in females ((18.57±2.61), and (7.26±0.83) kg, respectively) (P<0.001). For male, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat percentage and bone mineral density were 0.814, 0.601, 0.637, 0.558, and 0.434, respectively; for female, the correlation coefficients of skeletal muscle mass index with BMI, waist circumference, hip circumference, body fat rate and bone mineral density were 0.761, 0.534, 0.585, 0.610, and 0.304, respectively. The correlations were statistically significant (P<0.001). Multiple linear regression analysis showed that the skeletal muscle mass index of male decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.13, 95%CI:-0.15--0.12) (P<0.05), while increased with the increase of BMI (β=0.31, 95%CI: 0.29-0.32) and bone mineral density (β=0.54, 95%CI: 0.10-1.01) (P<0.05). The skeletal muscle mass index of female decreased with the increase of age (β=-0.01, 95%CI:-0.01-0.00) and body fat percentage (β=-0.12, 95%CI:-0.14--0.12) (P<0.05), while increased with the increase of BMI (β=0.26, 95%CI: 0.25-0.28) and hip circumference (β=0.01, 95%CI: 0.00-0.02) (P<0.05).@*Conclusion@#The skeletal muscle mass index of male was higher than it of female. For male, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and bone mineral density. While for female, the skeletal muscle mass index might be associated with age, BMI, body fat percentage and hip circumference.
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Objective@#To investigate the trends in overweight and obesity in Chinese students during 1985-2014.@*Methods@#Data were collected from the Chinese National Survey on Students Constitution and Health in 1985, 1995, 2000, 2005, 2010, and 2014, with the sample size of 409 946, 204 977, 216 786, 234 421, 215 319, and 214 354, respectively. The prevalence of overweight and obesity as well as the increase rates were calculated based on the body mass index (BMI) percentile criteria of Working Group on Obesity in China (WGOC).@*Results@#The prevalence of overweight and obesity in 2014 was 19.4% (41 608/214 354) among 7-18 y Chinese children. The prevalence of overweight and obesity was 24.2% (25 975/107 216) among boys, and 14.6% (15 633/107 138) among girls, with the prevalence among boys exceeding girls (P<0.001). The prevalence of overweight and obesity was 22.3% (23 911/107 239) among urban students, and 16.5% (17 697/107 115) among rural students, with the prevalence among urban students exceeding rural students (P<0.001). The prevalence in 2014 differed among provinces, ranging from 2.3% (Hainan Province 166/7 200) to 16.3% (Tianjin 168/7 186). During 1985-2014, the prevalence of overweight and obesity among 7-18 y Chinese children increased continuously, with the annual increase rate of overweight ranging 0.27%-0.63%, and the annual increase rate of obesity ranging 0.10%-0.58%. The annual increase rates in 2010-2014 of obesity among the urban boys, urban girls, rural boys and rural girls were 0.62%, 0.42%, 0.79%, and 0.49%,respectively, peaking the annual increase rates during 1985-2014.@*Conclusion@#The prevalence of overweight and obesity among 7-18 y Chinese children increased continuously during 1985-2014, with the annual increase rate of obesity in 2010-2014 peaking the increase rates during 1985-2014. There were gender and regional differences in the prevalence of overweight and obesity among 7-18 y Chinese children in 2014.
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Objective@#To investigate the prevalence of metabolic syndrome (MS) among children and adolescents aged 10-16 years old in 7 provinces in China.@*Methods@#Using the method of stratified cluster random sampling, 93 primary and secondary schools were selected from Guangdong, Hunan, Liaoning, Shanghai, Chongqing, Tianjin, and Ningxia provinces in China. A total of 9 296 students aged 10-16 years old with complete physical and biochemical parameters were selected as the subjects of the present study from above 93 primary and secondary schools. MS was determined using the definition of 'guideline of 2010 Chinese children and adolescents MS definition and treatment’. The standardized age-sex composition of the 2010 census was used to standardize the MS detection rate of every province. Chi-square test was used to compare the difference of MS prevalence among participants with different characteristics.@*Results@#The prevalence of MS was 4.1% (384/9 296) among children and adolescents aged 10-16 years old in 7 provinces in China. The prevalence of MS among males was 5.0% (237/4 754), which was significantly higher than females (3.2%) (147/4 542) (P<0.05). Stratified by nutrition conditions, the prevalence of MS was 0, 0.6% (39/6 733), 8.9% (104/1 170), 30.0% (241/803) for thin, normal weight, overweight, and obese population, respectively. The MS prevalence increased with the increase of body mass index (BMI) (P<0.001). Stratified by provinces, the prevalence of MS was the highest in Tianjin (9.2%) and the lowest in Hunan province (0.8%).@*Conclusion@#The prevalence of MS was high among children and adolescents aged 10-16 years old in 7 provinces in China. MS prevalence among males was higher than females; MS prevalence among overweight/obese population was higher than normal weight population. The detection rate of metabolic syndrome was different in different provinces.
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Objective@#To investigate the endemic distribution and related factors of elevated blood pressure in Chinese children and adolescents aged 7 to 18 years old.@*Methods@#A total of 214 354 students aged 7 to 18 years old with data integrity of height, weight, and blood pressure were selected from Chinese National Survey on Students Constitution and Health in 2014, including 31 provinces (with the exception of Hong Kong, Macao, and Taiwan) in China. The criterion of elevated blood pressure was defined by the diagnosis and treatment guideline of high blood pressure in US children and adolescent. The differences of elevated blood pressure between boys and girls and different groups of nutritional status were calculated by Chi-square test.@*Results@#The mean values of systolic pressure and diastolic pressure were (104.8 ± 12.8) mmHg (1 mmHg=0.133 kPa), and (65.4 ± 9.7) mmHg, respectively. The rate of elevated blood pressure in Chinese children and adolescents aged 7 to 18 years old was 6.4% (13 558/214 354), as well as 7.0% (7 537/106 982) in boys, and 5.7% (6 131/106 979) in girls (P<0.001). Meanwhile, the rate of elevated blood pressure was 3.2% (321/10 127), 4.9% (7 887/161 419), 9.8% (2 472/25 292), and 17.5% (2 988/17 051) in wasting group, normal group, overweight group and obesity group, respectively, which indicated a rising trend from wasting to obesity among four nutritional status groups(P<0.001).@*Conclusion@#The rate of elevated blood pressure in Chinese boys was higher than girls, especially in overweight and obese students. Therefore, the effective intervention on child and adolescent with overweight or obesity will become the key work on the prevention of high blood pressure in the future.
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Objective@#To investigate the characteristics of geographic distribution and change trend of myopia prevalence for children and adolescents aged 7-18 years old from 2005 to 2014, which provides the basis for the prevention of myopia.@*Methods@#Research material was selected from the data of 2005, 2010, and 2014 Chinese National Survey on Students Constitution and Health, including 31 provinces (with the exception of Hong Kong, Macao, and Taiwan). The complete detection data of binoculus in children and adolescents aged 7-18 years old were selected as our research objects. The research objects of three studies were 233 505, 216 474, and 215 160, respectively. We analyzed the characteristics of geographic distribution and change trend of myopia prevalence for children and adolescents aged 7-18 years old in 31 provinces from 2005 to 2014.@*Results@#The overall myopia detection rates in Chinese children and adolescents aged 7 to 18 years old in 31 provinces were 47.4% (111 707/235 505), 55.6% (120 456/216 474), and 57.2% (122 965/215 160) in 2005, 2010 and 2014, respectively. The growth range in this two phases were 8.0 percentage points, and 1.6 percentage points, respectively, and the difference was statistically significant (P<0.05). The detection rate of Myopia was growing quickly from 2005 to 2010 and only three provinces were in the situation of decline state including Tianjin, Hainan, and Ningxia. 90.3 percent (28/31) of provinces were in the situation of growth state and the growth range was 1.3%-22.3%. The growth of myopia was in the situation of slowdown from 2010 to 2014, and 38.7 percent (12/31) of the provinces were in negative growth districts including Hebei, Shanxi, Inner Mongolia, Zhejiang, Fujian, Shandong, Hubei, Guangxi, Guizhou, Tibet, Qianghai, and Xinjiang. The growth range in other provinces was 0.4%-24.7%.@*Conclusion@#The myopia detection rate was at a higher level and growing constantly in China. There was large difference for myopia of children and adolescents among the 31 provinces. However, the overall growth rate of myopia in children and adolescents was in the situation of a relatively low level form 2010 to 2014.
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Objective@#To investigate consistency of whole-body muscle mass (WBMM) assessed using multi-frequency bioelectrical impedance analysis (MF-BIA) and dual energy X-ray Absorptiometry (DXA) measurement, and to delvelop the correction regression formulas for the method of MF-BIA.@*Methods@#1 488 participants who resided in Beijing longer than one year, under 22 to 55 years of age, with self-report BMI ≥24 kg/m2 were voluntarily recruited based on convenience sampling in Beijing, from April 1st 2014 to May 2nd 2014. After excluded 171 participants who BMI ≤24 kg/m2 or with organic diseases when physical examination, Finally 1 317 overweight/obese participants were enrolled into the current study. All the subjects received the measurement of WBMM using both MF-BIA and DXA methods. The paired-samples T test was used to compare the difference of measurement values between MF-BIA and DXA methods. We evaluated the agreement of WBMM measured by MF-BIA and DXA using the interclass correlation coefficients (ICC) and the Bland-Altman plots, and using linear regression method established correction regression formulas.@*Results@#The differences of overweight male, obese male, overweight female, and obese female were (3.29 ± 1.94), (2.05 ± 2.65), (0.17 ± 1.85), and (-2.22 ± 2.89) kg between methods of MF-BIA and DXA, respectively; Except the overweight female, the others groups had the statistically significant difference (P<0.05). The ICC for overweight male, obese male, overweight female, and obese female were 0.958, 0.956, 0.911, and 0.851, respectively (P<0.001). Bland-Altman plots showed that the limit of agreement for four groups were -0.51-7.09, -3.14-7.24, -3.46-3.80, and -7.88-3.44 kg, respectively. Correction regression formulas: overweight male population: yDXA=-0.648+ 0.952 xMF-BIA; obese male population: yDXA=-3.646 + 1.026xMF-BIA; overweight female groups: yDXA=-4.800 + 1.117 xMF-BIA; obese female group: yDXA=-9.884+ 1.287xMF-BIA.@*Conclusion@#The correlation and agreement of WBMM measured by the methods of BIA and DXA were relative weak in Chinese excess weight male and obese female adults. Therefore, measuring WBMM by MF-BIA method in these adults should be corrected to reduce bias compared with the DXA method.
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Objective: To analyze the prevalence of reduced visual acuity (VA) and to examine the association between reduced visual acuity and influencing factors among Chinese Han students, so as to provide bases for the prevention and treatment of reduced visual acuity.Methods: Subjects were from 2014 Chinese National Surveys on Students' Constitution and Health (CNSSCH).In this survey, 261 832 Han students aged 7-22 years participated.Unaided distance VA was measured using a retro-illuminated lgMAR chart with tumbling-E optotypes.Ametropia was determined by using serial bronchoscopy.Logistic regression was used to assess the association between reduced visual acuity and influencing factors.ArcMap 10 was used to map the regional distribution of reduced visual acuity.Results: Nationwide, the overall prevalence of reduced visual acuity was 66.6%, and was highest among the urban girls (73.5%).The prevalence of myopia was 60.8% and accounted for more than 90% among the students with reduced visual acuity.Compared with 2010 CNSSCH, the increments of reduced visual acuity were highest in the students aged 13-15 years (6.8 percentage points).The prevalence of reduced visual acuity ranged from 50.6% to 76.2% in each province (autonomous region, municipality) in 2014 CNSSCH.The top three of the prevalence of reduced visual acuity were Jiangsu (76.2%), Zhejiang (76.0%) and Shandong (75.9%), and the lowest three were Hainan (50.6%), Guizhou (53.9%) and Xinjiang (57.6%).Logistic regression showed that the girls, urban students, and students who spent ≥2 h per day in their after school homework were more likely to develop reduced visual acuity, but the students with physical activity time ≥2 h per day were less likely to develop reduced visual acuity.Conclusion: Although the situation was different in each province (autonomous region, municipality), reduced visual acuity has become a public concern affecting the health of students in China.Based on the intervention on the key populations, such as urban girls and pre adolescent students, we should also continue to strengthen the prevention and control for reduced visual acuity among all students.
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Objective: To understand and analyze the current situation and secular trends for prevalence of malnutrition among Chinese children and adolescents aged 7-18 years from 2005 to 2014, and to provide important scientific basis for students' nutrition improvement.Methods: All the subjects aged 7-18 years in both sexes were sampled from 2005, 2010 and 2014 Chinese National Surveys on Students Constitution and Health.According to the new students' health standard of Screening Standard for Malnutrition of school-age children and adolescents(WS/T456-2014) in 2014 of China, the nutritional status of children in 31 provinces (autonomous regions and municipalities, excluding Hong Kong, Macao and Taiwan province) were analyzed and compared in different ages, genders, regions and provinces from 2005 to 2014.The Tibetan students was used with the data of Tibetan minority and all the other students from 30 provinces (autonomous regions, municipalities) were Han minority.Results: The prevalence of malnutrition of children and adolescents of Han minority aged 7-18 years in 2014 was 10.0%.The prevalence of malnutrition components, including stunting, mild wasting and moderate severe wasting, were 0.8%, 3.7%, and 5.5%.Compared with 2005 and 2010, the prevalence of malnutrition of Han children and adolescents in 2014 had declined with 5.0 and 2.6 percentage points, respectively, and its components had declined with 1.0, 1.8, 2.2 and 0.4, 1.1, 1.2 percentage points, respectively.The prevalence of malnutrition of 2014 in boys was higher than in girls (11.1% vs.8.9%), the rural was higher than the urban (11.0% vs.9.1%) and the west (11.7%) was higher than the east (9.0%) and the middle (9.2%).Mild wasting of Chinese children and adolescents aged 7-18 years was the main component in malnutrition and the stunting in the Han and Tibetan children and adolescents only accounted for 8.0% and 7.5%, respectively.Compared with 2005 and 2010, the prevalence of malnutrition for Chinese children and adolescents aged 7-18 years in 2014 had declined with various extents constantly, and there was a statistically significant difference among three surveys (P<0.05).Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China from 2005 to 2014.Compared with 2005 and 2010, the prevalence of malnutrition declined in 31 provinces (autonomous regions, municipalities) of China in 2014.The number of provinces (autonomous regions, municipalities) with high prevalence of malnutrition decreased constantly and increased for the number of province (autonomous regions, municipalities) with low prevalence.Conclusion: The prevalence of malnutrition among Chinese children and adolescents aged 7-18 years had declined from 2005 to 2014, but the total prevalence of malnutrition was still high.Mild wasting was the main component in malnutrition and the prevalence of stunting was low.Provinces (autonomous regions, municipalities) with high prevalence of malnutrition mainly concentrated in the southwest of China.
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Objective To explore the association between cesarean section and obesity in child and adolescent.Methods In this study,a total number of 42 758 primary and middle school students aged between 6 and 17 were selected,using the stratified cluster sampling method in 93 primary and middle schools in Hunan,Ningxia,Tianjin,Chongqing,Liaoning,Shanghai and Guangdong provinces and autonomous regions.Log-Binomial regression model was used to analyze the association between cesarean section and obesity in childhood or adolescent.Results Mean age of the subjects was (10.5±3.2) years.The overall rate of cesarean section among subjects attending primary or secondary schools was 42.3％,with 55.9％ in boys and,40.6％ in girls respectively and with difference statistically significant (P＜0.001).The rate on obesity among those that received cesarean section (17.6％) was significantly higher than those who experienced vaginal delivery (10.2％) (P＜0.001).Results from the log-binomial regression model showed that cesarean section significantly increased the risk of obesity in child and adolescent (OR=1.72,95％CI:1.63-1.82;P＜0.001).After adjusting for factors as sex,residential areas (urban or rural),feeding patterns,frequencies of milk-feeding,eating high-energy foods,eating fried foods and the levels of parental education,family income,parental obesity,physical activity levels,gestational age and birth weight etc.,the differences were still statistically significant (OR=1.48,95％ CI:1.39-1.57;P＜0.001).Conclusion The rate of cesarean section among pregnant women in China appeared high which may significantly increase the risk of obesity in child or adolescent.