| BackgroundChildhood is an important stage of growth and development,and the health status in this period will often affect the health of children as they grow up.To some extent,as a mirror of national and social development,it also reflects the development level of a country in economy,education,medical and other aspects.In recent years,the detection rate of overweight and obesity in children has shown an obvious upward trend worldwide.If the targeted strategic measures are not taken to effectively intervene,the overweight and obesity rates of school-age children aged 7 years and above in China will reach 22.3%by 2020.By 2030,this figure will even rise to 28.0%.Besides,overweight and obesity cam also cause many diseases,including recent target organ damage,adult obesity,hypertension,coronary heart disease,type Ⅱ diabetes,etc.Meanwhile,children’s overweight and obesity,as a complex health problem,are also affected by many factors such as heredity,environment,social economy and intestinal flora.Only through the joint efforts and cooperation of the whole society can we effectively prevent the occurrence of overweight and obesity in children.ObjectiveThis paper aims to understand the overweight and obesity status of children aged 6 to 12 years in Shandong province by analyzing the overweight and obesity status of children from different counties cities,ages and genders in Shandong province.According to the correlation analysis between children’s overweight and obesity and various factors(including relevant functional indicators,common diseases,economic factors,etc.),understand the influence and effect of different factors on overweight and obesity.At the same time,through the analysis of regional distribution differences and the prediction of childhood obesity rate in Shandong province in the future,the corresponding basic data will be provided for various counties in Shandong province,so that relevant departments in each district can take targeted prevention and control measures according to the characteristics of the region.Subjects and Methods1 SubjectsThe research data is derived from the physical examination data of primary and middle school students in Shandong Province from 2014 to 2017.Among them,children aged 6 to 12 years old were selected as subjects.After screening by gender and age(screening range-3<z<3),a total of 27,098,318 children were included.2 Statistical methodsRaw data was extracted using Microsoft SQL Server 2017,and the extracted data was read,organized,and analyzed using SPSS 22.0 and SAS 9.4.Measurement data were described by mean±standard deviation(x ±s),t test was used for comparison between groups,and analysis of variance was used for comparison between groups.The count data was expressed by the rate(%),and the comparison between groups was performed by chi-square test.The rank correlation analysis is used to analyze the correlation between functional indicators,common diseases and children’s overweight,obesity.Multivariate logistic regression analysis was used to analyze the influence of economic factors on childhood obesity.With the aid of AcrGIS 10.2 software,the natural breakpoint grading method(Jenks)is applied to map overweight and obesity of children aged 6-12 years old in Shandong province,and spatial autocorrelation analysis is carried out.Chi-square trend test and time series analysis were used to predict the future incidence rate of childhood obesity in Shandong province.Results1 Status of overweight and obesity in children aged 6 to 12 years in Shandong provinceFrom 2014 to 2017,the overall prevalence of overweight among children aged 6 to 12 years in Shandong province fluctuated between 16%and 17%.The detection rate of obesity increased from 14.84%to 17.81%.The difference between urban and rural areas shows that within the different geographical divisions,the overall detection rate of cities was higher than that of villages.Meanwhile,the detection rate of male students was higher than that of female students,and the same results were obtained in all counties in the province.There was a linear correlation between age and overweight and obesity.The overall performance was that the detection rate of children aged 6 years was higher than that of children 12 years old.2 Correlation between functional indicators and body mass index(BMI)Functional indicators(vital capacity,systolic blood pressure,diastolic blood pressure,vital capacity weight index)were found to be associated with BMI in all age groups and gender groups,in which vital capacity,systolic pressure and diastolic pressure were weakly positively correlated with BMI at first,while vital capacity weight index was negatively correlated with BMI at low level.3 Correlation between common diseases and children’s overweight and obesityCommon diseases(high blood pressure,poor vision and dental caries)were found to be associated with overweight and obesity in children.High blood pressure and poor vision were weakly positively correlated with overweight and obesity in children,while caries was weakly negatively correlated with overweight and obesity.Among them,the correlation between high blood pressure and overweight and obesity was higher than that of poor vision and dental caries.4 Correlation between economic factors and childhood obesityCompared with the counties with the lowest degree of obesity,the total retail sales of consumer goods and the per capita disposable income of rural residents were risk factors for the degree of obesity in the region,and the greater the degree difference,the stronger the influence.Gross domestic product and general public budget expenditure did not have any impact.5 Spatial differences of overweight and obesity in children aged 6-12 in Shandong provinceIn 2014,the county with a relatively high overall overweight rate in Shandong province was mainly concentrated in the eastern part of Shandong peninsula,western Shandong and southern regions.In 2015,it was mainly distributed in the eastern Shandong peninsula,most areas in southern Shandong and a few areas in the central and northern parts,with obvious low-value aggregation in the northwest.Moreover,Shandong showed scattered distribution in 2016 and 2017,and no spatial aggregation was detected.The distribution characteristics of obesity high-incidence counties in each year were relatively consistent,mainly concentrated in the eastern Shandong peninsula,central Shandong and northern regions.High-value accumulation areas were mainly found in the eastern part of the peninsula and also in the central part of Shandong.In contrast,the low-value accumulation areas gradually shifted from northwest Shandong to southwest and southeast Shandong.6 Prediction of obesity rates among children aged 6 to 12 years in Shandong province in 2018From 2018 to 2020,the obesity rates of children aged 6-12,boys and girls in Shandong province will continue to increase,and the overall detection rate will increase to 18.14%,19.06%and 19.98%.The detection rate of boys will reach 21.31%.22.40%and 23.50%.Girls will increase to 14.30%,14.99%and 15.69%.Conclusion1.From 2014 to 2017,the overweight rate of children was relatively stable,and the detection rate of obesity among children aged 6 to 12 years in Shandong province increased year by year.There was a great difference between male/female and urban/rural areas,with the former being higher than the latter.In terms of age,the 6-year-old detection rate was higher than 12 years old.2.The functional indicators(spirometry,blood pressure,vital capacity weight index)were found to be correlated with BMI in all age groups and gender groups.Among them,vital capacity,systolic blood pressure and diastolic blood pressure were weakly positively correlated with BMI,while vital capacity weight index was weakly negatively correlated.3.Common diseases(high blood pressure,poor vision and dental caries)were associated with overweight and obesity in children.High blood pressure and poor cision were weakly positively correlated with overweight and obesity in children,while caries is weakly negatively correlated.Among them,the correlation between high blood pressure and overweight and obesity was higher than the other two diseases.4.The total retail sales of consumer goods and the per capita disposable income of rural residents were risk factors for the degree of childhood obesity in the region;GDP and general public budget expenditure have no effect.5.The high prevalence of overweight among children aged 6-12 years in Shandong province was mainly concentrated in the eastern Shandong peninsula and southern Shandong in 2014 and 2015,with obvious low concentration in the northwest.In 2016 and 2017,there were scattered distribution characteristics and no spatial aggregation characteristics.The counties with high incidence of obesity were mainly concentrated in the eastern,central and northern parts of Shandong province,while the eastern part of the peninsula has obvious high-value concentration areas.Meanwhile,the low-value accumulation areas gradually shifted from northwest Shandong to southwest and southeast.6.From 2018 to 2020,the obesity rate of children aged 6 to 12 years old,boys and girls in Shandong province will continue to maintain an upward trend.The overall obesity rate of children will increase to 18.14%in 2018,and obesity rates of boys and girls will reach 21.31%and 14.30%respectively.In 2019 and 2020,the prevalence of obesity among children,boys and girls will reach 19.06%/19.98%,22.40%/23.50%,and 14.99%/15.69%,respectively. |
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