南京市中小学生身高、体重和超重肥胖自我报告值的准确性

叶青; 秦真真; 汪娜; 王志勇; 徐斐

doi:10.16462/j.cnki.zhjbkz.2020.10.022

南京市中小学生身高、体重和超重肥胖自我报告值的准确性

doi: 10.16462/j.cnki.zhjbkz.2020.10.022

叶青¹,
秦真真¹,
汪娜¹,
王志勇¹,
徐斐^{1, 2, ,}

1.
210003 南京, 南京市疾病预防控制中心慢性非传染病防制科
2.
211166 南京, 南京医科大学公共卫生学院流行病与卫生统计学系

基金项目:

南京市2017年第十五批科技发展计划项目 01715058

南京市医学科技发展资金资助 QRX17199

详细信息

通讯作者:
徐斐, E-mail:frankxufei@163.com

中图分类号: R195.2
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出版历程
- 收稿日期: 2020-02-22
- 修回日期: 2020-04-21
- 刊出日期: 2020-10-10

Accuracy of self-reported body height, weight and excess body weight among school students in Nanjing City

YE Qing¹,
QIN Zhen-zhen¹,
WANG Na¹,
WANG Zhi-yong¹,
XU Fei^{1, 2
, ,}

1.
Department of Chronic and Non-communicable Disease Control and Prevention, Nanjing Municipal Center for Disease Control and Prevention, Nanjing 210003, China
2.
Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China

Funds:

Nanjing Municipal Science and Technique Foundation 01715058

Nanjing Medical Science and technique Development Foundation QRX17199

More Information

Corresponding author: XU Fei, E-mail:frankxufei@163.com

摘要

摘要: 目的评价南京市中小学生身高、体重和体重状况的自我报告值的准确性及其影响因素。方法采用多阶段随机整群抽样方法，抽取南京市12个区小学4年级至高中3年级的在校学生进行面对面问卷调查及体格检查。采用配对t检验分析客观测量值与自我报告值之间差异，不同方法所收集数据之间的一致性比较采用kappa和Bland-Altman法进行分析。结果南京地区中小学生人群中依据客观测量数据所得的超重和肥胖比例分别为16.70%和10.97%。调查对象的身高自我报告值被高估1.33 cm，体重和体重指数（body mass index，BMI）分别被低估1.16 kg和0.76 kg/m²，差异均具有统计学意义（均有P < 0.05）。性别、年级、父母文化程度、城乡情况和体重状况均可影响自我报告值的准确性。自我报告与客观测量参数的体重状况分类的总体一致率为83.89%（κ=0.662）。Bland-Altman分析显示身高、体重和体BMI自我报告与客观测量数据的差值超出95%一致性限范围的点均小于5%。结论南京市中小学生身高和体重自我报告值与客观测量数值之间存在较好的一致性，适用于儿童青少年人群的大样本流行病学调查。
- 中小学生 /
- 身高 /
- 体重 /
- 自我报告 /
- 准确性
Abstract: Objective To assess the accuracy of self-reported body height and weight as well as body weight status among school students in Nanjing, and further to explore the factors affecting the accuracy. Methods With a multistage cluster sampling approach, students of grade four to twelve were randomly selected from 12 districts of Nanjing. All the data were gathered via face-to-face interview and physical examination. Cohen's kappa and Bland Altman plots were used to assess the agreement between self-reported and objectively-measured body height and weight as well as body weights status. Results The proportion of objectively-measured overweight and obesity was 16.70% and 10.97%, respectively, among these students. Participants' body height was significantly over-estimated with an average of 1.33 cm by self-report, while their body weight and body mass index (BMI) value were significantly under-estimated with 1.16 kg and 0.76 kg/m² (all P < 0.05), respectively. The accuracy of self-reported body height and weight might be influenced by participant's gender, grade, parent's educational level, residence location and body weight status. The concordance rate between self-reported and objectively-measured BMI categories was 83.89% (κ=0.662). For each anthropometric characteristic, fewer than 5% of subjects were out of 95% confidence interval of agreement based on Bland-Altman analysis. Conclusions The accuracy of self-reported body height and weight as well as body weight status was acceptable for primary and high school students in Nanjing. It suggests that self-reported anthropometric measurements could be used for population-based epidemiologic surveys among school-aged children and adolescents.
- Primary and high schools students /
- Height /
- Weight /
- Self-reported /
- Accuracy

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表 1 调查对象的一般情况[n (%)]

Table 1. General characteristic distribution of students[n (%)]

变量	人数
性别
男	2 204(50.23)
女	2 184(49.77)
学校类别
小学	1 602(36.51)
初中	1 455(33.16)
高中	1 331(30.33)
父母文化程度
初中及以下	1 264(28.81)
高中或中专	1 415(32.25)
大学及以上	1 709(38.94)
城乡
农村	2 030(46.26)
郊区	997(22.72)
城区	1 361(31.02)
体重分组^a
低体重或正常	3 174(72.33)
超重	733(16.70)
肥胖	481(10.97)
体重状况^b
低体重或正常	3 480(79.31)
超重	617(14.06)
肥胖	291(6.63)
注：^a表示体重分组：根据客观测量身高和体重所计算BMI值进行的体重分组; ^b表示体重分组：根据自我报告身高和体重所计算BMI值进行的体重分组。

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表 2 研究对象身高、体重的自我报告和客观测量值以及BMI值之间差异的比较

Table 2. Comparison of self-reported and measur ed height, weight and BMI of students

变量	身高(cm)				体重(kg)				BMI (kg/m²)
变量	差值^a	95% CI值	P值	趋势P值	差值^b	95% CI值	P值	趋势P值	差值^c	95% CI值	P值	趋势P值
总体	-1.33	-1.43~-1.24	＜0.001		1.16	1.01~1.31	＜0.001		0.76	0.70~0.82	＜0.001
性别				＜0.001				＜0.001				＜0.001
男	-1.62	-1.77~-1.48	＜0.001		0.98	0.74~1.22	＜0.001		0.75	0.65~0.85	＜0.001
女	-1.04	-1.17~-0.91	＜0.001		1.34	1.17~1.51	＜0.001		0.76	0.69~0.84	＜0.001
年级				＜0.001				＜0.001				0.100
小学	-2.24	-2.42~-2.06	＜0.001		0.82	0.59~1.06	＜0.001		0.86	0.75~0.97	＜0.001
初中	-0.96	-1.10~-0.82	＜0.001		1.53	1.27~1.79	＜0.001		0.79	0.69~0.89	＜0.001
高中	-0.65	-0.81~-0.49	＜0.001		1.16	0.88~1.44	＜0.001		0.60	0.50~0.69	＜0.001
父母文化程度				0.761				0.008				0.014
初中及以下	-1.35	-1.35~-1.17	＜0.001		0.79	0.48~1.09	＜0.001		0.61	0.48~0.73	＜0.001
高中或中专	-1.13	-1.32~-0.94	＜0.001		1.26	1.05~1.47	＜0.001		0.76	0.66~0.85	＜0.001
大学及以上	-1.48	-1.63~-1.35	＜0.001		1.35	1.11~1.60	＜0.001		0.87	0.77~0.97	＜0.001
城乡				＜0.001				0.156				＜0.001
农村	-1.12	-1.28~-0.97	＜0.001		1.01	0.77~1.25	＜0.001		0.66	0.56~0.76	＜0.001
郊区	-1.07	-1.24~-0.90	＜0.001		1.00	0.72~1.19	＜0.001		0.60	0.48~0.72	＜0.001
城区	-1.84	-2.01~-1.67	＜0.001		1.49	0.92~1.11	＜0.001		1.01	0.92~1.11	＜0.001
BMI (kg/m²)^d				＜0.001				＜0.001				＜0.001
低体重或正常	-1.13	-1.24~-1.02	＜0.001		0.37	0.23~0.51	＜0.001		0.37	0.31~0.43	＜0.001
超重	-1.64	-1.87~-1.43	＜0.001		2.33	1.89~2.77	＜0.001		1.33	1.17~1.49	＜0.001
肥胖	-2.22	-2.54~-1.89	＜0.001		4.58	3.96~5.19	＜0.001		2.42	2.18~2.66	＜0.001
注：^a差值：身高客观测量值-身高自我报告值; ^b差值：体重客观测量值-体重自我报告值; ^c差值：客观测量身高和体重所计算BMI值－自我报告身高和体重所计算BMI值; ^d BMI：客观测量身高和体重所计算BMI值。

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表 3 居于自我报告值与客观测量值所得BMI值进行体重状况分组的一致性分析[n (%)]

Table 3. The concordance between self-reported and measured BMI group [n (%)]

依据客观测量值分组	依据自我报告值分组			一致性(%)	kappa值	P值
依据客观测量值分组	低体重或正常	超重	肥胖	一致性(%)	kappa值	P值
总体				83.89	0.662	0.009
低体重或正常	3 078(70.15)	72(1.64)	24(0.55)
超重	347(7.91)	361(8.23)	25(0.57)
肥胖	55(1.25)	184(4.19)	242(5.52)
男生				81.45	0.691	0.012
低体重或正常	1 351(61.30)	47(2.13)	14(0.64)
超重	184(8.35)	260(11.80)	20(0.91)
肥胖	26(1.18)	118(5.35)	184(8.35)
女生				86.36	0.579	0.018
低体重或正常	1 727(79.08)	25(1.14)	10(0.46)
超重	163(7.46)	101(4.62)	5(0.23)
肥胖	29(1.33)	66(3.02)	58(2.66)

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