2021年学生营养健康状况监测地区中小学生维生素A水平及影响因素

孙文鑫; 徐培培; 甘倩; 许娟; 杨媞媞; 曹薇; 王宏亮; 罗瑞鹤; 潘慧; 王志芳; 付一萌; 张倩

doi:10.16462/j.cnki.zhjbkz.2024.05.005

2021年学生营养健康状况监测地区中小学生维生素A水平及影响因素

doi: 10.16462/j.cnki.zhjbkz.2024.05.005

孙文鑫¹,
徐培培¹,
甘倩¹,
许娟¹,
杨媞媞¹,
曹薇¹,
王宏亮¹,
罗瑞鹤¹,
潘慧¹,
王志芳¹,
付一萌¹,
张倩^{1, 2, ,}

1.
中国疾病预防控制中心营养与健康所，北京 100050
2.
国家卫生健康委员会微量元素与营养重点实验室，北京 100050

基金项目:

中国疾病预防控制中心营养所公共卫生应急反应机制的运行项目 131031107000180006

详细信息

通讯作者:
张倩，E-mail: zhangqian7208@163.com

中图分类号: R181
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- 被引次数: 0
出版历程
- 收稿日期: 2023-06-15
- 修回日期: 2023-09-20
- 网络出版日期: 2024-06-05
- 刊出日期: 2024-05-10

Analysis of vitamin A level and its influencing factors among students in monitoring area of nutritional health status of students in 2021

1.
National Institute for Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
2.
National Health Commission, Key Laboratory of Trace Element Nutrition, National Institute for Nurtrition and Health, Beijing 100050, China

Funds:

The Operation of Public Health Emergency Response Mechanisms of Chinese Center for Disease Control and Prevention 131031107000180006

More Information

Corresponding author: ZHANG Qian, E-mail: zhangqian7208@163.com

摘要

摘要: 目的分析2021年“农村义务教育学生营养改善计划”(简称“学生营养改善计划”)监测地区中小学生维生素A水平及影响因素。方法血清维生素A浓度0.2~0.3 μg/mL定义为维生素A边缘性缺乏，＜0.2 μg/mL定义为维生素A缺乏，将维生素A边缘缺乏和缺乏合并为维生素A不足。对“学生营养改善计划”监测地区6~17岁中小学生开展问卷调查、体格检测和实验室检查，分析其维生素A水平及影响因素。结果 45 702名中小学生维生素A的均值为0.37(0.31，0.44) μg/mL，维生素A边缘缺乏率为18.3%，缺乏率为1.0%。不同性别、年龄组、学校所在地的中小学生维生素A营养状况存在差异。多因素logistic回归分析模型分析结果显示6~＜9岁年龄组(OR=3.892, 95% CI: 3.303~4.587, P＜0.001)、学校位于农村(OR=1.148, 95% CI: 1.072~1.229, P＜0.001)、父母一方及以上在外务工(OR=1.234, 95% CI: 1.153~1.321, P＜0.001)、母亲文化程度在高中及以下(OR=1.169, 95% CI: 1.046~1.306, P=0.006)、无法保证每天都喝奶(OR=1.155, 95% CI: 1.075~1.240, P＜0.001)、蔬菜摄入＜4种/d(OR=1.081, 95% CI: 1.006~1.163, P=0.034)的中小学生维生素A不足的风险增加。结论 2021年“学生营养改善计划”学生营养健康状况监测地区中小学生维生素A边缘缺乏率较高，且低年龄段儿童更易发生维生素A边缘缺乏或维生素A缺乏。母亲文化程度、奶类和蔬菜摄入情况等是维生素A缺乏的潜在影响因素，需社会予以关注和重视。
- 维生素A /
- 中小学生 /
- 影响因素
Abstract: Objective To analyze the vitamin A levels and influencing factors among students in the monitoring areas of the Nutritional Improvement Program for Rural Compulsory Education Students in 2021. Methods Serum vitamin A concentration 0.2-0.3 μg/mL is defined as marginal vitamin A deficiency, < 0.2 μg/mL is defined as vitamin A deficiency, > 0.3 μg/mL is defined as vitamin A insufficient. In the monitoring area of the Nutritional Improvement Program, questionnaire surveys, physical examinations, and laboratory tests were conducted on primary and secondary school students aged 6-17 and their vitamin A levels and influencing factors were analyzed. Results Totally 45 702 primary and secondary school students were included in this study. The average of serum vitamin A level was 0.37 (0.31-0.44) μg/mL, the marginal deficiency rate was 18.3%, and the deficiency rate was 1.0%. Differences in vitamin A nutritional status were observed across different genders, ages, and school locations. Logistic regression model revealed that students aged 6- < 9 years (OR=3.892, 95% CI: 3.303-4.587, P < 0.001), whose schools are located in rural areas (OR=1.148, 95% CI: 1.072-1.229, P < 0.001), parents working outside (OR=1.234, 95% CI: 1.153-1.321, P < 0.001) and students with lower maternal education levels (OR=1.169, 95% CI: 1.046-1.306, P=0.006), students who could not guarantee to drink milk every day (OR=1.155, 95% CI: 1.075-1.240, P < 0.001) and consume less than 4 kinds of vegetables per day (OR=1.081, 95% CI: 1.006-1.163, P=0.034) have an increased risk of vitamin A deficiency. Conclusions The prevalence of marginal vitamin A deficiency among students in monitoring areas in 2021 was still high, especially among younger children. Maternal education level, intake of milk and vegetables are potential influencing factors of vitamin A deficiency, which need to be paid attention to by all sectors of society.
- Vitamin A /
- Primary and middle school student /
- Influencing factors

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表 1 2021年学生营养健康状况监测地区中小学生基本特征

Table 1. Basic characteristics of students in monitoring area of nutritional health status of students in 2021

特征Feature	合计Total		男生Male		女生Female
特征Feature	人数 Number of people	构成比/% Proportion/%	人数 Number of people	构成比/% Proportion/%	人数 Number of people	构成比/% Proportion/%
合计Total	45 702	100.0	22 982	50.3	22 720	49.7
年龄组/岁 ^① Age group/years ^①
6~＜9	7 892	17.3	3 938	17.2	3 954	17.4
9~＜12	15 179	33.3	7 597	33.1	7 582	33.4
12~＜15	15 340	33.6	7 701	33.6	7 639	33.7
15~17	7 187	15.8	3 690	16.1	3 497	15.5
地区 ^① Area ^①
东部Eastern	8 354	18.4	4 196	18.4	4 158	18.5
中部Central	13 962	30.8	7 066	31.0	6 896	30.6
西部Western	23 015	50.8	11 533	50.6	11 482	51.9
学校所在地 ^① School location ^①
城市Urban	20 373	45.2	10 245	45.2	10 128	45.2
农村Rural	24 736	54.8	12 438	54.8	12 298	54.8
营养状况 ^① Nutritional status ^①
生长迟缓Growth retardation	293	0.8	158	0.9	135	0.8
消瘦Under weight	2 463	6.8	1 397	7.8	1 066	5.9
正常Normal weight	25 055	69.6	11 626	64.8	13 429	74.3
超重Overweight	4 678	13.0	2 625	14.6	2 053	11.4
肥胖Obesity	3 530	9.8	2 145	11.9	1 385	7.6
注：①部分数据缺失。 Note: ① Partial data missing.

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表 2 2021年学生营养健康状况监测地区中小学生血清维生素A水平(μg/mL)

Table 2. Serum vitamin A level of students in monitoring area of nutritional health status of students in 2021 (μg/mL)

特征Feature	合计 ^① Total ^①	男生 ^① Male ^①	女生 ^① Female ^①	Z值 value	P值 value
合计Total	0.37(0.31，0.44)	0.37(0.31，0.43)	0.37(0.32，0.44)	8.485	＜0.001
年龄组/岁Age group/years
6~＜9	0.34(0.29，0.40)	0.34(0.28，0.39)	0.34(0.29，0.40)	-0.740	0.460
9~＜12	0.35(0.30，0.41)	0.35(0.30，0.41)	0.36(0.31，0.42)	3.984	＜0.001
12~＜15	0.39(0.33，0.46)	0.38(0.32，0.45)	0.40(0.34，0.46)	-3.020	0.003
15~17	0.41(0.34，0.48)	0.41(0.35，0.49)	0.40(0.34，0.47)	2.580	0.010
H值value	2 836.997	1 490.593	1 395.332
P值value	＜0.001	＜0.001	＜0.001
地区Area
东部Eastern	0.38(0.32，0.46)	0.49(0.38，0.54)	0.38(0.32，0.46)	1.505	0.133
中部Central	0.36(0.31，0.43)	0.36(0.30，0.52)	0.36(0.31，0.43)	4.393	＜0.001
西部Western	0.37(0.31，0.44)	0.37(0.31，0.43)	0.38(0.32，0.44)	7.646	＜0.001
H值value	282.205	159.737	128.465
P值value	＜0.001	＜0.001	＜0.001
学校所在地School location
城市Urban	0.37(0.32，0.44)	0.37(0.31，0.44)	0.38(0.32，0.44)	4.390	＜0.001
农村Rural	0.36(0.31，0.44)	0.36(0.30，0.43)	0.37(0.31，0.44)	7.364	＜0.001
Z值value	7.892	47.533	4.198
P值value	＜0.001	＜0.001	＜0.001
营养状况Nutritional status
生长迟缓Growth retardation	0.34(0.29，0.41)	0.33(0.28，0.40)	0.33(0.28，0.40)	3.377	0.001
消瘦Under weight	0.35(0.30，0.41)	0.35(0.30，0.41)	0.35(0.30，0.41)	-0.284	0.780
正常Normal weight	0.36(0.31，0.43)	0.36(0.30，0.42)	0.36(0.30，0.42)	-10.691	＜0.001
超重Overweight	0.38(0.32，0.45)	0.38(0.32，0.45)	0.38(0.32，0.45)	1.208	0.227
肥胖Obesity	0.39(0.33，0.45)	0.38(0.33，0.45)	0.38(0.33，0.45)	1.892	0.059
H值value	437.337	308.882	181.072
P值value	＜0.001	＜0.001	＜0.001
注：①以M(P₂₅，P₇₅)表示。 Note: ① M(P₂₅，P₇₅).

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表 3 2021年学生营养健康状况监测地区中小学生血清维生素A缺乏情况

Table 3. Serum vitamin A deficiency of students in monitoring area of nutritional health status of students in 2021

特征Feature	维生素A边缘型缺乏 Marginal vitamin A deficiency			维生素A缺乏 Vitamin A deficiency			维生素A不足 Insufficient vitamin A
特征Feature	人数(占比/%) Number of people (proportion/%)	χ²值 value	P值 value	人数(占比/%) Number of people (proportion/%)	χ²值 value	P值 value	人数(占比/%) Number of people (proportion/%)	χ²值 value	P值 value
合计Total	8 361 (18.3)			461 (1.0)			8 822 (19.3)
性别Gender		58.468	＜0.001		4.311	0.038		62.574	＜0.001
男Male	4 516 (19.7)			254 (1.1)			4 770 (20.8)
女Female	3 845 (16.9)			207 (0.9)			4 052 (17.8)
年龄组/岁 ^① Age group/years ^①		1 247.270	＜0.001		92.311	＜0.001		1 333.684	＜0.001
6~＜9	2 190 (27.8)			134 (1.7)			2 324 (29.4)
9~＜12	3 389 (22.3)			196 (1.3)			3 585 (23.6)
12~＜15	2 007 (13.1)			94 (0.6)			2 101 (13.7)
15~17	752 (10.5)			36 (0.5)			788 (11.0)
地区 ^① Area ^①		92.942	＜0.001		11.403	0.003		92.633	＜0.001
东部Eastern	1 283 (15.4)			62 (0.7)			1 345 (16.1)
中部Central	2 856 (20.5)			125 (0.9)			2 981 (21.4)
西部Western	4 167 (18.1)			261 (1.1)			4 428 (19.2)
学校所在地 ^① School location^①		79.239	＜0.001		24.186	＜0.001		94.465	＜0.001
城市Urban	3 390 (16.6)			150 (0.7)			3 540 (17.4)
农村Rural	4 901 (19.8)			296 (1.2)			5 197 (21.0)
营养状况 ^① Nutritional status ^①		223.503	＜0.001		6.756	0.149		228.456	＜0.001
生长迟缓Growth retardation	77 (26.3)			4 (1.4)			81 (27.6)
消瘦Under weight	622 (25.3)			28 (1.1)			650 (26.4)
正常Normal weight	5 013 (20.0)			278 (1.1)			5 291 (21.1)
超重Overweight	686 (14.7)			43 (0.9)			729 (15.6)
肥胖Obesity	470 (13.3)			24 (0.7)			494 (14.0)
注：①部分数据缺失。 Note: ① Partial data missing.

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表 4 维生素A不足影响因素的多因素logistic回归分析

Table 4. Multivariate logistic regression analysis of influencing factors of vitamin A deficiency

因素Factors	β值 value	s_x	Wald χ²值 value	OR值value (95% CI)	P值 value
性别Gender
男Male				1.000
女Female	-0.268	0.034	63.841	0.765(0.716~0.817)	＜0.001
年龄组/岁Age group/years
15~17				1.000
6~＜9	1.359	0.083	263.248	3.892(3.303~4.587)	＜0.001
9~＜12	1.005	0.053	356.968	2.733(2.462~3.033)	＜0.001
12~＜15	0.290	0.055	27.926	1.336(1.200~1.488)	＜0.001
地区Area
东部Eastern				1.000
中部Central	0.286	0.051	31.031	1.331(1.204~1.472)	＜0.001
西部Western	0.249	0.049	26.438	1.283(1.167~1.411)	＜0.001
学校所在地School location
城市Urban				1.000
农村Rural	0.138	0.035	15.754	1.148(1.072~1.229)	＜0.001
营养状况Nutritional status
生长迟缓Growth retardation				1.000
消瘦Under weight	0.087	0.168	0.268	1.091(0.784~1.519)	0.605
正常Normal weight	0.255	0.060	17.885	1.291(1.147~1.453)	＜0.001
超重Overweight	-0.452	0.056	64.867	0.636(0.570~0.710)	＜0.001
肥胖Obesity	-0.727	0.067	116.126	0.483(0.424~0.552)	＜0.001
父母在外务工情况Parents working outside
双方均未在外务工Neither				1.000
一方及以上在外务工One or more	0.211	0.035	36.845	1.234(1.153~1.321)	＜0.001
母亲文化程度Maternal education
大专及以上Junior college or above				1.000
高中及以下High school and below	0.156	0.057	7.612	1.169(1.046~1.306)	0.006
奶类摄入情况Frequency of milk intake
每天1次及以上Once or more per day				1.000
无法保证每天都喝Less than once a day	0.144	0.040	15.680	1.155(1.075~1.240)	＜0.001
蔬菜摄入情况/(种·d^-1) Vegetable intake /(kinds·d^-1)
≥4				1.000
＜4	0.078	0.040	4.475	1.081(1.006~1.163)	0.034

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特征Feature	合计Total		男生Male		女生Female
特征Feature	人数 Number of people	构成比/% Proportion/%	人数 Number of people	构成比/% Proportion/%	人数 Number of people	构成比/% Proportion/%
合计Total	45 702	100.0	22 982	50.3	22 720	49.7
年龄组/岁 ^① Age group/years ^①
6~＜9	7 892	17.3	3 938	17.2	3 954	17.4
9~＜12	15 179	33.3	7 597	33.1	7 582	33.4
12~＜15	15 340	33.6	7 701	33.6	7 639	33.7
15~17	7 187	15.8	3 690	16.1	3 497	15.5
地区 ^① Area ^①
东部Eastern	8 354	18.4	4 196	18.4	4 158	18.5
中部Central	13 962	30.8	7 066	31.0	6 896	30.6
西部Western	23 015	50.8	11 533	50.6	11 482	51.9
学校所在地 ^① School location ^①
城市Urban	20 373	45.2	10 245	45.2	10 128	45.2
农村Rural	24 736	54.8	12 438	54.8	12 298	54.8
营养状况 ^① Nutritional status ^①
生长迟缓Growth retardation	293	0.8	158	0.9	135	0.8
消瘦Under weight	2 463	6.8	1 397	7.8	1 066	5.9
正常Normal weight	25 055	69.6	11 626	64.8	13 429	74.3
超重Overweight	4 678	13.0	2 625	14.6	2 053	11.4
肥胖Obesity	3 530	9.8	2 145	11.9	1 385	7.6
注：①部分数据缺失。 Note: ① Partial data missing.

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2021年学生营养健康状况监测地区中小学生维生素A水平及影响因素

doi: 10.16462/j.cnki.zhjbkz.2024.05.005

通讯作者:
张倩，E-mail: zhangqian7208@163.com

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Analysis of vitamin A level and its influencing factors among students in monitoring area of nutritional health status of students in 2021

Corresponding author: ZHANG Qian, E-mail: zhangqian7208@163.com

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2021年学生营养健康状况监测地区中小学生维生素A水平及影响因素

doi: 10.16462/j.cnki.zhjbkz.2024.05.005

通讯作者: 张倩，E-mail: zhangqian7208@163.com

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Analysis of vitamin A level and its influencing factors among students in monitoring area of nutritional health status of students in 2021

Corresponding author: ZHANG Qian, E-mail: zhangqian7208@163.com

计量

出版历程

目录

通讯作者:
张倩，E-mail: zhangqian7208@163.com