Objective: To understand the occurrence of different patterns of multimorbidity among children and adolescents aged 9-18 in Tianjin and analyze the cumulative effects of lifestyle on these patterns of multimorbidity. Method: From September to November 2022, a stratified cluster random sampling method was used to select students from primary schools, junior high schools, general high schools, and vocational schools in 16 districts of Tianjin to screen for height, weight, blood pressure, distant vision, and diopter. One year later, a follow-up measurement and questionnaire survey were conducted. The log-binomial model was used to analyze the strength of the association between lifestyle factors and different patterns of multimorbidity. Results: The age of 9 488 students was (12.37±2.49) years old, including 4 999 boys and 4 489 girls. The detection rates of three patterns of multimorbidity of overweight obesity and high blood pressure, overweight obesity and myopia, and overweight obesity with high blood pressure and myopia were 6.63%, 9.32%, and 4.21%, respectively. The detection rates of the three types of multimorbidity in boys were higher than those in girls (all P<0.001). The detection rate of overweight obesity and high blood pressure in suburban areas was higher than that in urban areas (P=0.002). The detection rate of overweight obesity and myopia in suburban areas was lower than that in urban areas (P=0.034). The detection rate of overweight obesity and myopia among those aged 9-12 years old was higher than other age groups (all P<0.001). The ARR (95%CI) for the association between favorable physical activity and the occurrence of overweight obesity and high blood pressure was 0.79 (0.68-0.92). The ARR (95%CI) for the association between favorable physical activity and the occurrence of overweight obesity with high blood pressure and myopia was 0.82 (0.67-0.99). Compared with children and adolescents with 0-2 favorable lifestyle factors, those with 4-5 favorable lifestyle factors had a lower risk of overweight obesity and high blood pressure (ARR=0.84, 95%CI: 0.59-0.92). Conclusion: Boys aged 9-18 in Tianjin are more prone to multimorbidity of overweight obesity and high blood pressure, overweight obesity and myopia, and overweight obesity with high blood pressure and myopia. Children and adolescents with 4-5 favorable lifestyle factors have a reduced risk of occurrence of overweight obesity and high blood pressure. Lifestyle has cumulative effects on multimorbidity of overweight obesity and high blood pressure.
目的： 了解天津市9~18岁儿童青少年不同多病模式的发生情况并分析生活方式对多病模式的累积效应。 方法： 采用分层整群随机抽样方法于2022年9—11月选取天津市16个区的小学、初中、普高和职高的学生进行身高、体重、血压、远视力和屈光度的测量，1年后对其开展追踪测量和问卷调查。采用对数二项模型分析生活方式与不同多病模式之间的关联强度。 结果： 共纳入研究对象9 488名，年龄为（12.37±2.49）岁，其中男生4 999名，女生4 489名。超重肥胖和血压偏高共患、超重肥胖和近视共患，超重肥胖和血压偏高及近视共患的检出率分别为6.63%、9.32%、4.21%。男生的3种多病模式检出率均高于女生（均P<0.001）；郊区学生的超重肥胖和血压偏高共患检出率高于城区学生（P=0.002），而超重肥胖和近视共患检出率低于城区学生（P=0.034）；9~12岁学生的超重肥胖和近视共患检出率高于其他年龄段（均P<0.001）。良好身体活动与超重肥胖和血压偏高共患的ARR=0.79（95%CI：0.68~0.92），良好身体活动与超重肥胖和血压偏高及近视共患的ARR=0.82（95%CI：0.67~0.99）。与0~2个良好生活方式的儿童青少年相比，4~5个良好生活方式的儿童青少年超重肥胖和血压偏高的多病风险降低［ARR=0.84（95%CI：0.59~0.92）］。 结论： 天津市9~18岁男生更易共患超重肥胖和血压偏高、超重肥胖和近视，超重肥胖和血压偏高及近视，满足4~5个良好生活方式的儿童青少年超重肥胖和血压偏高共患风险降低，生活方式对其具有累积效应。.