背景增加体力活动位居健康促进措施之首，其健康效应已涉及超重、肥胖及相关慢性病的发生、发展和预后。而大量久坐行为独立于中高强度体力活动水平，增加超重、肥胖及相关慢性病的患病风险。因此，要评估体力活动与肥胖间的真实效应，仅关注中高强度活动或静坐活动是片面的，应综合考虑日常生活中多种体力活动组合形式与超重、肥胖的关联。目的探讨城区成年居民不同体力活动模式与超重、肥胖的关系。方法于2013年3—10月，采用多阶段随机抽样方法，在南京市和上海市选取756名成年居民进行调查。收集研究对象性别、年龄、文化程度、身高、体质量、慢性病患病情况，采用体力活动日志调查研究对象连续7d的体力活动时间。采用因子分析评价研究对象体力活动模式，将各体力活动模式的因子得分分为等距的4组，由低到高将研究对象分为Q1组、 Q2组、 Q3组和Q4组。结果研究对象超重率和肥胖率分别为33.2％(251／756）和6.3％(48／756）。男性超重率、肥胖率均高于女性(χ2＝23.80、8.79， P＜0.01）。各年龄段超重率比较，差异有统计学意义(χ2＝23.20， P＜0.05）。因子分析提取前4个为主要因子，特征值分别为2.52、2.00、1.45和1.18，累积贡献率为57.5％，分别命名为久坐模式、居家模式、均衡模式、锻炼模式。 Logistic回归分析显示，经校正混杂因素后，久坐模式是超重、肥胖的危险因素，居家模式是超重、肥胖的保护因素( P＜0.05）。未发现均衡模式、锻炼模式与超重、肥胖的发生风险有关( P＞0.05）。久坐模式Q1组与Q4组中强度活动、高强度活动时间百分比比较，差异均无统计学意义( P＞0.05）； Q1组静坐活动时间百分比低于Q4组，低强度活动时间百分比高于Q4组，总能耗高于Q4组(P＜0.05）。居家模式Q1组与Q4组中强度活动、高强度活动时间百分比比较，差异均无统计学意义( P＞0.05）； Q1组静坐活动时间百分比高于Q4组，低强度活动时间百分比低于Q4组，总能耗低于Q4组(P＜0.05）。均衡模式与锻炼模式各强度活动时间百分比及总能耗比较，差异均无统计学意义(P＞0.05）。结论以静态活动为主的久坐模式是超重、肥胖的危险因素，锻炼模式并不能完全保护个体久坐对健康的消极影响，通过低强度体力活动累积而获得高水平能量消耗量增加的居家模式可补偿久坐对健康的危害。%Background Increasing physical activity is the top measure for promoting health, and its health effects have been observed in the incidence, development, and prognosis of overweight, obesity, and related chronic diseases.However, many sedentary behaviors, separated from levels of medium to high physical activities, can increase the risks of overweight, obesity, and related chronic diseases.Therefore, only focusing on medium to high physical activities or sedentary behaviors is insufficient for evaluating the real relationships between physical activities and obesity.Association between combinations of various physical activities in daily life and overweight and obesity should be taken into consideration.Objective To explore the relationship between different physical activity patterns and overweight and obesity of adult residents in urban areas.Methods A total of 756 adult residents in Nanjing and Shanghai were the objects of the study.They were selected through multistage random sampling method from March to October in 2013.Data on gender, age, education level, height, weight, and history of chronic diseases were collected.Physical activity log investigation was used to gather the activity duration time of the objects for consecutive seven days.Factor analysis was applied to analyze the objects′physical activity patterns.The objects were divided into four groups (Q1, Q2, Q3, and Q4), based on factor scoring of the physical activity patterns with equal interval.Results Overweight and obesity rates accounted for 33.2% (251/756) and 6.3% (48/756), respectively. The overweight and obesity rates of male objects were higher than those of female objects (χ2 =23.80, 8.79; P <0.01). When the overweight rates of objects among different age groups were compared, the differences were statistically significant (χ2=23.20, P<0.05).The first four factors were selected as the main factors through factor analysis.The characteristic roots were 2.52, 2.00, 1.45, and 1.18, with an accumulative contribution rate of 57.5%.The four factors were named as sedentary pattern, the housebound pattern, the balance pattern, and the exercise pattern. The Logistic regression analysis showed that, after correction of confounding factors, the sedentary pattern was the risk factor of overweight and obesity, and the housebound pattern was the protective factor of overweight and obesity (P<0.05).Association between the balance pattern and overweight and obesity or association between the exercise pattern and overweight and obesity was not found ( P>0.05) .When the time percentage of medium intensity activities and high intensity activities between group Q1 and group Q4 in the sedentary pattern were compared, the differences were not statistically significant (P>0.05).The time percentage of sedentary activities of group Q1 was lower than that of group Q4, the low intensity activities time percentage of group Q1 was higher than that of group Q4, and the total energy consumption of group Q1 was higher than that of group Q4 in the sedentary pattern (P<0.05).When the time percentage of medium intensity activities and high intensity activities were compared between group Q1 and group Q4 in the housebound pattern, the differences were not statistically significant (P>0.05).The time percentage of sedentary activities of group Q1 was higher than that of group Q4, the time percentage of low intensity activities of group Q1 was lower than that of group Q4, and the total energy consumption of group Q1 was lower than that of group Q4 in the housebound pattern (P<0.05). When the time percentage of activities of all intensity levels and total energy consumption were compared between group Q1 and group Q4 in the balance pattern and the exercise pattern, the differences were not statistically significant ( P >0.05 ) . Conclusion The sedentary pattern dominated by sedentary activities is the risk factor of overweight and obesity.The exercise pattern cannot completely protect individuals from the negative effect of sedentary activities on health.The housebound pattern, in which high amount of energy can be consumed through accumulation of low intensity physical activities, can offset the negative effect of sedentary activities on health.
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