天津幼儿发育与健康队列研究

王晶; 陈宜人; 郭园园; 姜畅; 李悦; 李喆; 刘功姝; 陈芳芳

doi:10.16835/j.cnki.1000-9817.2023.08.025

天津幼儿发育与健康队列研究

doi: 10.16835/j.cnki.1000-9817.2023.08.025

王晶¹,
陈宜人²,
郭园园¹,
姜畅¹,
李悦³,
李喆³,
刘功姝^1, ,,
陈芳芳^2, ,

1.
天津市妇女儿童保健中心妇幼健康研究所筹备组, 天津 300070
2.
首都儿科研究所流行病学研究室
3.
天津市妇女儿童保健中心检验科

基金项目:

国家重点研发计划项目 2016YFC1300100

北京市属医学科研院所公益发展改革试点项目京医研2021-3

详细信息

作者简介:
王晶(1984-), 女, 天津市人, 硕士, 主治医师, 主要研究方向为妊娠期糖尿病、儿童肥胖和儿童孤独症

陈宜人(1999-), 女, 安徽省人, 在读硕士, 主要研究方向为儿童营养与生长发育评估

通讯作者:
刘功姝, E-mail: liugongshu727@163.com

陈芳芳, E-mail: airechen@126.com

利益冲突声明 所有作者声明无利益冲突。
王晶与陈宜人为共同第一作者。
中图分类号: R723.14 R589 R179
计量
- 文章访问数: 239
- HTML全文浏览量: 143
- PDF下载量: 20
- 被引次数: 0
出版历程
- 收稿日期: 2022-12-30
- 修回日期: 2023-06-06
- 网络出版日期: 2023-08-26
- 刊出日期: 2023-08-25

A cohort study of infant development and health in Tianjin

1.
Preparatory Group of Maternal and Child Health Research Institute, Tianjin Women's and Children's Health Center, Tianjin(300070), China

摘要

摘要: 目的了解学龄前儿童肥胖及相关代谢异常的发生现状，为今后开展干预提供理论支持。方法采用整群抽样法，选取2017年9月—2018年10月入学就读幼儿园小班的3 952名天津本地出生儿童进行基线调查及随访(问卷调查、体格检测和实验室检测)，同时依托天津市妇幼卫生信息系统，回顾母亲孕产期检查、分娩和儿童出生后至学龄前期的定期体检信息，形成双向队列研究。结果分别有3 935，3 654和2 739名儿童完成幼儿园小、中、大班阶段的随访。幼儿园儿童的身高和体重随年龄递增，而体脂百分比随年龄递减(β_线性趋势=-0.74，P＜0.01)。3年中男童的身高、体重和体质量指数(BMI)均高于女童(P值均＜0.05)，而体脂百分比低于女童(小班17.5%，18.5%;中班16.4%，17.2%;大班16.1%，17.1%, P值均＜0.05)。儿童超重肥胖检出率和肥胖检出率均随年龄递增(χ_趋势²值分别为15.51，38.72，P值均＜0.05)，其中肥胖的总检出率从基线水平的5.4%增长到9.6%。实验室检测结果显示，小班男童的空腹血糖异常检出率高于女童(7.7%，4.8%)，血脂异常检出率低于女童(23.8%，27.7%)(χ²值分别为12.01，6.63，P值均＜0.05)。结论研究建立了一个起始于胚胎初期的大型生长队列，将从多维度探索促进儿童健康、防治儿童肥胖和慢性病的策略。
- 肥胖症 /
- 代谢疾病 /
- 队列研究 /
- 儿童, 学龄前
Abstract: Objective To investigate the current situation of obesity and related metabolic abnormalities among preschool children, so as to provide theoretical support for future intervention. Methods A cohort of 3 952 children, born in Tianjin and enrolled in the kindergarten from September 2017 to October 2018, were selected to conduct a baseline survey and a three-year follow-up (questionnaire survey, physical examination and laboratory testing). At the same time, a two-way cohort study was conducted to retrospectively collect maternal prenatal examination, delivery and regular physical examination information of children from birth to preschool age from Tianjin Maternal and Child Health Information System. Results A total of 3 935, 3 654 and 2 739 children completed the follow-up in the primary, middle and senior classes of kindergarten respectively. The height and weight of pre-school children increased with age, while the percentage of body fat decreased with age (β_trend=-0.74, P < 0.01). During three-year follow up, height, weight and body mass index of boys were higher than girls (P < 0.05), while the percentage of body fat was lower than girls (primary class: 17.5%, 18.5%; middle class: 16.4%, 17.2%; senior class: 16.1%, 17.1%, P < 0.05). The detection rate of overweight (including obesity) and obesity increased with age(χ² trend were 15.51, 38.72, P < 0.05). The total detection rate of obesity increased from 5.4% at the baseline level to 9.6%. Laboratory test results showed that the detection rates of fasting blood glucose of boys were higher than that of girls in primary class, but blood lipid abnormalities were in the opposite (glucose: 7.7%, 4.8%; lipid: 23.8%, 27.7%)(χ²=12.01, 6.63, P < 0.05). Conclusion The study has established a large growth cohort starting from the early embryonic stage, which will help to establish the strategies to promote children's health and prevent obesity and chronic diseases from multidimensional perspectives.
- Obesity /
- Metabolic diseases /
- Cohort studies /
- Child, preschool
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

2) 王晶与陈宜人为共同第一作者。

HTML全文

表 1 基线及随访不同性别幼儿身体测量指标比较(x±s)

Table 1. Distribution of children's anthropometry measurements at baseline and follow-up(x±s)

调查时间	性别	人数	统计值	年龄/岁	身高/cm	体重/kg	BMI/(kg·m^-2)	体脂百分比/%
小班	男	2 056		3.8±0.3	103.2±4.4	16.8±2.4	15.7±1.5	17.5±5.5
	女	1 879		3.8±0.3	102.2±4.5	16.3±2.3	15.5±1.4	18.5±5.6
			t值	1.07	6.97	6.93	3.86	-5.75
			P值	0.29	＜0.01	＜0.01	＜0.01	＜0.01
中班	男	1 909		4.6±0.3	109.1±4.6	18.7±3.0	15.7±1.7	16.4±6.0
	女	1 745		4.6±0.3	108.0±4.6	18.1±2.7	15.5±1.6	17.2±6.0
			t值	1.48	6.92	6.81	4.26	-4.32
			P值	0.14	＜0.01	＜0.01	＜0.01	＜0.01
大班	男	1 426		5.6±0.3	116.6±5.3	21.7±4.2	15.8±2.1	16.1±7.1
	女	1 313		5.6±0.3	115.5±5.2	20.9±3.7	15.5±1.9	17.1±6.7
			t值	1.60	5.26	5.17	3.72	-3.79
			P值	0.11	＜0.01	＜0.01	＜0.01	＜0.01

下载: 导出CSV

表 2 基线不同性别幼儿实验室指标比较(x±s)

Table 2. Comparison of laboratory indicators in infants of different genders at baseline

性别	人数	血红蛋白/ (g·L^-1)	TC/ (mmol·L^-1)	HDL-C/ (mmol·L^-1)	LDL-C/ (mmol·L^-1)	TG/ (mmol·L^-1)^*	血尿酸/ (μmol·L^-1)
男	2 056	128.04±8.35	4.43±0.79	1.38±0.27	2.46±0.66	0.79(0.63, 1.00)	240.84±54.72
女	1 879	127.52±8.28	4.43±0.81	1.34±0.25	2.51±0.67	0.84(0.66, 1.07)	235.75±53.43
t值		1.82	0.01	4.48	-1.94	-5.00	2.72
P值		0.07	0.99	＜0.01	0.05	＜0.01	0.01
注：*M(P₂₅，P₇₅)。

下载: 导出CSV

表 3 幼儿园各班级不同性别儿童生活行为报告率及分布比较

Table 3. Comparison of lifestyle status of children of different genders in kindergarten classes

调查时间	性别	人数	统计值	生活行为情况		进食零食频率				进食快餐频率				进食饮料频率
调查时间	性别	人数	统计值	理想运动	理想睡眠	＜1次/月	1~3次/月	1~3次/周	4~7次/周	＜1次/月	1~3次/月	1~3次/周	4~7次/周	＜1次/月	1~3次/月	1~3次/周	4~7次/周
小班	男	2 056		291(14.3)	1 734(86.3)	220(11.3)	501(25.7)	632(32.4)	595(30.5)	1 133(60.8)	693(37.2)	30(1.6)	7(0.4)	1 086(61.5)	491(27.8)	146(8.3)	43(2.4)
	女	1 879		250(13.4)	1 587(86.5)	205(11.4)	420(23.4)	590(32.9)	577(32.2)	1 128(66.0)	551(32.2)	30(1.8)	1(0.1)	1 030(63.9)	445(27.6)	110(6.8)	26(1.6)
			χ²值	0.67	0.06	2.87				14.19				5.89
			P值	0.41	0.81	0.41				＜0.01				0.12
中班	男	1 909		258(15.9)	1 293(84.8)	182(11.4)	886(55.3)	400(25.0)	134(8.4)	278(17.3)	1279(79.7)	40(2.5)	7(0.4)	735(46.0)	749(46.9)	92(5.8)	21(1.3)
	女	1 745		221(15.1)	1 155(84.0)	141(9.7)	803(55.4)	394(27.2)	112(7.7)	254(17.5)	1172(80.6)	23(1.6)	5(0.3)	661(45.6)	684(47.2)	93(6.4)	11(0.8)
			χ²值	0.38	0.39	3.74				3.33				2.82
			P值	0.54	0.53	0.29				0.34				0.42
大班	男	1 426		56(4.1)	879(68.0)	149(11.1)	764(56.8)	362(26.9)	71(5.3)	186(13.8)	1 112(82.7)	44(3.3)	3(0.2)	304(22.6)	855(63.7)	166(12.4)	18(1.3)
	女	1 313		55(4.4)	851(69.9)	123(9.9)	706(56.7)	336(27.0)	80(6.4)	193(15.5)	1025(82.1)	27(2.2)	4(0.3)	272(21.8)	793(63.7)	164(13.2)	16(1.3)
			χ²值	0.09	1.11	2.35				4.34				0.53
			P值	0.77	0.29	0.50				0.23				0.91
注：()内数字为报告率或构成比/%。

下载: 导出CSV

参考文献(12)

[1]	ENDOCRINOLOGY T L D. Childhood obesity: a growing pandemic[J]. Lancet Diabetes Endocrinol, 2022, 10(1): 1. doi: 10.1016/S2213-8587(21)00314-4
[2]	李辉, 宗心南, 季成叶, 等. 中国2~18岁儿童青少年超重和肥胖筛查体重指数界值点的研究[J]. 中华流行病学杂志, 2010, 31(6): 616-620. doi: 10.3760/cma.j.issn.0254-6450.2010.06.004 LI H, ZONG X N, JI C Y, et al. Body mass index cut-offs for overweight and obesity in Chinese children and adolescents aged 2-18 years[J]. Chin J Epidemiol, 2010, 31(6): 616-620. (in Chinese) doi: 10.3760/cma.j.issn.0254-6450.2010.06.004
[3]	American Diabetes Association. Diagnosis and classification of diabetes mellitus[J]. Diabetes Care, 2010, 33(S1): 62-69.
[4]	《中华儿科杂志》编委会, 中华医学会儿科学分会儿童保健学组, 中华医学会儿科学分会心血管学组, 等. 儿童青少年血脂异常防治专家共识[J]. 中华儿科杂志, 2009, 47(6): 426-428. doi: 10.3760/cma.j.issn.0578-1310.2009.06.007 The Editorial Board of Chinese Journal of Pediatrics, Subspecialty Group of Child Health Care, the Society of Pediatrics, Cardiovascular Disease of Chinese Society of Pediatrics. Experts consensus or prevention and treatment of dyslipidemia in children and adolescents[J]. Chin J Pediatr, 2009, 47(6): 426-428. (in Chinese) doi: 10.3760/cma.j.issn.0578-1310.2009.06.007
[5]	学龄前儿童(3~6岁)运动指南编制工作组, 关宏岩, 赵星, 等. 学龄前儿童(3~6岁)运动指南[J]. 中国儿童保健杂志, 2020, 28(6): 714-720. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202006031.htm Working Group on Physical Activity Guideline for Chinese Preschoolers (aged 3-6 years old), GUAN H Y, ZHAO X, et al. Physical activity guideline for Chinese preschoolers aged 3-6 years old[J]. Chin J Child Health Care, 2020, 28(6): 714-720. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202006031.htm
[6]	SILVERMAN B L, RIZZO T A, CHO N, et al. Long-term effects of the intrauterine environment: the Northwestern University Diabetes in Pregnancy Center[J]. Diabetes Care, 1998, 21 (Suppl 2): B142-B149.
[7]	TAM W, MA R, YANG X, et al. Glucose intolerance and cardiometabolic risk in children exposed to maternal gestational diabetes mellitus in utero[J]. Pediatrics, 2008, 122(6): 1229-1234. doi: 10.1542/peds.2008-0158
[8]	KOLETZKO B, VON KRIES R, MONASTEROLO R C, et al. Infant feeding and later obesity risk[J]. Adv Exp Med Biol, 2009, 646: 15-29.
[9]	SALAHUDDIN M, PEREZ A, RANJIT N, et al. The associations of large-for-gestational-age and infant feeding practices with children's body mass index Z-score trajectories: the early childhood longitudinal study, birth cohort[J]. Clin Obes, 2017, 7(5): 307-315. doi: 10.1111/cob.12201
[10]	WANG J, LIU E, WANG Y, et al. Association of early pregnancy body mass index and children's birth weight with risk of being overweight in childhood[J]. Am J Human Biol, 2018, 30(5): e23174. doi: 10.1002/ajhb.23174
[11]	WANG J, PAN L, LIU E, et al. Gestational diabetes and offspring's growth from birth to 6 years old[J]. Int J Obes, 2019, 43(4): 663-672. doi: 10.1038/s41366-018-0193-z
[12]	刘军廷, 刘功姝, 吴艳华, 等. 生物电阻抗法测量3~6岁儿童体成分的准确性[J]. 中华实用儿科临床杂志, 2021, 36(2): 104-108. LIU J T, LIU G S, WU Y H, et al. Validation of bioelectrical impedance analysis in measuring body composition of children aged from 3 to 6[J]. Chin J Appl Clin Pediatr, 2021, 36(2): 104-108. (in Chinese)