母乳喂养时长对儿童脂肪重积聚时间的影响

林丹; 陈迪迪; 李云; 温晓飒; 黄俊; 史慧静; 汪玲

doi:10.16835/j.cnki.1000-9817.2022.06.003

母乳喂养时长对儿童脂肪重积聚时间的影响

doi: 10.16835/j.cnki.1000-9817.2022.06.003

林丹¹,
陈迪迪^{2, 3},
李云⁴,
温晓飒^{2, 3},
黄俊⁴,
史慧静^1, ,,
汪玲^1, ,

1.
复旦大学公共卫生学院妇幼与儿少卫生教研室，上海 200032
2.
上海市闵行区疾病预防控制中心学校卫生科
3.
复旦大学公共卫生学院闵行分院
4.
上海市闵行区妇幼保健院儿保科

基金项目:

上海市加强公共卫生体系建设第五轮重点学科建设项目 GWV-10.1-XK08

详细信息

作者简介:
林丹(1983-)，女，福建福州人，在读博士，副编审，主要研究方向为生命早期保健和慢性病预防

通讯作者:
史慧静，E-mail：hjshi@fudan.edu.cn

汪玲，E-mail：lingwang@fudan.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R 723.14 R 179
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-16
- 修回日期: 2022-01-10
- 网络出版日期: 2022-06-23
- 刊出日期: 2022-06-25

Effect of breastfeeding duration on age at adiposity rebound in children

LIN Dan¹,
CHEN Didi^{2, 3},
LI Yun⁴,
WEN Xiaosa^{2, 3},
HUANG Jun⁴,
SHI Huijing^{1
, ,},
WANG Ling^{1
, ,}

1.
Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai (200032), China

摘要

摘要: 目的研究儿童出生后母乳喂养时长对于儿童脂肪重积聚发生时间的影响，为生命早期养育照护和肥胖预防提供科学依据。方法选取上海市闵行区2019年9月入学的6 148名小学一年级学生为研究对象，回顾性获得1~80月龄时的身长(身高)和体重检查记录，采用自然3次样条函数拟合体质量指数(BMI)的生长轨迹，计算脂肪重积聚时间。通过多元线性回归模型和广义相加模型分析出生后母乳喂养持续时长与脂肪重积聚时间的关系。结果研究对象的平均母乳喂养时间为(3.71±3.28)个月。男童母乳喂养时长≤4个月的报告率为69.63%，女童为70.45%。母乳喂养时长与脂肪重积聚时间存在正向线性关系[男童：B值(B值95%CI)=0.16(0.02~0.30)，女童：B值(B值95%CI)=0.34(0.18~0.51)，总体：B值(B值95%CI)=0.23(0.12~0.34)](P值均 < 0.05)。结论母乳喂养时长独立影响脂肪重积聚发生时间，在24月龄内延长母乳喂养时长可能有助于推迟儿童脂肪重积聚时间，从而帮助降低生命后期超重肥胖的发病风险。
- 母乳喂养 /
- 脂肪组织 /
- 时间 /
- 回归分析 /
- 儿童
Abstract: Objective To explore the effect of breastfeeding duration on age at adiposity rebound, and provide a scientific theoretical basis for identifying early life factors of obesity in children and adolescents, while promoting early intervention. Methods In September 2019, first graders from a primary school in Minhang District, Shanghai, were selected to participate in this study, and their growth information was retrospectively collected. The natural cubic spline function was used to fit the body mass index trajectory of the subjects from 1 to 80 months, and age at adiposity rebound was calculated. A total of 6 148 subjects were selected, and complete data of adiposity rebound timing and breastfeeding duration were obtained. A multiple linear regression model was used to analyze the relationship between these two variables. Results The average breastfeeding duration of all children included in the study was (3.71±3.28) months, and most of the subjects (69.63% for male and 70.45% for female) were breastfed for less than 4 months. A positive linear relationship was found between them [male, B=0.16(0.02-0.30), female, B=0.34(0.18-0.51), total, B=0.23(0.12-0.34), P < 0.05]. The linear relationship was determined using the multivariate model. Conclusion Breastfeeding duration independently affected age at adiposity rebound. Prolonging the duration of breastfeeding within 24 months of age may help to delay the timing of adiposity rebound, and thus reduce later risks of overweight and obesity.
- Breast feeding /
- Adipose tissue /
- Time /
- Regression analysis /
- Child
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

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图 1 儿童随母乳喂养时长变化的脂肪重积聚时间

Figure 1. Timing of adiposity rebound changed with breastfeeding duration in children

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表 1 不同性别儿童基本特征情况比较

Table 1. Comparison of the basic characteristics of children with different genders

性别	人数	母亲孕期并发症			早产^*	剖宫产	母亲一胎多产^*			食欲好
性别	人数	贫血^*	高血压^*	糖尿病^*	早产^*	剖宫产	母亲一胎多产^*			食欲好
男	3 214	6(0.24)	6(0.24)	18(0.72)	129(4.01)	1 557(48.47)			40(1.76)	3 161(98.35)
女	2 934	8(0.36)	7(0.31)	12(0.54)	120(4.10)	1 346(45.88)			42(2.03)	2 877(98.06)
χ²值		0.24	0.03	0.35	0.01	4.05			0.29	0.60
P值		0.46	0.63	0.42	0.86	0.04			0.51	0.39

性别	人数	出生体重		睡眠缺乏				睡眠过度
性别	人数	巨大儿	大于胎龄儿	0~3月龄^*	4~11月龄^*	12~24月龄^*		0~3月龄^*	4~11月龄^*	12~24月龄^*
男	3 214	282(8.98)	346(11.36)	57(1.78)	1 185(36.93)	11(0.34)		52(1.62)	22(0.69)	101(3.15)
女	2 934	137(4.82)	311(11.20)	34(1.28)	1 087(40.91)	7(0.25)		60(2.12)	7(0.26)	106(3.87)
χ²值		39.00	0.02	2.06	9.55	0.16		1.80	4.66	2.07
P值		< 0.01	0.85	0.13	< 0.01	0.50		0.15	0.02	0.13
注： ()内数字为报告率/%；巨大儿报告率计算时，分母排除了低出生体重儿童；大于胎龄儿报告率计算时，分母排除了小于胎龄儿；*表示数据有缺失。

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表 2 儿童母乳喂养时长与脂肪重积聚时间的线性回归分析[B值(B值95%CI)]

Table 2. Linear regressions of breastfeeding duration and the age at adiposity rebound in children[B(B 95%CI)]

模型	男(n=3 214)	女(n=2 934)	总体(n=6 148)
单因素	0.15(0.04~0.26)^*	0.02(-0.08~0.13)	0.09(0.01~0.16)^*
模型1	0.17(0.03~0.31)^*	0.03(-0.11~0.17)	0.10(0.00~0.20)^*
模型2	0.16(0.02~0.30)^*	0.34(0.18~0.51)^**	0.23(0.12~0.34)^**
注： P < 0.05，*P < 0.01。

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