学龄前儿童握力发展特点及与体成分的相关性

李一辰; 王辰冉; 何辉; 徐韬; 尚晓瑞; 单峥荣; 康洪霞; 徐轶群

doi:10.16835/j.cnki.1000-9817.2022.06.022

学龄前儿童握力发展特点及与体成分的相关性

doi: 10.16835/j.cnki.1000-9817.2022.06.022

1.
首都医科大学附属北京妇产医院/北京妇幼保健院，北京 100026
2.
中国疾病预防控制中心妇幼保健中心
3.
北京市东城区妇幼保健院
4.
北京市大兴区妇幼保健院

基金项目:

中国疾病预防控制中心妇幼保健中心科技创新发展项目 2019KJ06

详细信息

作者简介:
李一辰(1976-)，女，北京市人，硕士，副主任医师，主要从事儿童保健工作

通讯作者:
徐轶群，E-mail：xuyq@chinawch.org.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: G804.49 R179 G613.7
计量
- 文章访问数: 672
- HTML全文浏览量: 263
- PDF下载量: 47
- 被引次数: 0
出版历程
- 收稿日期: 2021-11-06
- 修回日期: 2022-02-14
- 网络出版日期: 2022-06-23
- 刊出日期: 2022-06-25

Development of grip strength and its relationship with body composition in preschoolers

1.
Beijing Obstetrics and Gynecology Hospital, Capital Medical University/Beijing Maternal and Child Health Care Hospital, Beijing (100026), China

摘要

摘要: 目的了解学龄前儿童握力的发育特点，并探讨握力与身高、体重和体成分指标的相关性。方法 2020年9—10月，对北京4所幼儿园的900名学龄前儿童进行问卷调查，并进行身高、体重和握力测量，使用生物电阻抗方法检测体成分，采用偏相关、多元线性回归对握力与体成分指标的相关性进行分析。结果北京学龄前儿童握力随年龄增长逐渐升高，男童由(5.2±1.7)kg增至(9.3±2.5)kg，女童由(4.3±1.6)kg增至(7.9±2.5)kg(F值分别为57.93，48.77，P值均 < 0.01)，男童握力高于女童(t=6.42，P < 0.01)，肥胖男童握力高于超重和正常体重男童(F=5.35，P < 0.01)。调整身高、体重、出生体重、母亲文化程度及过去1周家中进食各类食物频率后，男童握力与瘦体重、上肢肌肉量呈正相关，与体脂肪呈负相关(r值分别为0.11，0.09，-0.18，P值均 < 0.05)；女童握力与体脂肪呈负相关，与瘦体重呈正相关(r值分别为-0.09，0.09，P值均 < 0.05)。多元线性回归分析发现，年龄、瘦体重和上肢肌肉量对男童的握力影响有统计学意义(F=66.75，P < 0.01)；年龄、瘦体重对女童的握力影响有统计学意义(F=150.81，P < 0.01)。结论学龄前期男童握力可以反映瘦体重和上肢骨骼肌水平的变化，女童可以反映瘦体重的变化。增加瘦体重可以提高学龄前儿童握力水平。
- 握力 /
- 身体成分 /
- 生长和发育 /
- 回归分析 /
- 儿童, 学龄前
Abstract: Objective To study the development of grip strength and its relationship with body weight, height and body composition in preschool children. Methods Data was collected from 900 children aged 3-6 years in 4 preschools in Beijing during Sept. to Oct. of 2020. A questionnaire survey (birth weight, dietary and exercise), height, weight, bioelectrical impedance analysis of body composition and dominant hand grip strength tests were conducted. Partial correlational analysis, multivariate linear regression were used for association between grip strength and body composition. Results The grip strength gradually increased with age, from (5.2±1.7) to (9.3±2.5)kg in boys (F=57.93, P < 0.01), and from (4.3±1.6) to (7.9±2.5)kg in girls (F=48.77, P < 0.01). Grip strength in boys were significant higher than that of girls (t=6.42, P < 0.01). The grip strength increased with weight status in boys (F=5.35, P < 0.01), with highest in obese group, followed by overweight and normal weight group. After adjusted for height, weight and birth weight, as well as maternal education, food consumption during the past week, grip strength in boys was positively correlated with fat-free mass, upper limb muscle mass (r=0.11, 0.09, P < 0.05), and negatively correlated with body fat mass (r=-0.18, P < 0.05). Grip strength in girls was negatively correlated with body fat mass, and positively correlated with fat free mass (r=-0.09, 0.09, P < 0.05). Grip strength varied significantly by age, fat-free mass and upper muscle mass in boys (F=66.75, P < 0.01), and by age and fat-free mass in girls (F=150.81, P < 0.01). Conclusion The grip strength can partially reflect changes in fat-free mass for boys and girls, it also reflect changes in upper limb muscle mass for boys. Increases in fat-free mass helps grip strength improvement.
- Hand strength /
- Body composition /
- Growth and development /
- Regression analysis /
- Child, preschool
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

表 1 不同性别学龄前儿童各年龄段握力及体成分比较(x±s)

Table 1. Comparison of grip strength and body composition among preschool children with different sexes and ages(x±s)

性别	年龄/岁	人数	统计值	握力/kg	BMI/(kg·m^-2)	体脂肪/kg	瘦体重/kg	上肢肌肉量/kg	下肢肌肉量/kg
男	3	103		5.2±1.7^**	16.2±1.5^*	3.0±1.3	14.1±1.5^**	1.5±0.4	3.5±1.3
	4	185		6.6±2.2^**	16.3±1.9^*	3.6±2.0	15.5±1.8^**	1.4±0.3^**	3.6±0.8^**
	5	139		8.5±2.4^**	16.3±2.2	3.9±2.5	17.9±2.4^**	1.5±0.4^**	4.1±1.1^**
	6	33		9.3±2.5^*	16.3±2.0	3.8±2.6	18.7±3.9	1.8±1.0^*	5.0±2.8^*
	合计	460		7.0±2.5^**	16.3±1.9^**	3.6±2.1	16.1±2.7^**	1.5±0.5^**	3.8±1.3^**
			F值	57.93	0.05	3.15	84.35	5.21	17.88
			P值	< 0.01	0.98	0.03	< 0.01	< 0.01	< 0.01
女	3	107		4.3±1.6	15.8±1.4	3.0±1.3	13.0±1.3	1.4±1.2	3.4±4.0
	4	176		5.6±2.2	15.9±1.7	3.5±1.7	14.7±1.6	1.3±0.2	3.3±0.6
	5	110		7.2±2.3	15.8±1.7	3.8±1.9	16.7±1.8	1.3±0.3	3.7±0.6
	6	47		7.9±2.5	16.1±1.8	4.4±2.0	17.8±1.9	1.4±0.3	3.9±0.7
	合计	440		6.0±2.5	15.9±1.6	3.6±1.8	15.1±2.3	1.3±0.6	3.5±2.0
			F值	48.77	0.35	8.43	146.58	0.68	1.50
			P值	< 0.01	0.79	< 0.01	< 0.01	0.57	0.21
注：各年龄男女童比较，P < 0.05；*P < 0.01。

下载: 导出CSV

表 2 不同性别不同营养状况学龄前儿童握力及体成分比较(x±s)

Table 2. Comparison of grip strength and body composition among preschool children with different sexes and weight status(x±s)

性别	营养状况	人数	统计值	握力/kg	BMI/(kg·m^-2)	体脂肪/kg	瘦体重/kg	上肢肌肉量/kg	下肢肌肉量/kg
男	正常	322		6.9±2.5^**	15.3±0.8	2.7±0.9^**	15.6±2.4^**	1.4±0.5	3.6±1.4
	超重	82		7.0±2.3^**	17.3±0.4^**	4.1±0.9^**	16.6±2.5	1.6±0.2^**	4.1±0.8^**
	肥胖	56		8.1±3.0	20.3±1.9	7.9±2.6	18.8±2.8	1.9±0.3	4.6±0.8
	合计	460		7.0±2.5^**	16.3±1.9^**	3.6±2.1	16.1±2.7^**	1.5±0.5^**	3.8±1.3^**
			F值	5.35	660.78	423.39	40.60	34.73	19.59
			P值	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01	< 0.01
女	正常	352		5.9±2.4	15.3±0.9	3.0±1.0	14.8±2.1	1.3±0.7	3.4±2.3
	超重	72		5.9±2.7	17.6±0.5	5.2±1.4	16.0±2.6	1.5±0.2	3.8±0.6
	肥胖	16		6.6±2.0	21.0±2.0	9.1±2.6	17.4±3.1	1.8±0.3	4.3±1.0
	合计	440		6.0±2.5	15.9±1.6	3.6±1.8	15.1±2.3	1.3±0.6	3.5±2.0
			F值	0.59	443.47	298.90	16.78	6.46	2.08
			P值	0.55	< 0.01	< 0.01	< 0.01	< 0.01	0.13
注：不同营养状况组男、女童比较，**P < 0.01。

下载: 导出CSV

表 3 不同性别儿童握力与体成分指标的多元线性回归分析

Table 3. Multiple linear regression analysis of the effects of body composition on grip strength among children with different sexes

性别	常量与自变量	B值(B值95%CI)	标准误	t值	P值
男 (n=460)	常量	-3.43(-4.71~-2.14)	0.65	-5.24	< 0.01
	年龄	1.21(0.92~1.49)	0.14	8.39	< 0.01
	瘦体重	0.25(0.15~0.33)	0.04	5.43	< 0.01
	上肢肌肉量	0.57(0.14~0.98)	0.21	2.65	< 0.01
女 (n=440)	常量	-2.30(-3.61~-0.99)	0.66	-3.46	< 0.01
	年龄	1.01(0.67~1.34)	0.17	5.87	< 0.01
	瘦体重	0.24(0.11~0.36)	0.06	3.60	< 0.01

下载: 导出CSV

参考文献(22)

[1]	CAMERON C E, BROCK L L, MURRAH W M, et al. Fine motor skills and executive function both contribute to kindergarten achievement[J]. Child Dev, 2012, 83(4): 1229-1244. doi: 10.1111/j.1467-8624.2012.01768.x
[2]	GREG P, 耿培新, 梁国立. 人类动作发展概论[M]. 北京: 人民教育出版社, 2008: 173-187. GREG P, GENG P X, LIANG G L. Introduction to human motor development[M]. Beijing: People's Education Press, 2008: 173-187.
[3]	PUH U. Age-related and sex-related differences in hand pinch and grip strength in adults[J]. Int J Rehabil Res, 2010, 33(1): 4-11. doi: 10.1097/MRR.0b013e328325a8ba
[4]	WIND A E, TAKKEN U, HELDERS P J, et al. Is grip strength a predictor for total muscle strength in health children, adolescents, and young adults?[J]. Eur J Pediatr, 2010, 169(3): 281-287. doi: 10.1007/s00431-009-1010-4
[5]	KARABIBER H, GARIPARDIC M, UZEL M, et al. Hand grip and pinch strength in patients with nocturnal enuresis: is there a role of muscle strength in pathogenesis of enuresis?[J]. Neurourol Urodyn, 2011, 30(4): 525-528. doi: 10.1002/nau.21027
[6]	JENSEN K C, BELLINI S G, DERRICK J W, et al. Handgrip strength and malnutrition(undernutrition) in hospitalized versus nonhospitalized children aged 6-14 years[J]. Nutr Clin Pract, 2017, 32(5): 687-693. doi: 10.1177/0884533617698098
[7]	BECKER P, CARNEY L N, CORKINS M R, et al. Consensus Statement of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition: indicators recommended for the identification and documentation of pediatric malnutrition (undernutrition)[J]. Nutr Clin Pract, 2015, 30(1): 147-161. doi: 10.1177/0884533614557642
[8]	刘军廷, 侯冬青, 朱忠信, 等. 学龄儿童握力水平与体成分的相关性研究[J]. 中国儿童保健杂志, 2020, 28(6): 613-617. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202006005.htm LIU J T, HOU D Q, ZHU Z X, et al. Relationship of handgrip strength and body composition among school-age children[J]. Chin J Child Health Care, 2020, 28(6): 613-617. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO202006005.htm
[9]	COHEN D D, GOMEZ-ARBELUEZ D, CAMACHO P A, et al. Low muscle strength is associated with metabolic risk factors in Colombian children: the ACFIES study[J]. PLoS One, 2014, 9(4): e93150. doi: 10.1371/journal.pone.0093150
[10]	国家卫生健康委. 关于印发新生儿访视等儿童保健技术规范的通知[A/OL]. (2012-05-02)[2012-05-20]. http://www.nhc.gov.cn/wjw/gfxwj/201304/d8a8bd0cb3c242fe86a4804a8810e741.shtml. National Health Commission of the PRC. Notice on the issuance of technical specifications for child health care, such as newborn visits[A/OL]. (2012-05-02)[2012-05-20]. http://www.nhc.gov.cn/wjw/gfxwj/201304/d8a8bd0cb3c242fe86a4804a8810e741.shtml.
[11]	何彦璐, 薛子颖, 宋骏, 等. 南京市4~6岁儿童握力水平常摸构建与分析[J]. 中国儿童保健杂志, 2013, 21(12): 1270-1272. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201312014.htm HE Y L, XUE Z Y, SONG J, et al. Norm construction and analysis of grip strength in children aged 4 to 6 at Nanjing[J]. Chin J Child Health Care, 2013, 21(12): 1270-1272. https://www.cnki.com.cn/Article/CJFDTOTAL-ERTO201312014.htm
[12]	MOLENAAR H M, SELLES R W, ZUIDAM J, et al. Growth diagrams for grip strength in children[J]. Clin Orthop Relat Res, 2010, 468(1): 217-223. doi: 10.1007/s11999-009-0881-z
[13]	AGER C L, OLIVETT B L, JOHNSON C L. Grasp and pinch strength in children 5 to 12 years old[J]. Am J Occup Ther, 1984, 38(2): 107-113. doi: 10.5014/ajot.38.2.107
[14]	PLOEGMAKERS J J, HEPPING A M, GEERTZEN J H, et al. Grip strength is strongly associated with height, weight and gender in childhood: a cross sectional study of 2241 children and adolescents providing reference values[J]. J Physiother, 2013, 59(4): 255-261. doi: 10.1016/S1836-9553(13)70202-9
[15]	BEAR-LEHMAN J, KAFKO M, MAH L, et al. An ecploratory look at hand strength and hand size among preschoolers[J]. J Hand Ther, 2002, 15(4): 340-346. doi: 10.1016/S0894-1130(02)80005-9
[16]	MARIANA A S, CYNTIA R J, MICHELE M B, et al. Normative data for hand grip strength in healthy children measured with a bulb dynamometer: a cross-sectional study[J]. Physiotherapy, 2014, 100(4): 313-318. doi: 10.1016/j.physio.2013.11.004
[17]	SHYAMAL K, ARVINDER P S. An association of dominant hand grip strength with some anthropometric variables in indian collegiate population[J]. Anthrop, 2009, 67(1): 21-28.
[18]	RENATA M B, DENISE P G, BERNARDO L H. Birth weight, intrauterine growth restriction and nutritional status in childhood in relation to grip strength in adults: from the 1982 Pelotas (Brazil) birth cohort[J]. Nutrition, 2016, 32(2): 228-235. doi: 10.1016/j.nut.2015.08.014
[19]	AMIRA G M, EMAN I E, MOHAMED S H, et al. Determining correlations between hand grip strength and anthropometric measurements in preschool children[J]. J Taib Univ Med Sci, 2020, 15(1): 75-81.
[20]	SAUNDERS J, SMITH T. Malnutrition: causes and consequences[J]. Clin Med, 2010, 10(6): 624-627. doi: 10.7861/clinmedicine.10-6-624
[21]	SECKER D J, JEEJEEBHOY K N. Subjective global nutritional assessment for children[J]. Am J Clin Nutr, 2007, 85(4): 1083-1089. doi: 10.1093/ajcn/85.4.1083
[22]	TIES MOLENAAR H M, DE KRAKER M, ZUIDAM J M, et al. Visual feedback and weight reduction of a grip strength dynamometer do not increase reliability in healthy children[J]. J Hand Ther, 2010, 23(3): 272-279. doi: 10.1016/j.jht.2010.01.001