华中地区乡村3~6岁儿童贫血状况及与膳食行为的关联

刘英杰; 王辉; 杨科; 李明丽

doi:10.16835/j.cnki.1000-9817.2023.01.010

华中地区乡村3~6岁儿童贫血状况及与膳食行为的关联

doi: 10.16835/j.cnki.1000-9817.2023.01.010

1.
商丘师范学院体育学院, 河南 476000
2.
郑州西亚斯学院体育学院
3.
武汉大学教育学院
4.
湖南医药学院体育教学研究部

详细信息

作者简介:
刘英杰(1979-), 男, 河南商丘人, 硕士, 讲师, 主要研究方向为体育教学训练与健康促进

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出版历程
- 收稿日期: 2022-07-07
- 修回日期: 2022-09-05
- 网络出版日期: 2023-02-06
- 刊出日期: 2023-01-25

Anemia among rural children aged 3-6 in central China and its association with dietary behaviors

1.
School of Physical Education, Shangqiu Normal University, Shangqiu(476000), Henan Province, China

摘要

摘要: 目的了解华中地区乡村3~6岁儿童贫血状况及其与膳食行为的关联, 为乡村学龄前儿童贫血的预防和干预提供参考。方法 2021年4—6月, 以班级为单位采用分层整群抽样的方法, 对华中地区乡村1 246名3~6岁学龄前儿童采集无名指末梢血, 采用比色法进行血红蛋白测定, 分析贫血状况。同时对谷薯类、水果、蔬菜、豆制品类、奶类、动物性食物、食物多样性、饮水等8个方面的膳食行为进行调查。采用Logistic回归分析法, 分析贫血与膳食行为的关联。结果华中地区乡村3~6岁儿童贫血检出率为13.88%。留守儿童贫血检出率(19.00%)高于非留守儿童(11.27%), 差异有统计学意义(χ²=13.93, P＜0.01)。Logistic回归分析显示, 留守儿童(OR=1.28, 95%CI=1.16~1.56)发生贫血的比例高于非留守儿童; 动物性食物摄入频率≥3次/周(OR=0.82, 95%CI=0.69~0.91)、蔬菜摄入种类≥2种(OR=0.86, 95%CI=0.71~0.93)的学龄前儿童发生贫血的比例较低(P值均＜0.05)。结论华中地区乡村3~6岁儿童贫血检出率较高, 尤其应重点关注留守儿童的贫血问题。应进一步提升抚养人膳食素养, 增加动物性食物和蔬菜的摄入量, 以降低学龄前儿童贫血的发生。
- 贫血 /
- 膳食 /
- 行为 /
- 回归分析 /
- 儿童, 学龄前
Abstract: Objective To understand the status of anemia among rural children aged 3-6 in central China and its relationship with dietary behavior, and to provide reference for prevention and intervention of anemia in rural children. Methods From April to June 2021, stratified cluster sampling was used to select 1 246 preschool children aged 3 to 6 years old in rural areas in central China. Peripheral blood of the ring finger was collected. Dietary behaviors regarding consumption of cereals and potatoes, fruits, vegetables, soy products, milk, animal foods, food diversity, and drinking water were investigated. Logistic regression analysis was used to analyze the association between anemia and dietary behaviors. Results The detection rate of anemia in rural children aged 3-6 in central China was 13.88%. The anemia detection rate of left-behind children (19.00%) was higher than that of non-left-behind children (11.27%), and the difference was statistically significant (χ²=13.93, P < 0.01). Logistic regression analysis showed that the proportion of left-behind children (OR=1.28, 95%CI=1.16-1.56) with anemia was higher than that of non-left-behind children (P < 0.01). Consumption of animal food intake ≥3 times/week (OR=0.82, 95%CI=0.69-0.91), and ≥2 kinds of vegetables (OR=0.86, 95%CI=0.71-0.93) were associated with lower rate of anemia (P < 0.05). Conclusion The detection rate of anemia in rural children aged 3-6 years in central China is relatively high, especially in left-behind children. Dietary literacy of caregivers should be further improved regarding increased intake of animal foods and vegetables to reduce the risk for anemia in preschoolers.
- Anemia /
- Diet /
- Behavior /
- Regression analysis /
- Child, preschool
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表 1 华中地区不同组别乡村3~6岁儿童贫血检出率比较

Table 1. Comparison of anemia detection rate among children aged 3-6 years in rural areas of central China

组别	选项	统计值	男童		女童		总计
组别	选项	统计值	人数	贫血人数	人数	贫血人数	人数	贫血人数
年龄/岁	3~4		385	52(13.51)	351	52(14.81)	736	104(14.13)
	5~6		270	40(14.81)	240	29(12.08)	510	69(13.53)
		χ²值		0.20		0.90		0.09
		P值		0.65		0.34		0.76
独生子女	是		308	39(12.66)	273	38(13.92)	581	77(13.25)
	否		347	53(15.27)	318	43(13.52)	665	96(14.44)
		χ²值		0.92		0.02		0.36
		P值		0.34		0.89		0.55
留守儿童	是		216	42(19.44)	205	38(18.54)	421	80(19.00)
	否		439	50(11.39)	386	43(11.14)	825	93(11.27)
		χ²值		7.78		6.19		13.93
		P值		0.01		0.01		< 0.01
监护人	父亲或母亲		375	49(13.07)	338	33(9.76)	713	82(11.50)
	祖父母或其他		280	43(15.36)	253	48(18.97)	533	91(17.07)
		χ²值		0.70		10.38		7.92
		P值		0.40		< 0.01		0.01
注： ()内数字为检出率/%。

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表 2 华中地区不同组别乡村3~6岁儿童血红蛋白水平比较(x±s，g/L)

Table 2. Comparison of hemoglobin status among children aged 3-6 years in rural areas of central China(x±s, g/L)

组别	选项	统计值	男童		女童		总计
组别	选项	统计值	人数	血红蛋白	人数	血红蛋白	人数	血红蛋白
年龄/岁	3~4		385	126.6±15.4	351	154.2±13.8	736	140.4±15.1
	5~6		270	123.8±16.6	240	127.1±15.2	510	125.5±16.2
		t值		2.22		22.49		16.62
		P值		0.03		＜0.01		＜0.01
独生子女	是		308	126.8±18.5	273	126.3±15.9	581	126.6±16.9
	否		347	123.1±18.4	318	126.4±16.8	665	122.8±16.8
		t值		2.56		-0.07		3.97
		P值		0.01		0.94		＜0.01
留守儿童	是		216	118.2±14.6	205	119.5±15.3	421	118.9±14.7
	否		439	127.6±15.6	386	128.3±16.8	825	128.0±16.8
		t值		-7.40		-6.25		-9.42
		P值		＜0.01		＜0.01		＜0.01
监护人	父亲或母亲		375	126.6±16.2	338	129.1±17.5	713	127.9±17.6
	祖父母或其他		280	122.1±18.2	253	119.4±16.8	533	120.8±17.8
		t值		3.34		6.78		7.01
		P值		< 0.01		＜0.01		＜0.01
合计			655	125.1±15.6	591	129.8±15.7	1 246	128.0±15.6

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表 3 华中地区不同组别乡村3~6岁儿童膳食平衡指数比较[M(P₂₅, P₇₅)]

Table 3. Comparison of dietary balance index status among children aged 3-6 years in rural areas of central China[M(P₂₅, P₇₅)]

组别	选项	人数	统计值	总分	负端分	正端分	膳食质量距
是否贫血	是	173		-19.4(-26.3，-13.8)	26.5(19.4，33.6)	7.5(2.3，14.2)	37.9(24.1，44.4)
	否	1 073		-16.3(-20.9，-9.7)	23.8(17.6，31.7)	8.7(3.8，13.6)	35.2(28.6，42.1)
			Z值	-24.56	6.22	-0.89	4.86
			P值	＜0.01	0.02	0.31	0.03
是否留守	是	421		-19.3(-26.7，-14.2)	25.9(19.9，31.6)	8.8(4.1，14.5)	36.9(25.3，44.8)
	否	825		-17.2(-23.5，-11.8)	24.3(18.3，31.4)	7.3(3.2，13.2)	35.6(27.6，42.5)
			Z值	-47.89	13.25	4.11	4.86
			P值	＜0.01	＜0.01	0.03	0.03
超重肥胖	是	140		-17.8(-24.4，-11.9)	24.2(18.2，29.8)	9.1(4.2，15.6)	36.8(26.4，43.8)
	否	1 106		-19.1(-25.8，-12.9)	25.8(20.8，32.9)	7.3(3.6，14.7)	36.4(28.5，45.9)
			Z值	2.17	-3.69	6.34	2.77
			P值	0.12	0.02	0.02	0.06

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表 4 华中地区不同组别乡村3~6岁儿童食物摄入状况评分比较[M(P₂₅, P₇₅)]

Table 4. Comparison of food intake status scores of children aged 3-6 years in rural areas of central China[M(P₂₅, P₇₅)]

组别	选项	人数	统计值	谷薯类	水果蔬菜	豆制品奶类	动物性食物	食物多样性	饮水
是否贫血	是	173		6.2(3.1，8.6)	-6.5(-13.2，0.7)	-6.9(-11.8，-0.6)	-3.5(-6.6，0.9)	-8.6(-10.2，-3.6)	-3.5(-6.8，-0.8)
	否	1 073		6.5(3.8，8.7)	-6.8(-12.3，0.9)	-6.1(-9.8，0.3)	-0.8(-4.6，2.1)	-7.4(-9.6，-1.9)	-3.6(-6.6，-0.6)
			Z值	-0.29	2.06	-6.24	-18.25	-7.25	1.68
			P值	0.42	0.08	0.02	＜0.01	0.02	0.12
是否留守	是	421		6.5(3.6，8.3)	-6.9(-12.3，1.7)	-7.2(-11.9，-0.8)	-3.3(-6.1，0.8)	-8.5(-10.3，-4.1)	-3.6(-6.2，-0.5)
	否	825		6.3(4.1，8.2)	-6.3(-10.6，0.8)	-5.9(-9.6，0.4)	-0.9(-4.2，1.7)	-7.3(-9.6，-2.6)	-3.8(-6.6，-0.4)
			Z值	1.02	-1.36	-3.34	-12.46	-8.67	0.45
			P值	0.25	0.19	0.04	＜0.01	＜0.01	0.38
超重肥胖	是	140		7.2(4.1，11.5)	-7.1(-13.5，0.6)	-6.3(-12.5，-0.9)	-1.1(-5.3，1.4)	-7.2(-11.3，-3.7)	-3.6(-7.5，-0.6)
	否	1 106		6.2(3.9，8.8)	-6.3(-12.9，1.4)	-6.7(-11.9，0.3)	-3.5(-6.6，0.9)	-8.5(-12.6，-3.6)	-3.8(-7.7，-0.6)
			Z值	7.38	-3.49	0.58	3.89	2.79	1.26
			P值	0.02	0.04	0.32	0.04	0.06	0.18

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表 5 华中地区乡村3~6岁儿童贫血影响因素Logistic回归分析(n=1 246)

Table 5. Logistic regression analysis of factors influencing anemia in children aged 3-6 years in rural areas of central China(n=1 246)

自变量	选项	β值	标准误	Wald χ²值	P值	OR值(OR值95%CI)
年龄		-0.22	0.26	3.32	0.07	0.79(0.61~1.12)
性别	女	-0.19	0.17	2.46	0.11	0.82(0.63~1.11)
母亲学历	高中及以上	-0.04	0.25	0.04	0.71	0.95(0.66~1.52)
是否留守儿童	是	0.93	0.23	10.81	＜0.01	1.28(1.16~1.56)
动物性食物摄入频率/(次·周^-1)	≥3	-0.87	0.19	6.86	＜0.01	0.82(0.69~0.91)
奶类摄入量/mL	≥200	0.09	0.15	0.46	0.19	1.16(0.95~1.42)
豆类摄入频率/(次·周^-1)	≥2	-0.26	0.19	3.86	0.06	0.77(0.58~1.12)
每天蔬菜摄入种类	≥2	-0.43	0.21	5.24	0.01	0.86(0.71~0.93)
水果摄入频率/(次·周^-1)	≥4	0.08	0.19	0.32	0.23	1.08(0.94~1.24)

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参考文献(25)

[1]	MANTEY A A, ANNAN R A, LUTTERODT H E, et al. Iron status predicts cognitive test performance of primary school children from Kumasi, Ghana[J]. PLoS One, 2021, 16(5): e0251335. doi: 10.1371/journal.pone.0251335
[2]	ORSANGO A Z, LOHA E, LINDTJØRN B, et al. Co-morbid anaemia and stunting among children 2-5 years old in southern Ethiopia: a community-based cross-sectional study[J]. BMJ Paediatr Open, 2021, 5(1): e001039. doi: 10.1136/bmjpo-2021-001039
[3]	YOUSSEF M A M, HASSAN E S, YASIEN D G. Effect of iron deficiency anemia on language development in preschool Egyptian children[J]. Int J Pediatr Otorhinolaryngol, 2020, 135(3): e110114.
[4]	中国营养学会. 国民营养计划(2017—2030年)[J]. 营养学报, 2017, 39(4): 6. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSPZ201704038.htm Chinese Nutrition Society. National nutrition plan(2017-2030)[J]. Acta Nutr Sinica, 2017, 39(4): 6. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZSPZ201704038.htm
[5]	孙畅, 孟莎, 叶睿雪, 等. 西部两省少数民族贫困农村婴幼儿贫血与妇幼卫生服务利用的关联研究[J]. 中华预防医学杂志, 2019, 53(3): 330-333. doi: 10.3760/cma.j.issn.0253-9624.2019.03.019 SUN C, MENG S, YE R X, et al. A study on the association between the infant anemia and the utilization of maternal and child health services in ethnic minorities gathering in poverty stricken rural areas of two provinces in Western China[J]. Chin J Prev Med, 2019, 53(3): 330-333. (in Chinese) doi: 10.3760/cma.j.issn.0253-9624.2019.03.019
[6]	贾丽媛, 王丽, 孟宪彬, 等. 石家庄市学龄前儿童贫血现状及危险因素分析[J]. 实用预防医学, 2020, 27(9): 1099-1101. doi: 10.3969/j.issn.1006-3110.2020.09.020 JIA L Y, WANG L, MENG X B, et al. Analysis of the status and risk factors of anemia in preschool children in Shijiazhuang City[J]. Pract Prev Med, 2020, 27(9): 1099-1101. (in Chinese) doi: 10.3969/j.issn.1006-3110.2020.09.020
[7]	王瑞英, 谢浩俊. 深圳市学龄前儿童贫血状况和种类调查分析[J]. 中国热带医学, 2012, 12(5): 646-648. doi: 10.13604/j.cnki.46-1064/r.2012.05.037 WANG R Y, XIE H J. Survey of anaemia in preschool children in Shenzhen City[J]. China Trop Med, 2012, 12(5): 646-648. (in Chinese) doi: 10.13604/j.cnki.46-1064/r.2012.05.037
[8]	束莉, 李梦瑶, 李晓璐, 等. 安徽农村学龄前儿童缺铁性贫血及膳食营养相关因素分析[J]. 中国学校卫生, 2021, 42(12): 1793-1797. doi: 10.16835/j.cnki.1000-9817.2021.12.009 SHU L, LI M Y, LI X L, et al. Prevalence of iron deficiency anemia and the association with dietary nutrition factors of preschool children in rural Anhui Province[J]. Chin J Sch Health, 2021, 42(12): 1793-1797(in Chinese) doi: 10.16835/j.cnki.1000-9817.2021.12.009
[9]	肖述月. 2020年我国五市城区3~6岁儿童营养状况及与饮食行为关系的研究[D]. 北京: 中国疾病预防控制中心, 2021. XIAO S Y. A study on the nutritional status of children aged 3 to 6 years old and their relationship with eating behavior in urban areas of five cities in my country in 2020[D]. Beijing: Chinese Center for Disease Control and Prevention, 2021. (in Chinese)
[10]	刘永芳. 维生素A、锌及复合多种维生素改善学龄前儿童贫血的研究[D]. 重庆: 重庆医科大学, 2010. LIU Y F. Study on the improvement of anemia in preschool children by vitamin A, zinc and multivitamins[D]. Chongqing: Chongqing Medical University, 2010. (in Chinese)
[11]	国家体育总局. 国民体质测定标准手册(幼儿部分)[M]. 北京: 人民体育出版社, 2018. General Administration of Sports of the PRC. National physical fitness measurement standards manual(early childhood part)[M]. Beijing: People's Sports Publishing House, 2018. (in Chinese)
[12]	WHO Multicentre Growth Reference Study Group. WHO child growthstandards based on length/height, weight, and age[J]. Acta Paediatr, 2006, 450(1): 76-85.
[13]	国家卫生和计划生育委员会. 人群贫血筛查方法: WS/T 441—2013[S]. 北京: 中国标准出版社, 2013. National Health and Family Planning Commission of the PRC. Method for anemia screen: WS/T 441-2013[S]. Beijing: China Standards Press, 2013. (in Chinese)
[14]	杨利玲, 平潇. 学龄前儿童营养配餐与食谱设计[J]. 安阳工学院学报, 2016, 15(2): 69-71, 79. https://www.cnki.com.cn/Article/CJFDTOTAL-AYXB201602019.htm YANG L L, PING X. Nutrition prescription and recipe design for preschool children[J]. J Anyang Inst Technol, 2016, 15(2): 69-71, 79. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-AYXB201602019.htm
[15]	中国营养学会. 中国居民膳食营养素参考摄入量(2013版)[M]. 北京: 科学出版社, 2014. Chinese Nutrition Society. Dietary nutrient reference intakes of Chinese residents (2013 Edition)[M]. Beijing: Science Press, 2014. (in Chinese)
[16]	房玥晖, 何宇纳, 李春丽. 基于中国学龄前儿童平衡膳食指数的2010—2012年中国学龄前儿童膳食质量评价[J]. 中华预防医学杂志, 2020, 54(6): 662-667. doi: 10.3760/cma.j.cn112150-20190909-00719 FANG Y H, HE Y N, LI C L. Evaluation of dietary quality of Chinese preschool children based on Chinese diet balance index for preschool children[J]. Chin J Prev Med, 2020, 54(6): 662 -667. (in Chinese) doi: 10.3760/cma.j.cn112150-20190909-00719
[17]	王璇, 范振崴. 吉林市3~6岁农村留守儿童缺铁性贫血及影响因素分析[J]. 中国学校卫生, 2018, 39(1): 109-110. doi: 10.16835/j.cnki.1000-9817.2018.01.033 WANG X, FAN Z W. Analysis of iron-deficiency anemia and its influencing factors in rural left-behind children aged 3-6 in Jilin City[J]. Chin J Sch Health, 2018, 39(1): 109-110. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2018.01.033
[18]	杨玲. 厦门市思明区学龄前儿童的入园血检分析[J]. 中国继续医学教育, 2020, 12(22): 94-96. https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202022038.htm YANG L. Analysis of blood tests for preschool children in Siming District of Xiamen City[J]. China Contin Med Educ, 2020, 12(22): 94-96. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JXUY202022038.htm
[19]	张学春. 留守儿童与非留守儿童教育成长分析[J]. 西华大学学报(哲学社会科学版), 2021, 40(6): 83-89. https://www.cnki.com.cn/Article/CJFDTOTAL-JNSZ202002014.htm ZHANG X C. An analysis of the educational growth of left behind and non left behind children[J]. J Xihua Univ(Philos Soc Sci), 2021, 40(6): 83-89. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JNSZ202002014.htm
[20]	秦祖国, 杨帆, 鲁志威, 等. 广东经济欠发达地区农村3~6岁儿童贫血状况及监护人自觉症状分析[J]. 中国学校卫生, 2016, 37(1): 145-146. doi: 10.16835/j.cnki.1000-9817.2016.01.046 QIN Z G, YANG F, LU Z W, et al. Analysis of anemia status and guardian's subjective symptoms of rural children aged 3-6 in economically underdeveloped areas in Guangdong[J]. Chin J Sch Health, 2016, 37(1): 145-146. (in Chinese) doi: 10.16835/j.cnki.1000-9817.2016.01.046
[21]	国家卫生和计划生育委员会. 中国居民营养与慢性病状况报告[R]. 北京, 2015. National Health and Family Planning Commission of the PRC. Report on nutrition and chronic disease status of Chinese residents[R]. Beijing, 2015. (in Chinese)
[22]	PITA-RODRÍGUEZ G M, CHÁVEZ-CHONG C, LAMBERT-LAMA-ZARES B, et al. Influence of inflammation on assessing iron-deficiency anemia in Cuban preschool children[J]. MEDICC Rev, 2021, 23(3/4): 37-45.
[23]	KAPIL U, KAPIL R, GUPTA A. Prevention and control of anemia amongst children and adolescents: theory and practice in India[J]. Ind J Pediatr, 2019, 86(6): 523-531.
[24]	MULETA A, HAILU D, BELACHEW T. Camel milk consumption was associated with lower prevalence of anemia among preschool children in rural pastoral districts of Somali, eastern Ethiopia[J]. Nutrition, 2021, 86: 111170.
[25]	ISLAM G M R. Association of socioeconomic status with childhood anemia among infant, toddler, and preschool children in Bangladesh[J]. Value Health Reg Issues, 2020, 21: 141-148.