膳食宏量营养素与学龄儿童肺功能关联的前瞻性研究

李露; 陈梦雪; 李蕊瑞; 刘雪婷; 汪晓语; 徐裕杰; 熊静远; 成果

doi:10.16835/j.cnki.1000-9817.2025060

膳食宏量营养素与学龄儿童肺功能关联的前瞻性研究

doi: 10.16835/j.cnki.1000-9817.2025060

李露¹,
陈梦雪²,
李蕊瑞¹,
刘雪婷¹,
汪晓语²,
徐裕杰²,
熊静远¹,
成果^{2, 3, ,}

1.
四川大学华西公共卫生学院/华西第四医院，成都 610041
2.
四川大学华西第二医院妇儿营养中心
3.
四川大学华西护理学院

基金项目:

国家自然科学基金面上项目 82173512

国家自然科学基金青年科学基金项目 82304135

四川省科技厅应用基础项目 2021YJ0156

详细信息

作者简介:
李露(1999-)，女，陕西安康人，在读硕士，主要研究方向为营养与健康

通讯作者:
成果，E-mail：ehw_cheng@126.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 R153.2 Q471
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- 被引次数: 0
出版历程
- 收稿日期: 2024-11-11
- 修回日期: 2024-12-16
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Prospective study of association between dietary macronutrients and lung function in school-aged children

1.
West China School of Public Health/West China Fourth Hospital, Sichuan University, Chengdu (610041), Sichuan Province, China

摘要

摘要: 目的探究学龄儿童膳食宏量营养素与肺功能的纵向关联，为促进儿童肺健康提供营养研究证据。方法 2021年11月，采用分层整群随机抽样方法从中国西南儿童营养与生长(SCCNG)队列中选取2所位于四川省成都市的小学，共纳入1 112名8~13岁学龄儿童，基线时调查儿童的膳食、社会人口学特征等，随访1年后测量儿童的用力肺活量(FVC)并将其转换为Z评分(FVC-Z)，同时计算肺活量指数(VCI); 采用广义线性回归分析膳食宏量营养素与肺功能的关联，及其与性别和年龄的交互作用，并进行分层分析。结果广义线性回归模型分析结果显示，调整混杂因素后，碳水化合物供能比与学龄儿童FVC-Z(β=-0.02)和VCI(β=-0.16)均呈负相关，脂肪供能比与FVC-Z(β=0.03)和VCI(β=0.23)均呈正相关(P值均 < 0.05); 蛋白质供能比仅在女童中与FVC-Z(β=0.09)和VCI(β=0.60)呈正相关(P值均 < 0.05); 年龄对宏量营养素和肺功能关联有交互作用(P_交互值均 < 0.01)，在8~9和10~11岁儿童中，碳水化合物供能比与FVC-Z(β值分别为-0.04，-0.03)和VCI(β值分别为-0.29，-0.21)均呈负相关，脂肪供能比与FVC-Z(β值分别为0.07，0.05)和VCI(β值分别为0.46，0.32)均呈正相关(P值均 < 0.05)。结论膳食宏量营养素与儿童肺功能的关联存在年龄和性别差异。低碳水高脂肪的膳食对儿童肺功能有促进作用，蛋白质对女童肺功能有促进作用，学龄儿童早期可能是膳食干预肺功能的窗口期。
- 营养状况 /
- 膳食调查 /
- 肺 /
- 回归分析 /
- 儿童
Abstract: Objective To explore the longitudinal associations between dietary macronutrients and lung function in school-aged children, so as to provide the nutritional research evidence for promoting children's lung health. Methods In November 2021, two primary schools located in Chengdu, Sichuan Province were selected from the Southwest China Childhood Nutrition and Growth (SCCNG) cohort by a stratified cluster random sampling method, enrolling a total of 1 112 school-aged children aged 8 to 13 years. At baseline, the dietary and sociodemographic characteristics of the children were assessed. One year later, the forced vital capacity (FVC) of the children was measured and converted into Z-scores (FVC-Z), while the vital capacity index (VCI) was also calculated. Generalized linear regression analysis was employed to examine the associations between dietary macronutrients and lung function, considering interactions with gender and age, followed by stratified analysis. Results After adjusting for confounding factors, the analysis results of the generalized linear regression model showed that the carbohydrate energy ratio was negatively correlated with FVC-Z (β=-0.02) and VCI (β=-0.16), while the fat energy ratio showed a positive correlation with FVC-Z (β=0.03) and VCI (β=0.23) (P < 0.05). The protein energy ratio was positively correlated with FVC-Z (β=0.09) and VCI (β=0.60) specifically in girls (P < 0.05). Additionally, there was an interaction effect of age on the associations between macronutrients and lung function (P < 0.01); in children aged 8-9 and 10-11, the carbohydrate energy supply ratio was negatively correlated with FVC-Z (β=-0.04, -0.03) and VCI (β=-0.29, -0.21), and fat energy supply ratio was positively correlated with FVC-Z (β=0.07, 0.05) and VCI (β=0.46, 0.32) (P < 0.05). Conclusions There are age and sex differences in the association of dietary macronutrients with lung function, with a low-carbohydrate, high-fat diet promoting lung function in children. Additionally, protein intake appears to have a positive influence on the lung function of girls. The early school-age period may represent a critical window for dietary interventions aimed at promoting lung health.
- Nutritional status /
- Diet surveys /
- Lung /
- Regression analysis /
- Child
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 宏量营养素供能比与学龄儿童肺功能关联的广义线性回归分析[β值(95%CI)，n=1 112]

Table 1. Generalized linear regression analysis of association between macronutrient energy ratios and lung [JZ] function in school-aged children[β(95%CI), n=1 112]

宏量营养素供能比	FVC-Z		VCI
宏量营养素供能比	模型1	模型2	模型1	模型2
碳水化合物	-0.03(-0.05~-0.01)^**	-0.02(-0.04~-0.01)^**	-0.21(-0.38~-0.05)^*	-0.16(-0.28~-0.03)^*
蛋白质	0.03(-0.03~0.08)	0.04(-0.01~0.09)	0.11(-0.35~0.58)	0.25(-0.10~0.60)
脂肪	0.05(0.02~0.08)^**	0.03(0.01~0.06)^**	0.38(0.15~0.60)^**	0.23(0.06~0.40)^**
注：^P < 0.05，^*P < 0.01; 模型1未调整混杂因素; 模型2调整了性别、年龄、BMI-Z、母亲文化水平、家庭月收入、是否暴露于吸烟环境、MVPA、久坐行为、能量摄入; 因变量FVC-Z、VCI与自变量碳水化合物、蛋白质和脂肪供能比均为连续型变量。

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表 2 不同性别儿童宏量营养素供能比与肺功能关联的广义线性回归分析[β值(95%CI)]

Table 2. Generalized linear regression analysis of association between macronutrient energy ratios and lung function in children of different genders[β(95%CI)]

因变量	自变量	男童(n=541)		女童(n=571)		P_交互值
因变量	自变量	模型1	模型2	模型1	模型2	P_交互值
FVC-Z	碳水化合物	-0.02(-0.05~0.01)	-0.01(-0.04~0.01)	-0.04(-0.07~-0.01)^**	-0.04(-0.06~-0.01)^**	0.19
	蛋白质	-0.01(-0.08~0.08)	-0.01(-0.08~0.06)	0.06(-0.02~0.14)	0.09(0.02~0.16)^*	0.06
	脂肪	0.04(0.01~0.08)^*	0.03(-0.01~0.06)	0.06(0.02~0.09)^**	0.04(0.01~0.08)^*	0.47
VCI	碳水化合物	-0.16(-0.40~0.08)	-0.09(-0.27~0.10)	-0.29(-0.51~-0.06)^*	-0.23(-0.40~-0.06)^**	0.28
	蛋白质	-0.08(-0.74~0.58)	-0.06(-0.57~0.45)	0.40(-0.24~1.04)	0.60(0.12~1.08)^*	0.07
	脂肪	0.35(0.03~0.67)^*	0.19(-0.06~0.44)	0.42(0.11~0.73)^**	0.28(0.05~0.51)^*	0.67
注：^P < 0.05，^*P < 0.01; 模型1未调整混杂因素; 模型2调整了年龄、BMI-Z、母亲文化水平、家庭月收入、是否暴露于吸烟环境、MVPA、久坐行为、能量摄入; P_交互值根据模型2计算性别与三大宏量营养素的交互作用; 因变量FVC-Z、VCI与自变量碳水化合物、蛋白质和脂肪供能比均为连续型变量。

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表 3 不同年龄组儿童宏量营养素供能比与肺功能的广义线性回归分析[β值(95%CI)]

Table 3. Generalized linear regression analysis of association between macronutrient energy ratios and lung function in children of different ages[β(95%CI)]

因变量	自变量	8~9岁(n=191)		10~11岁(n=541)		12~13岁(n=380)		P_交互值
因变量	自变量	模型1	模型2	模型1	模型2	模型1	模型2	P_交互值
FVC-Z	碳水化合物	-0.06(-0.10~-0.01)^**	-0.04(-0.08~-0.01)^*	-0.03(-0.06~-0.01)^*	-0.03(-0.06~-0.01)^**	0.02(-0.02~0.06)	0.02(-0.01~0.05)	< 0.01
	蛋白质	0.10(-0.02~0.22)	0.05(-0.06~0.17)	0.04(-0.04~0.12)	0.06(-0.01~0.13)	-0.09(-0.19~0.01)	-0.05(-0.14~0.03)	< 0.01
	脂肪	0.09(0.03~0.14)^**	0.07(0.01~0.12)^*	0.06(0.02~0.09)^**	0.05(0.02~0.08)^**	-0.02(-0.08~0.03)	-0.03(-0.08~0.01)	< 0.01
VCI	碳水化合物	-0.49(-0.88~-0.09)^*	-0.29(-0.58~-0.00)^*	-0.22(-0.45~0.01)	-0.21(-0.38~-0.04)^*	0.16(-0.15~0.46)	0.14(-0.10~0.38)	< 0.01
	蛋白质	0.83(-0.30~1.96)	0.40(-0.42~1.22)	0.08(-0.57~0.73)	0.35(-0.12~0.82)	-0.64(-1.46~0.17)	-0.39(-1.03~0.26)	< 0.01
	脂肪	0.75(0.22~1.27)^**	0.46(0.08~0.84)^*	0.41(0.10~0.72)^**	0.32(0.10~0.55)^**	-0.19(-0.60~0.23)	-0.22(-0.54~0.11)	< 0.01
注：^P < 0.05，^*P < 0.01; 模型1未调整混杂因素; 模型2调整了性别、BMI-Z、母亲文化水平、家庭月收入、是否暴露于吸烟环境、MVPA、久坐行为、能量摄入; P_交互值根据模型2计算年龄与三大宏量营养素的交互作用; 因变量FVC-Z、VCI与自变量碳水化合物、蛋白质和脂肪供能比均为连续型变量。

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