照护者营养素养与8~10岁儿童非酒精性脂肪性肝病的相关性

杨依凡; 励丽; 张萍萍; 王佑新; 王明月; 杨树涵; 吴玉莹; 王辉

doi:10.16835/j.cnki.1000-9817.2025102

照护者营养素养与8~10岁儿童非酒精性脂肪性肝病的相关性

doi: 10.16835/j.cnki.1000-9817.2025102

1.
北京大学公共卫生学院妇幼卫生学系, 北京 100191
2.
宁波大学附属第一医院内分泌科
3.
宁波大学附属第一医院慢病管理办公室健康生活方式研究中心

基金项目:

浙江省卫生健康重大科技计划项目 WKJ-ZJ-2216

宁波市公益性科技计划项目 2022S182

唐仲英基金会 2022-B126

详细信息

作者简介:
杨依凡(2000- )，女，山西临汾人，在读硕士，主要研究方向为儿童健康影响因素。

通讯作者:
王辉，E-mail: huiwang@bjmu.edu.cn

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 G78 R333.4 R714.255
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出版历程
- 收稿日期: 2024-11-20
- 修回日期: 2025-02-17
- 网络出版日期: 2025-05-08
- 刊出日期: 2025-04-25

Associations between caregivers' nutrition literacy and pediatric nonalcoholic fatty liver disease of children aged 8- 10

1.
Department of Maternal and Child Health Medicine, School of Public Health, Peking University, Beijing (100191), China

摘要

摘要: 目的探讨照护者营养素养水平与儿童非酒精性脂肪性肝病(NAFLD)的相关性，为后期制定家庭干预措施提供理论依据。方法 2022年9月，以浙江省宁波市鄞州区、海曙区、镇海区6所学校招募的1 609名小学三年级学生及其照护者为研究对象，通过采集空腹静脉血，测量血脂指标调查儿童NAFLD患病情况，采用儿童家庭食物环境问卷调查照护者的营养素养水平。采用广义线性回归方法探究照护者营养素养水平与儿童NAFLD患病率之间的相关性。结果调查儿童中，NAFLD组有191名，非NAFLD组1 418名。NAFLD组与非NAFLD组照护者营养素养得分中位数均为11.00(9.00，12.00)，差异无统计学意义(Z=-0.40，P=0.71)。广义线性回归分析结果显示，照护者的营养素养水平与儿童甘油三酯-葡萄糖指数和甘油三酯-葡萄糖腰高比指数的相关性均无统计学意义[β值(95%CI)分别为0.001(-0.005~0.006)和0.000(-0.014~0.014)，P值均＞0.05]。结论照护者营养素养水平与儿童NAFLD患病率无相关性。在家庭干预措施中，不仅要提高父母的营养素养，更要将营养知识有效运用于实践中、优化健康管理。
- 营养素养 /
- 法定监护人 /
- 脂肪肝 /
- 回归分析 /
- 儿童
Abstract: Objective To explore the associations between caregivers' nutrition literacy and pediatric nonalcoholic fatty liver disease (NAFLD), so as to provide scientific evidence for the key contents of family intervention measures. Methods In September 2022, a study involving 1 609 third-grade students and their caregivers from six schools in Yinzhou, Haishu, and Zhenhai Districts of Ningbo City, Zhejiang Province, was conducted. Venous blood samples were collected to measure lipid profiles and investigate the prevalence of nonalcoholic fatty liver disease (NAFLD) among the children. Family Food Environment Questionnaire was used to assess the nutrition literacy levels of the caregivers. Generalized linear regression analysis was employed to explore the correlation between caregivers' nutrition literacy levels and the prevalence of NAFLD in children. Results Among the surveyed students, 191 were in the NAFLD group, whereas 1 418 were in the non-NAFLD group. The median nutrition literacy score of caregivers in the NAFLD group and non-NAFLD group all were 11.00 (9.00, 12.00), which was not significantly different (Z=-0.40, P=0.71). The generalized linear regression results revealed that the level of nutrition literacy of caregivers had no significant effect on children's Triglyceride-glucose (TyG) index and Triglyceride-glucose-Waist-to-height ratio (TyG-WHtR) [β(95%CI) were 0.001(-0.005-0.006) and 0.000(-0.014-0.014), P>0.05]. Conclusions The nutrition literacy level of caregivers has no significant correlation with the direct incidence of NAFLD in children. As for family intervention measures, it is necessary not only to improve the nutrition literacy level of caregivers but also to effectively apply nutritional knowledge in practice to optimize health management.
- Nutrition literacy /
- Legal guardians /
- Fatty liver /
- Regression analysis /
- Child
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表 1 不同营养素养水平照护者间儿童NAFLD相关代谢指标比较[M(P₂₅, P₇₅)]

Table 1. Comparison of NAFLD-related metabolic indexes indicators of children among different caregivers' nutritional literacy levels[M(P₂₅, P₇₅)]

照护者营养素养水平	人数	BMI/(kg·m^-2)	腰围/cm	臀围/cm		收缩压/mmHg	舒张压/mmHg	空腹胰岛素/(pmol·L^-1)
非优秀	1 247	15.80(14.70, 17.75)	56.00(53.00, 61.00)	70.00(65.00, 74.00)		100.00(94.50, 108.00)	63.00(59.00, 67.00)	46.58(33.04, 63.91)
优秀	362	15.80(14.68, 17.33)	55.35(52.53, 60.00)	69.00(66.00, 74.00)		102.00(96.00, 108.00)	63.00(59.00, 67.00)	44.74(31.35, 60.08)
总体	1 609	15.80(14.70, 17.70)	56.00(53.00, 61.00)	70.00(66.00, 74.00)		101.00(95.00, 108.00)	63.00(59.00, 67.00)	46.00(32.80, 63.14)
Z值		-0.79	-0.91	-0.13		-1.24	-0.98	-1.59
P值		0.43	0.36	0.90		0.21	0.33	0.11

照护者营养素养水平	人数	空腹血糖/(mmol·L^-1)	甘油三酯/(mmol·L^-1)	总胆固醇/(mmol·L^-1)	低密度脂蛋白胆固醇/(mmol·L^-1)	高密度脂蛋白胆固醇/(mmol·L^-1)	TyG指数	TyG-WHtR指数
非优秀	1 247	4.91(4.68, 5.15)	0.70(0.56, 0.92)	4.57(4.10, 5.12)	2.76(2.36, 3.12)	1.56(1.39, 1.76)	7.92(7.69, 8.20)	3.37(3.14, 3.68)
优秀	362	4.86(4.61, 5.08)	0.71(0.60, 0.91)	4.68(4.19, 5.27)	2.79(2.45, 3.26)	1.57(1.41, 1.77)	7.93(7.73, 8.17)	3.35(3.14, 3.65)
总体	1 609	4.89(4.66, 5.13)	0.70(0.56, 0.92)	4.60(4.12, 5.15)	2.77(2.38, 3.15)	1.56(1.39, 1.76)	7.92(7.69, 8.19)	3.36(3.14, 3.68)
Z值		-2.54	-1.51	-2.28	-2.29	-0.81	-1.01	-0.73
P值		0.01	0.13	0.02	0.02	0.42	0.31	0.47
注： 1 mmHg=0.133 kPa。

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表 2 儿童NAFLD相关代谢指标与照护者营养素养水平的广义线性回归分析[β值(95%CI), n=1 609]

Table 2. Generalized linear regression on NAFLD-related metabolic indexes of children and nutritional literacy levels of caregivers[β(95%CI), n=1 609]

NAFLD相关代谢指标	模型1	模型2
BMI	-0.007(-0.025~0.010)	-0.003(-0.021~0.015)
腰围/cm	-0.004(-0.017~0.009)	-0.001(-0.015~0.013)
臀围/cm	0.002(-0.009~0.012)	0.000(-0.011~0.011)
收缩压/mmHg	0.003(-0.009~0.016)	0.003(-0.009~0.016)
舒张压/mmHg	0.007(-0.007~0.021)	0.012(-0.002~0.026)
空腹胰岛素/(pmol·L^-1)	-0.061(-0.125~0.003)	-0.053(-0.118~0.013)
空腹血糖/(mmol·L^-1)	-0.009(-0.018~-0.001)^*	-0.006(-0.015~0.003)
甘油三酯/(mmol·L^-1)	0.025(-0.019~0.068)	0.007(-0.038~0.051)
总胆固醇/(mmol·L^-1)	0.024(0.003~0.045)^*	0.006(-0.015~0.027)
低密度脂蛋白胆固醇/(mmol·L^-1)	0.035(0.008~0.061)^*	0.013(-0.014~0.040)
高密度脂蛋白胆固醇/(mmol·L^-1)	0.006(-0.015~0.027)	-0.007(-0.029~0.015)
TyG指数	0.003(-0.003~0.008)	0.001(-0.005~0.006)
TyG-WHtR指数	-0.002(-0.016~0.012)	0.000(-0.014~0.014)
注：模型1调整儿童的性别、年龄；模型2在模型1基础上调整照护者的文化程度、家庭年收入；^*P＜0.05。

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