中国七个城市学龄前儿童消瘦、超重和肥胖状况的队列研究
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摘要
目的了解学龄前儿童消瘦、超重和肥胖的发展趋势,为儿童体格发育的干预提供依据。方法采取整群抽样的方法,在7个城市随访学龄前儿童的身高和体重,完成基线和4次随访的3 494例数据纳入分析。结果基线时儿童消瘦、正常、超重和肥胖的检出率分别为2.12%、79.14%、10.88%和7.87%。4次随访儿童消瘦、超重和肥胖的检出率均呈现增长的趋势,平均半年增长率分别为12.91%、3.76%和10.34%;男童超重、肥胖的检出率均高于女童,其差值随年龄增长逐渐增大。基线消瘦的儿童,在4次随访仍有30%左右的儿童维持在消瘦状态;基线体型正常、超重的儿童,4次随访发展为超重/肥胖、肥胖的检出率均逐渐增加;基线肥胖的儿童,4次随访仍为肥胖的检出率均高于70%。结论调查地区学龄前儿童超重、肥胖检出率较高,消瘦现象仍然存在;随着其年龄的增长,儿童超重、肥胖检出率逐渐增加、男女童超重肥胖检出率的差值逐渐增大,家长和妇幼卫生工作者应加强对儿童体格发育的重视。
Objective To understand the development trend of thin, overweight and obesity of preschool children among 7 cities in China, and in order to provide basis for physical development intervention of preschool children. Methods Cluster sampling method was used and preschool children of kindergartens in 7 cities were selected, the children's height and weight were measured. All of the 3 494 children who had participated in baseline and 4 follow-up were enrolled in the analysis. Results Among the children, the detection rate of thin, normal, overweight and obese was 2.12%, 79.14%, 10.88% and 7.87% respectively. From the first follow-up to the fourth follow-up, the detection rate of thin, overweight and obese among the children were all increasing gradually, and the increase rate of average 6 month was 12.91%, 3.76% and 10.34% respectively. Boys had higher detection rate in overweight and obesity, and the difference values were increasing along with the children developed. In the four follow-ups, 30% of the children who was thin in baseline were also thin, the children who were normal physical in baseline developed into overweight and obesity were increasing gradually, the children who were overweight in baseline developed into obesity were increasing gradually, and more than 70% of the children who were obesity in baseline were also obesity. Conclusions Preschool children had high detection rate of overweight and obesity in the survey areas, the detection rate and the difference values of the detection rate between the boys and girls were increasing along with the children developed, the thin status of the children also occurred in these survey areas. Parents and medical workers should pay attention to the children's physique development.
Objective To understand the development trend of thin, overweight and obesity of preschool children among 7 cities in China, and in order to provide basis for physical development intervention of preschool children. Methods Cluster sampling method was used and preschool children of kindergartens in 7 cities were selected, the children's height and weight were measured. All of the 3 494 children who had participated in baseline and 4 follow-up were enrolled in the analysis. Results Among the children, the detection rate of thin, normal, overweight and obese was 2.12%, 79.14%, 10.88% and 7.87% respectively. From the first follow-up to the fourth follow-up, the detection rate of thin, overweight and obese among the children were all increasing gradually, and the increase rate of average 6 month was 12.91%, 3.76% and 10.34% respectively. Boys had higher detection rate in overweight and obesity, and the difference values were increasing along with the children developed. In the four follow-ups, 30% of the children who was thin in baseline were also thin, the children who were normal physical in baseline developed into overweight and obesity were increasing gradually, the children who were overweight in baseline developed into obesity were increasing gradually, and more than 70% of the children who were obesity in baseline were also obesity. Conclusions Preschool children had high detection rate of overweight and obesity in the survey areas, the detection rate and the difference values of the detection rate between the boys and girls were increasing along with the children developed, the thin status of the children also occurred in these survey areas. Parents and medical workers should pay attention to the children's physique development.
引文
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[2] Zong XN,Li H.Secular trends in prevalence and risk factors of obesity in infants and preschool children in 9 Chinese cities,1986-2006 [J].PLoS One,2012,7(10):1-8.DOI:10.1371/journal.pone.0046942.
[3] Piernas C,Wang D,Du S,et al.The double burden of under- and overnutrition and nutrient adequacy among Chinese preschool and school-aged children in 2009-2011 [J].Eur J Clin Nutr,2015,69(12):1323-1329.DOI:10.1038/ejcn.2015.106.
[4] 毛萌.我国儿童营养与生长发育面临的挑战 [J].中国儿童保健杂志,2018,26(9):929-931.DOI:10.11852/zgetbjzz2018-26-09-01.Mao M.Challenges of nutrition and growth development of children in China [J].Chin J Child Health Care,2018,26(9):929-931.DOI:10.11852/zgetbjzz2018-26-09-01.
[5] 石淑华,戴耀华.儿童保健学 [M].第3版.北京:人民卫生出版社,2014:302.Shi SH,Dai YH.Child hygiene [M].3rd ed.Beijing:People’s Medical Publishing House,2014:302.
[6] World Health Organization.The WHO child growth standards [S].Geneva:World Health Organization,2006.
[7] 由悦,陈敏,翟屹,等.862名北京城区学龄前儿童超重及肥胖变化3年跟踪研究 [J].卫生研究,2005,34(5):620-621.DOI:10.3969/j.issn.1000-8020.2005.05.033.You Y,Chen M,Zhai Y,et al.Three years follow-up study on the changes of overweight and obesity among 862 pre-school children in Beijing city [J].J Hygiene Research,2005,34(5):620-621.DOI:10.3969/j.issn.1000-8020.2005.05.033.
[8] 陈贻珊,张一民,孔振兴,等.我国儿童青少年超重、肥胖流行现状调查 [J].中华疾病控制杂志,2017,21(9):866-869,878.DOI:10.16462/j.cnki.zhjbkz.2017.09.002.Chen YS,Zhang YM,Kong ZX,et al.The prevalence of overweight and obesity in children and adolescents in China [J].Chin J Dis Control Prev,2017,21(9):866-869,878.DOI:10.16462/j.cnki.zhjbkz.2017.09.002.
[9] 王付曼,金曦,冯宁,等.家长对学龄前儿童体型认知的现状和需求分析 [J].中国妇幼保健,2016,31(23):5019-5023.DOI:10.7620/zgtybj.j.issn.1001-4411.2016.23.45.Wang FM,Jin X,Feng N,et al.Cognition status and requirement analysis of parents about physique of preschool children [J].Chin Maternal Child Health Care,2016,31(23):5019-5023.DOI:10.7620/zgtybj.j.issn.1001-4411.2016.23.45.
[10] 张军,杨国俊,李友炳,等.农村学龄前儿童肥胖发生率及家长肥胖知信行现况调查 [J].中国妇幼保健,2015,30(31):5324-5326.DOI:10.7620/zgfybj.j.issn.1001-4411.2015.31.08.Zhang J,Yang GJ,Li YB,et al.A survey on obesity among rural preschool children and their parents,knowledge,attitude and practice [J].Chin Maternal Child Health Care,2015,30(31):5324-5326.DOI:10.7620/zgfybj.j.issn.1001-4411.2015.31.08.
[11] 赵文芝,赵艾,马德福,等.中国9地区3～12岁儿童生长发育Z评分分析 [J].中国儿童保健杂志,2015,23(9):920-923.DOI:10.11852/zgetbjzz2015-23-09-08.Zhao WZ,Zhao A,Ma DF,et al.Analysis of 3-12 years old children growing development Z-score from 9 areas of China [J].Chin J Child Health Care,2015,23(9):920-923.DOI:10.11852/zgetbjzz2015-23-09-08.