目的 了解重庆市婴儿超重和肥胖流行情况,结合体成分分析,为儿童营养评估及儿童肥胖的防控提供依据。方法 选取2021年9月-2023年9月就诊于重庆市妇幼保健院儿童保健科门诊0~12月婴儿4 546例,常规进行体格测量,同时运用三维建模体成分分析仪对其进行体成分测定,检测指标包括身长、体重、体质量指数(BMI)、蛋白质、无机盐、总体水含量、肌肉量、去脂体重等,分析不同性别、月龄、营养状态与体成分之间的关系以及体脂百分比与身长别体重Z评分(WLZ)判断婴儿肥胖的一致性。结果 男童身长、体重、BMI、基础代谢率、总体水含量、体脂百分比、体脂重、去脂体重、肌肉重、蛋白质、无机盐较女童组高(t=10.427、14.183、10.586、10.413、10.291、20.712、22.222、10.601、10.139、9.559、17.447,P<0.001)。婴儿超重和肥胖检出率在5、6月龄到达峰值(P<0.05)。在总体成分中,体脂重所占比例在消瘦、正常、超重、肥胖组间逐渐增加(13.72%、17.81%、20.79%、23.34%,P<0.05)。男童超重、肥胖检出率高于女童(χ2=37.808、17.655,P<0.001)。以WLZ诊断的婴儿肥胖检出率男童为10.60%,女童为7.04%,以体成分检测诊断的婴儿肥胖检出率男童为19.67%,女童为12.95%,体脂百分比以及WLZ对婴儿肥胖筛查一致性较高,男童、女童Kappa指数分别为0.614、0.649(P<0.001)。结论 重庆市婴儿超重和肥胖现状不容乐观,结合体成分检测可降低漏诊、误诊率以及制定个体化的干预措施,对调整婴儿营养结构以及降低健康风险具有重要意义。
Abstract
Objective To investigate the prevalence of overweight and obesity among infants in Chongqing,and to analyze the consistency of body composition with overweight /obesity,so as to provide a basis for child nutrition assessment and the prevention and control of childhood obesity. Methods A total of 4 546 infants aged 0 to 12 months who visited the outpatient clinic of the Department of Child Health of Chongqing Maternal and Child Health Hospital were selected into this study from September 2021 to September 2023,and physical measurements were routinely performed.At the same time,a three-dimensional modeling body composition analyzer was used to determine their body composition,and the detection indicators included length,weight,body mass index (BMI),protein,inorganic salt,body water,muscle mass,lean body mass,etc.The relationship of gender,month age and nutritional status with body composition,and the consistency of body fat percentage and weight-for-length Z-score (WLZ) diagnosing overweight/obesity were analyzed. Results The body length,weight,BMI,basal metabolism,total water content,body fat percentage,body fat weight,fat-free body weight,muscle weight,protein and inorganic salt of male infants were significantly higher than those in female infants (t=10.427,14.183,10.586,10.413,10.291,20.712,22.222,10.601,10.139,9.559,17.447,P<0.001).The detection rates of overweight and obesity reached the peak at 5 and 6 months old (P<0.05).In the total composition,the proportion of body fat weight gradually increased among weight loss(13.72%),normal(17.81%),overweight (20.79%) and obesity(23.34%) groups (P<0.05).The detection rates of overweight and obesity was higher male infants than in female infants (χ2=37.808,17.655,P<0.001).The detection rate of infant obesity diagnosed by WLZ was 10.60% for male infants and 7.04% for female infants,while the detection rate of infant obesity diagnosed by body composition test was 19.67% for male infants and 12.95% for female infants.The consistency of percentage of body fat and WLZ screening for infant obesity was high,with a Kappa index of 0.614 and 0.649 for male and female infants,respectively(P<0.001). Conclusions The current situation of overweight and obesity among infants in Chongqing is not optimistic,and the combination of body composition testing can reduce the rate of missed diagnosis and misdiagnosis,as well as the development of individualized interventions.It is of great practical significance to adjust the infant nutrition structure and reduce the health risk.
关键词
体成分 /
婴儿 /
肥胖 /
营养评估
Key words
body composition /
infants /
obesity /
nutritional assessment
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基金
重庆市教育委员会 (23SKGH053);重庆市教育委员会人文社会科学研究重点项目(21SKGH026);重庆市自然科学基金面上项目(CSTB2023NSCQ-MSX0431)
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