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Table of Content

    10 November 2024, Volume 32 Issue 11
    Professional Forum
    History, achievements, problems and prospects of survey and research on physical growth and development of children in China
    ZONG Xin'nan
    2024, 32(11):  1163-1168.  DOI: 10.11852/zgetbjzz2024-1054
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    The survey and research on physical growth and development of children in China can be traced back to the the 1910s and 1920s. After the first national survey on children's physical growth and development was launched in 1975, other representative surveys and researches have emerged in succession. The improvement in growth levels and the decline in undernutrition are major achievements in the field of child development in China. Up to now, China has built a set of growth evaluation system for Chinese children. Children's growth and nutrition in China have entered a new stage of development,with a slowdown in the long-term growth trend and a reversal of the detection rate of overweight and obesity from undernutrition. Overall, the rapid increase of overweight and obesity among children has not been effectively curbed, and China may face the challenge that rural area and medium epidemic area are growing at a high rate.
    Individualized nutritional management strategies for food allergy in children
    LI Dongdan, WU Jie
    2024, 32(11):  1169-1172.  DOI: 10.11852/zgetbjzz2024-1220
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    In recent years, the incidence of food allergies has shown an upward trend, significantly impacting children's health, growth and development, as well as their quality of life. Despite the continuous improvement in the standardized diagnosis and treatment of food allergies in children, and the increasing attention paid to the monitoring and assessment of nutritional status, there are still many nutritional issues in clinical practice.Therefore, to ensure optimal nutrition for children with food allergies, it is recommended to adopt individualized and standardized management that takes into account factors such as the child's age, immune-mediated mechanisms, types and quantities of allergic foods, nutritional status, and dietary behaviors. This management should involve collaboration among allergists, dietitians, and parents, with regular follow-ups and monitoring of outcomes.
    Original Articles
    Association between the pubertal timing and high blood pressure in children and adolescents in Suzhou City
    WANG Xi, LYU Huiling, HU Jiale, HAN Di, DING Ziyao, SHEN Hui, HU Jia
    2024, 32(11):  1173-1178.  DOI: 10.11852/zgetbjzz2024-0478
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    Objective To investigate the association of the timing of pubertal onset with blood pressure levels and hypertension risk in children and adolescents,in order to provide scientific evidence for hypertension prevention and control. Methods A multi-stage stratified cluster random sampling method was used to select 1 992 children and adolescents aged 9 - 16 years from four primary schools and four junior high schools in Suzhou between October and November 2022.Basic information including height,weight,and blood pressure was collected on-site.Questionnaires were used to gather data on students' dietary habits,screen time,academic performance,and physical activity.The Pubertal Development Scale (PDS) was employed to categorize pubertal timing into early group(>P75),timely group(P25 -P75),and delayed groups(<P25).Linear regression analysis was conducted to examine the association between different pubertal timing and blood pressure levels.Logistic regression analysis was performed to assess the relationship between pubertal timing and the risk of elevated blood pressure. Results A total of 999 males (50.2%) and 993 females (49.8%) were enrolled in this study.The average age of males and females was (12.76±1.76) years and (12.31±1.77) years,respectively,and thesystolic blood pressure (SBP) of males and females were (114.40±12.70) and (110.34±11.74) mmHg (χ2=7.412,P<0.001),respectively,and diastolic blood pressure(DBP) was (65.05±7.36) and (65.44±7.41) mmHg (P>0.05).The detection rates of high blood pressure in male and female students were 26.3% and 16.3%,respectively (χ2=29.744, P<0.001).After adjusting for the relevant covariates,linear regression analysis revealed a negative correlation between delayed pubertal timing and SBP Z-score in boys(β=-0.340,95%CI:-0.340 - -0.140), while the results of the girls were not statistically significant (P>0.05),and the early and delayed puberty initiation groups and the DBP Z-score were not statistically significant (P>0.05).No significant correlations were observed between early or delayed pubertal timing and DBP Z-score in either gender (P>0.05).Logistic regression analysis indicated a negative association between delayed pubertal timing and the risk of elevated blood pressure in boys (OR=0.545,95%CI:0.314 - 0.944),whereas no statistical significance was found in girls (P>0.05). Conclusions The association of pubertal timing with blood pressure levels and hypertension risk varies by gender in children and adolescents.Early intervention measures should be taken to improve pubertal development,particularly in boys.
    Influence of lifestyle on overweight and obesity, abnormally high blood pressure and their morbidity among college students in northern China
    CAI Bingyao, CAO Ying, ZHU Siying, CAO Da, JIANG Jianuo, DONG Yanhui, MA Jun
    2024, 32(11):  1179-1185.  DOI: 10.11852/zgetbjzz2024-0363
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    Objective To understand the prevalence of obesity, elevated blood pressure, and comorbidities among college students in Inner Mongolia in 2021, and to analyze the influence of lifestyle factors on disease occurrence, so as to provide scientific evidence for chronic disease prevention and control in local universities. Methods From October to November 2021,physical examination data were collected from college students in Inner Mongolia Autonomous Region, and questionnaires were used to understand their lifestyles. Descriptive statistical methods were used to analyze body weight, blood pressure, and comorbidity conditions, and χ2 tests were used to compare differences across genders and grades. Correlation analysis and univariate Logistic regression were used to identify the main lifestyle factors affecting overweight/obesity, elevated blood pressure, and comorbidities. The distribution of these lifestyles among students was then statistically analyzed, and multivariate Logistic regression models were applied to precisely calculate the impact of each factor on the risk of disease after adjusting for gender, grade, and school factors. Results A total of 2 337 students were surveyed, with 25.9% (605/2 337) having elevated normal blood pressure, 8.3% (195/2 337) having high blood pressure, 13.7% (319/2 337) being obese, and 8.0% (186/2 337) having comorbidities. Male students had significantly higher detection rates for obesity (22.4% vs. 9.9%), high blood pressure (18.3% vs. 4.0%), and comorbidities (17.1% vs. 4.0%) compared to female students (χ2=89.60, 218.93, 116.40, P<0.001). Senior students had a higher proportion of elevated blood pressure than junior students (χ2=6.45, P<0.05), while there were no significant differences in overweight/obesity and comorbidities across grades (P>0.05). In terms of school type, the reported rates of overweight/obesity, high blood pressure, and comorbidities were higher in vocational colleges than in undergraduate institutions (χ2 =24.10, 14.30, 4.94,P<0.05). Among lifestyle factors, male students tended to exercise more but had poorer habits overall compared to female students, and there were no significant differences in lifestyle habits across grades(P>0.05). Students in vocational colleges reported less adequate sleep but more exercise and lower rates of binge drinking compared to students in undergraduate institutions. Adequate sleep and regular exercise were protective factors against overweight/obesity and high blood pressure (adequate sleep: OR=0.67, 95%CI: 0.48 - 0.94, P=0.019; regular exercise: OR=0.63, 95%CI: 0.40 - 0.97, P=0.042). Smoking and alcohol consumption were risk factors for comorbidities (smoking: OR=1.59, 95%CI: 1.03 - 2.42, P=0.033; alcohol consumption: OR=1.60, 95% CI: 1.02 - 2.46, P=0.033). Conclusions Adequate sleep and regular weekly exercise are protective factors against overweight/obesity, high blood pressure, and comorbidities, while smoking and alcohol consumption are risk factors. It is recommend that universities adjust the lights-out time to ensure students get adequate sleep, strengthen health education to discourage smoking and alcohol consumption, and organize campus sports activities to improve students' enthusiasm in participating in physical exercise, so as to promote overall health and well-being.
    Effect of childhood obesity intervention on body shape perception and the mediating role of body shape perception in changes of obesity indicators
    DUAN Peifen, YUAN Jianhui, FENG Xiangxian
    2024, 32(11):  1186-1189.  DOI: 10.11852/zgetbjzz2024-0522
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    Objective To evaluate the effect of childhood obesity intervention on body shape perception among primary school students,and to further explore the mediating role of body shape perception in changes in obesity indicators,in order to provide scientific evidence for future effective intervention strategies. Methods A randomized controlled trial for childhood obesity prevention was carried out in 8 primary schools in Changzhi from 2018 to 2019,and 393 children in grade four were included.A questionnaire was used to collect children's body shape perception,along with anthropometric measurements.Generalized estimating equation models were used to analyze the effect of intervention on children's body shape perception,and the mediation model was used to explore the role of body perception in changes in obesity indicators. Results After one year intervention,the proportion of the children's body shape perception conducive to weight loss (overestimated or correctly estimated) increased from 58.1% to 74.2% in the intervention group,while the proportion in the control group only increased from 53.8% to 58.4%.Compared to the controls,the intervention group showed a greater improvement on the proportion of body size perception conducive to weight loss(OR=1.638,95%CI:1.007 - 2.663,P<0.05).Stratified analysis revealed that the intervention had a larger effect on body shape perception for those who were overweight/obese(OR=2.247,95%CI:1.169~4.320) and for girls(OR=2.195,95%CI:1.080~4.458).Mediation analysis showed that changes in body shape perception played a mediating role in the relationship between comprehensive intervention and changes in body mass index(Za*Zb=-0.13,95%CI:-0.30 - -0.01)and waist circumference(Za*Zb=-0.85,95%CI:-1.87 - -0.08),but not in body fat percentage. Conclusions Comprehensive intervention can effectively improve children's body shape perception,and changes in body shape perception act as a mediator in improvements to obesity indicators.Incorporating body shape perception into comprehensive interventions can enhance the effectiveness of childhood obesity interventions.
    Association between outdoor activity time of students and scoliosis
    HUANG Kun, LI Xiuhong, WU Jiaqi, CHEN Jin, HAN Xiaopu, LIN Rong
    2024, 32(11):  1190-1195.  DOI: 10.11852/zgetbjzz2024-0662
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    Objective To investigate the prevalence of spinal scoliosis among primary and secondary school students in Baiyun District,Guangzhou,and to analyze the relationship between outdoor activity time and scoliosis,in order to provide basis for developing intervention measures for scoliosis. Methods A stratified cluster sampling method was used to select 1 732 primary and secondary school students from six schools in Baiyun District,Guangzhou in February 2023, for scoliosis screening and questionnaire survey.The distribution of outdoor activity time among students was investigated,and the relationship between outdoor activity time and scoliosis in primary and secondary school students was analyzed. Results The detection rate of abnormal scoliosis in Baiyun District was 4.85% (84/1 732).The highest detection rate of scoliosis was observed in general high schools (6.52%),followed by middle schools (5.35%),primary schools (3.57%),and vocational high schools (2.12%).The distribution of students' daily outdoor activity time was as follows:<1hour (48.09%),1-<2hours (36.95%),2-<3hours (9.58%),and ≥3hours (5.37%).The proportion of students reporting less than 1 hour of outdoor activity time per day was greatest in general senior high schools (59.09%),followed by primary schools (53.15%),junior high schools (42.60%),and vocational senior high schools (22.22%).After controlling for confounding factors,compared with less than 1 hour of daily outdoor activity time,students with 1 to less than 2 hours of daily outdoor activity time had a lower risk of scoliosis (OR=0.52,95% CI:0.31-0.89,P < 0.05). Conclusions The prevalence of scoliosis among primary and secondary school students in Baiyun District,Guangzhou is higher than the national average.Insufficient outdoor activity time is identified as a risk factor for spinal scoliosis.It is recommended to strengthen spinal health education and promote increased outdoor activity time among students.
    Value of serum levels of kisspeptin in distinguishing the activation of hypothalamic-pituitary-gonadal axis
    OUYANG Lixue, QIE Di, YANG Fan
    2024, 32(11):  1196-1200.  DOI: 10.11852/zgetbjzz2024-0325
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    Objective To explore the role of kisspeptin in identifying the activation of the hypothalamic-pituitary-gonadal axis (HPGA),in order to simplify the diagnostic process for precocious puberty. Methods A total of 54 girls who presented with breast development as the main complaint in the pediatric outpatient clinic of West China Second Hospital from June 2021 to June 2023 were selected as the study subjects.Physical examination,laboratory tests,and imaging examinations were conducted.The level of kisspeptin was detected using an enzyme-linked immunosorbent assay (ELISA) kit.The diagnostic value of kisspeptin in discerning the initiation of HPGA was determined via receiver operating characteristic (ROC) curve analysis. Results Significant differences in kisspeptin levels were observed among central precocious puberty (CPP),rapidly progressive puberty (RPP),and premature thelarche (PT) groups (H=14.147,P=0.003).Spearman correlation analysis revealed positive correlations between kisspeptin level and parameters such as height,weight,bone age,basal luteinizing hormone(LH),basal follicle-stimulating hormone(FSH),peak LH in gonadotropin-releasing hormone (GnRH) stimulation test,and LH/FSH peak ratio (P<0.05),with the largest correlation coefficients for LH peak (rs=0.479) and LH/FSH peak ratio (rs=0.507).The ROC curve showed that the area under the curve (AUC) of kisspeptin was 0.702 (95%CI:0.570 - 0.834).When the cut-off value was 310.38ng/mL,the Youden index was maximized (0.418),with a sensitivity and specificity of 81.8% and 60.0%,respectively. Conclusion Kisspeptin has diagnostic significance in differentiating the initiation of HPGA,and it can be used as an auxiliary diagnostic indicator or preliminary screening indicator,which can provide certain references and direction for simplifying the diagnosis procedure of precocious puberty in the future.
    Causal relationship between gut microbiota and short stature based on genome-wide association study data
    ZHENG Zhimin, SUN Hao, ZHAO Tingting, XIAO Xuwu
    2024, 32(11):  1201-1205.  DOI: 10.11852/zgetbjzz2024-0581
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    Objective To investigate the causal relationship between gut microbiota and short stature by genomewide Mendelian randomization(MR), in order to proride reference of clinical treatment of short statue. Methods Genus level gut microbiota genome-wide association study data of 18 340 samples was obtained from the MiBioGen as the exposure group, and genome-wide association study data of short stature were obtained from FinnGen R9 as the outcome group. The inverse variance weighting method was used as the main analysis method forMR analysis, and sensitivity analysis such as leave-one-out, heterogeneity test, and pleiotropy analysis were performed, reverse MR to rule out reverse causality. Results Prevotella9 (OR=1.76, 95%CI:1.10 - 2.82, P=0.018), Alloprevotella (OR=1.82, 95%CI:1.22 - 2.72, P=0.003), and FamilyXIIIAD3011group (OR=1.86, 95%CI:1.04 - 3.31, P=0.036) were positively correlated with the onset of short stature. Parasutterella (OR=0.58, 95%CI: 0.37 - 0.92, P=0.020), Clostridiumsensustricto1 (OR=0.50, 95%CI: 0.25 - 0.99, P=0.045), and Roseburia (OR=0.48, 95%CI:0.26 - 0.89, P=0.020) were negatively correlated with the onset of short stature. Conclusion Prevotella9, Alloprevotella, and FamilyXIIIAD3011group increase the risk of short stature, while Parasutterella, Clostridiumsensustricto1 and Roseburia have protective effects on the occurrence of short stature.
    Breastfeeding status and influencing factors of breastfeeding behavior in children aged 0 - 3 years with cleft lip and palate
    LI Nan, ZHANG Jing, ZHANG Kuan, CUI Jie, ZHU Hongping
    2024, 32(11):  1206-1211.  DOI: 10.11852/zgetbjzz2024-0289
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    Objective To analyze the status of breastfeeding and related factors of breastfeeding behavior in children with cleft lip and palate aged 0 - 3 years, in order to provide scientific basis for promoting breastfeeding in children with cleft lip and palate. Methods From April 2021 to December 2022, 270 mothers of children with cleft lip and palate who underwent sequential treatment of cleft lip and palate in Peking University School and Hospital of Stomatology were selected as subjects. The breastfeeding status was investigated and breastfeeding rate was calculated. Multiple linear regression was used to analyze the influencing factors of breastfeeding behavior in children with cleft lip and palate. Results Among 270 children with cleft lip and palate, 75 were breastfed for more than 6 months, with the breastfeeding rate of 27.78%. There were significant differences in breastfeeding bahaviors among mothers with different education levels, breastfeeding time, breastfeeding patterns and attitudes towards breastfeeding(F=4.09,12.19,6.29,19.79,P<0.05). Multiple linear regression showed that breastfeeding time, attitude towards breastfeeding, and breastfeeding guidance were the influencing factors of breastfeeding behavior in children with cleft lip and palate ( R2=0.222, F=4.342, P<0.05). Conclusions The breastfeeding rate of children with cleft lip and palate aged 0 - 3 years still needs to be improved. Targeted feeding guidance and nursing intervention measures should be carried out to improve breastfeeding knowledge and promote scientific feeding.
    Baseline characteristics analysis of the Beijing Children and Adolescents Natural Population Cohort
    LIU Junting, LI Shaoli, CHEN Fangfang, ZONG Xinnan, HUANG Chunlei, ZHANG Tong, TAI Jun, GU Qinglong, On behalf of the Beijing Children and Adolescent Health Cohort Collaborative Group
    2024, 32(11):  1212-1218.  DOI: 10.11852/zgetbjzz2024-0013
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    Objective To establish the Beijing Children and Adolescents Health Cohort and report on its research protocol and baseline population characteristics, in order to provide reference for in-depth studies on factors influencing obesity, myopia, and other chronic diseases in children and adolescents. Methods From 2022 to 2023, the Beijing Children and Adolescents Health Cohort was launched in a district of Beijing, including 10 representative primary and secondary schools. The baseline survey consisted of two parts: A questionnaire and a health examination. The questionnaire covered personal and family medical history, diet, exercise, sleep, and other behavioral and lifestyle habits. The health examination involved physical measurements, internal and external medical examinations, body composition analysis, bone mineral density and bone age assessment, abdominal ultrasound, optometric tests, and venous blood sample collection for biochemical and routine blood tests. Results The cohort included 5 579 children and adolescents aged 6 to 18 years, with an average age of 10.6 years. A higher proportion of participants were in the 6 - 11 and 12 - 14 age groups. Self-reported smoking and drinking initiation rates were 0.8% and 4.9%, respectively, with a daily secondhand smoke exposure rate of 7.8%.The rate of poor vision was 57.6%. The prevalence for underweight, overweight, and obesity were 6.5%, 16.0%, and 25.2%, respectively,with a prevalence rate of abdominal obesity of 35.9%. The prevalence rates of dyslipidemia, elevated blood pressure, impaired fasting glucose, and fatty liver were 23.7%, 16.8%, 4.0%, and 11.3%, respectively. Conclusions The baseline data of the Beijing Children and Adolescents Health Cohort indicate a high detection rate of myopia, obesity, and related chronic metabolic diseases, which should be given serious attention. Comprehensive intervention strategies and evaluations of intervention effects need to be actively promoted.
    Review
    Research progress on food preferences of children and adolescents
    ZHANG Fen, JIA Lina
    2024, 32(11):  1219-1225.  DOI: 10.11852/zgetbjzz2024-0316
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    Food preferences is established and shaped during childhood and adolescence, influencing dietary choices and nutritional intake of young individuals, thus playing a critical role in their future health. Understanding their food preference can help implement effective interventions aimed at promoting healthy eating behaviors. This review summarizes the associated factors and effective interventions of food preferences in children and adolescents according to previous literature, providing suggestions for promoting a nutritious diet among this demographic.
    Effects of dietary avoidance by lactating mothers on breast milk nutrients composition and infant growth and development
    WANG Ruian, ZHANG Xuan
    2024, 32(11):  1226-1231.  DOI: 10.11852/zgetbjzz2024-0500
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    Breast milk is the optimal source of food and fluid for infants in the early postnatal period.Current studies both domestically and internationally demonstrate that while breast milk possesses a certain degree of stability,maternal dietary restrictions can still influence its nutrient content.Fats and proteins are more affected by consumed foods,whereas carbohydrates are less influenced by diet.The relationship of vitamins and minerals with maternal intake requires further research for clarification.Whether maternal dietary avoidance affects the growth and development of exclusively breastfed infants remains to be elucidated.Clinicians and researchers have observed a considerable number of breastfed infants presenting with suspected or confirmed food allergies,leading their mothers to engage in varied levels of dietary restriction.For the mothers of these infants,the implementation of a scientifically informed approach to dietary avoidance necessitates additional research.This includes the identification of specific food items to be avoided,the temporal extent of such avoidance,and its impact for the infants' growth and development,as well as the prognosis of their allergic conditions.
    Research progress on dietary nutrition and intestinal flora in children with tic disorder
    TANG Yajun, LIU Xiumei
    2024, 32(11):  1232-1235.  DOI: 10.11852/zgetbjzz2023-1384
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    Children with tic disorder (TD) have dietary behaviors and nutritional problems, which may lead to unbalanced dietary nutrition structure and affect the composition of their gut microbiota. Nutrients and gut microbiota may participate in the occurrence and development of tic through various metabolic pathways or microbial-gut-brain axis. Supplements may help relieve tic symptoms. This article reviews dietary nutrition, gut flora characteristics and related interventions in children with TD, and discusses the underlying biological mechanisms to provide a scientific basis for clinical monitoring of dietary nutritional problems and early intervention in children with TD.
    Research progress on the role of histamine in the pathogenesis of tic disorder
    LIN Duan, LIU Xiumei
    2024, 32(11):  1236-1240.  DOI: 10.11852/zgetbjzz2023-0646
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    The relationship between histamine and tic disorder(TD) as a neuromodulator is gradually gaining attention. Specific gene mutations of histidine decarboxylase(HDC), a key enzyme in histamine synthesis, have been discovered in TD families, verifying the hypothesis that histamine is involved in TD generation in human and animal models. Histamine and its receptors play a role in regulating cortico-striato-thalamo-cortical(CSTC) circuits, neurotransmitters, and microglia-mediated neuroinflammation, which subsequently affect the development of TD. The H3 receptor shows promise as a pharmacotherapeutic target for treating TD. This article reviews the role of histamine and its receptors in the pathogenesis of TD.
    Effects of sleep fragmentation on cognitive function in children
    WANG Leilei, ZHAO Pengjun
    2024, 32(11):  1241-1245.  DOI: 10.11852/zgetbjzz2024-0362
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    Sleep fragmentation refers to the state of several brief awakenings during night sleep, which is an intermittent sleep pattern, and its symptoms are manifested as difficulty in falling asleep again after waking up, daytime sleepiness, and lack of attention. Cognitive function includes executive function, attention deficit, learning and memory function, etc. This paper comprehensively analyzes the possible mechanism of the influence of sleep fragmentation on cognitive function, and expounds its clinical significance, so as to provide insights for further clinical research and treatment.
    Meta Analysis
    Meta-analysis of effect of calcium supplementation on children's height
    WU Huahong, SHU Wen, YU Chengdong, ZHANG Yaqin, WU Ting, ZONG Xinnan
    2024, 32(11):  1246-1251.  DOI: 10.11852/zgetbjzz2024-0189
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    Objective To explore the effect of calcium supplementation on children's height, in order to provide reference for scientific supplementation of calcium. Methods PubMed, the Cochrane Library, Scopus, Web of Science, China National Knowledge Infrastructure (CNKI), and Wanfang Data database were searched for randomized controlled trials on the effect of calcium supplementation on children's height. Papers published from the establishment of these databases to November 6th, 2023 were extracted. Meta-analysis was conducted using RevMan 5.3 software, and the quality of the articles was assessed using the Cochrane bias assessment tool in this software. The study subjects were divided into three subgroups according to age (<6 years old, 6 - 12 years old and >12 years old) for subgroup analysis. According to whether the calcium intake reached recommended intake dose, the study subjects were also divided into three groups for subgroup analysis: "both inadequate before and after intervention", " inadequate before and adequate after ", and "adequate before to excessive after". Results A total of 12 randomized controlled trials were included in this Meta-analysis. The overall meta-analysis results showed that the difference in height increment between the calcium supplementation group and the control group was 0.21cm (95%CI: -0.09 to 0.52), but the difference was not statistically significant (P=0.17). Subgroup analysis showed that there was no statistical differences in height increment between the calcium supplementation and control group in different age groups (P>0.05). Among different calcium intake dose groups, only in the "inadequate before and adequate after" group, children in the calcium supplementation group had a significantly higher height increment than control group, with a difference of 0.48cm (95%CI: 0.09 - 0.87, P=0.02), while there was no significant difference in height increments between the calcium supplementation and control group in the other two groups (P>0.05). Conclusions For children with insufficient calcium intake, adequate calcium supplementation can promote their height growth. While for those with sufficient calcium intake, excessive calcium supplementation has no significant effect on height.
    Clinical Research
    Pathway of the effect of screen exposure on overweight and obesity among children and adolescents
    WU Shuxian, WU Qingqing, WANG Lei, ZHAO Xiang, LYU Qiaohong, HUANG Yu
    2024, 32(11):  1252-1255.  DOI: 10.11852/zgetbjzz2024-0335
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    Objective To analyze the mediating pathway of the effect of screen exposure on overweight and obesity among children and adolescents,in order to provide evidence for the prevention and behavioral intervention of overweight and obesity in this population. Methods A total of 842 students in the same class from primary,junior and senior high schools in Zhejiang Province were selected by cluster random sampling method from September to November 2020.Data on demographic characteristics,body mass index (BMI),physical activity,frequency of eating while watching screens,and screen exposure were collected via questionnaires.Analysis of variance and chi-square test were used to compare the differences among non-and overweight and obesity groups,and the possible mediating effects were clarified. Results Among the 842 participants,205 (24.4%) were detected with overweight or obesity.Time of weekly more than one-hour physical activity was (3.0±2.3) days,and the average weekly screen exposure duration was (22.0±9.0) hours.Approximately 69.7% of children and adolescents had the habit of eating while watching screens.Screen exposure had no direct effect on BMI (β=-0.002,P=0.179), but could increase the risk of overweight and obesity through the mediating effect of physical activity (β =-0.030,P=0.001;β =-0.016,P=0.003). Conclusion Screen exposure increases the risk of overweight among children and adolescents by reducing their level of physical activity.
    Feeding index and its influencing factors of preterm and low birth weight infants
    LI Xiaoqiang, GUO Zhirong, MA Zhengying, WANG Lixia, SHEN Wei
    2024, 32(11):  1256-1260.  DOI: 10.11852/zgetbjzz2024-0320
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    Objective To explore the feeding index and influencing factors in preterm low birth weight infants,in order to provide reference for improving their feeding and nutritional status. Methods A total of 100 preterm low birth weight infants at the corrected age of 6 to 24 months,who underwent health check-ups at the PKUFH-Ningxia Women and Children's Hospital between June 2023 and March 2024,were selected as the case group.Meanwhile,108 healthy infants and toddlers undergoing routine check-ups during the same period were selected as the control group.The feeding indices were compared and analyzed between the two groups. Results The overall feeding index score for preterm low birth weight infants was 10.56±4.77.Scores for the 6 - 8 month age group,the 9 - 11 month age group,and the overall score in the preterm low birth weight infants were lower than those in the control group,but only the difference in the 6 - 8 month age group was statistically significant (P< 0.05).Unconditional Logistic regression analysis showed that the main facilitators of the feeding index were breastfeeding (OR=2.864,95%CI:1.023 - 8.015,P=0.045),formula feeding duration (OR=2.185,95%CI:1.138 - 4.195,P=0.019),and age in months (OR=2.426,95%CI:1.276 - 4.612,P=0.007). Conclusion The feeding index in preterm low birth weight infants is relatively low,indicating the need for relevant intervention measures.
    Development risk factors and prediction model construction of children with developmental hip dysplasia
    MA Xiaopeng, LI Xingzhen, XIE Kunxia, LIU Tian, HAO Tingting
    2024, 32(11):  1261-1265.  DOI: 10.11852/zgetbjzz2024-0187
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    Objective To explore the risk factors for developmental dysplasia of the hip (DDH) in children and construct a relevant prediction model, in order to provide more information for clinical screening, prevention, and treatment of DDH. Methods A retrospective study was conducted involving 62 children with DDH diagnosed and treated at the Affiliated Hospital of Yan'an University from January 2018 to December 2023. Additionally, 62 healthy children undergoing physical examinations during the same period were matched at a 1∶1 ratio as the control group. The occurrence of DDH in children was analyzed, and the risk factors were explored. Results Among the 62 children with DDH included in this study, 30 had the affected hip on the right side, and 32 on the left side. According to the Graf classification, there were 15 cases of type Ⅱa(+), 22 cases of type Ⅱa(-), 7 cases of type Ⅱb, 6 cases of type Ⅱc, 5 cases of type D, 6 cases of type Ⅲ, and 1 case of type Ⅳ. Univariate analysis revealed that gender, fetal position during delivery, prematurity status, leg wrapping and leggings habits, and family history of DDH may be associated with the occurrence of DDH in children (P<0.05). Logistic multivariate analysis confirmed that female, breech delivery, non-prematurity, leg wrapping and leggings habits, and family history of DDH were independent risk factors for DDH in children (P<0.05). Using the independent influencing factors and P-value prediction probabilities from the regression model to predict the risk of DDH in children, the Youden indices were 37.50%, 14.83%, 81.42%, 25.00%, 8.69%, and 82.42%, respectively. Conclusions Children who are female, delivered in the breech position, non-premature, having leg wrapping and leggings habits and family history of DDH are more prone to developing DDH. The data model constructed using these five factors demonstrates good performance in predicting the occurrence of DDH in patients and is worthy of further analysis in clinical practice.
    Influencing factors for malnutrition in children with cerebral palsy
    XU Yanhong, LI Hong, CHEN Jing, XU Jinbo, DING Hao
    2024, 32(11):  1266-1270.  DOI: 10.11852/zgetbjzz2024-0378
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    Objective To explore the influencing factors of malnutrition in children with cerebral palsy (CP), so at to provide references for its prevention and treatment. Methods A total of 80 cases of CP children who visited the Department of Rehabilitation at Anhui Provincial Children's Hospital from January to July 2021 were collected and divided into malnutrition group and control group based on the presence or absence of malnutrition. The differences between the two groups regarding gender, age, gestational age, birth weight, feeding time, Subjective Global Nutritional Assessment (SGNA), clinical classification, Gross Motor Function Classification System (GMFCS) level, serum total protein (TP), 25-hydroxyvitamin D [25-(OH)D], hemoglobin (HGB), and ferritin (FE) were compared. Spearman correlation analysis was used to analyze the correlations of TP, 25-(OH)D, HGB and FE with nutritional status. Multivariate Logistic regression analysis was conducted to identify the influencing factors of malnutrition in children with CP. Results The proportion of patients with feeding time ≥30 minutes(χ2=21.798) and abnormal SGNA assessment(χ2=45.263)in the malnutrition group was significantly higher than that in the control group, while the average values of TP, HGB and FE were significantly lower than those in the control group (t=2.739,2.674,2.155,P<0.01). Serum HGB was positively correlated with nutritional status Z-score (rs=0.314, P<0.05) in children with CP. Multivariate Logistic regression analysis showed that GMFCS levels Ⅱ, Ⅲ,Ⅳ, and Ⅴ were risk factors for malnutrition in CP children compared to GMFCS level Ⅰ (OR=1.750, 3.667, 1.374, 2.375, P<0.05). Conclusions GMFCS levels Ⅱ, Ⅲ,Ⅳ, and Ⅴ are risk factors for the occurrence of malnutrition in children with CP. Early identification and intervention can help improve their nutritional status.
    Status quo of obesity and its influencing factors among children aged 0 - 5 in 10 cities in Jiangsu province
    LI Lihua, LI Guiyan, QIN Rui, ZHAO Yan
    2024, 32(11):  1271-1276.  DOI: 10.11852/zgetbjzz2024-0329
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    Objective To understand the current prevalence and influencing factors of obesity in children aged 0 to 5 years in Jiangsu Province,in order to proride reference for the prevention and treatment of childhood obesity. Methods A stratified cluster random sampling method was used to recruit children aged 0 to 5 years from 10 cities in Jiangsu Province between April 2014 and March 2015 for a multi-center large-sample survey. Through a self-designed questionnaire, information on height/length, weight, gender, birth condition, region, and season was collected. A multivariate Logistic regression model was used to analyze the influencing factors of obesity in children aged 0 to 5 years. Results A total of 5 284 children aged 0 to 5 years were surveyed, with an obesity detection rate of 6.8%. The obesity detection rates for children aged 0 to <1 year, 1 to <2 years, 2 to <3 years, 3 to <4 years, 4 to <5 years, and 5 to <6 years were 7.7%, 4.7%, 4.0%, 6.0%, 7.1%, and 11.0%, respectively. Multivariate Logistic regression analysis indicated that compared to children aged 2 to <3 years, the risk of obesity was higher in children aged 0 to <1 year and 5 to <6 years (OR=1.982, 2.202); boys, children with birth weight ≥4 000 g, and children surveyed during winter had a higher risk of obesity (OR=1.581, 1.600, 2.109, P<0.05). Conclusions The obesity rate in children aged 0 to 5 years in Jiangsu Province is at a relatively high level. The incidence of obesity is statistically associated with age, gender, birth weight, and the season of the survey,related intervention measures are warranted for the prevention and treatment of childhood obesity.