目的 了解北京市婴幼儿超重肥胖流行现状,结合体成分检测结果,探究影响婴幼儿身体成分的影响因素。方法 2021年1-4月于北京市海淀区、昌平区、石景山区及通州区4区开展多中心现况调查,招募单胎且无明显畸形和遗传代谢病的0~2岁婴幼儿作为研究对象。调查内容包括问卷调查(婴幼儿一般人口学特征、母亲孕期及分娩情况和婴幼儿出生情况等)和体格检查(身长、体重和身体成分测量)。选取电子问卷调查和体成分检测数据均完整的样本,最终共纳入896名研究对象。结果 以身长别体重Z值(WHZ)诊断的北京市4区男童和女童超重/肥胖检出率分别为9.65%和4.42%;但是,以体成分检测诊断的男童和女童超重/肥胖检出率高达21.46%和7.67%。母亲孕前超重肥胖(男童:β=0.222,95%CI:0.021~0.423;女童:β=0.237,95%CI:0.048~0.426)、婴幼儿出生时为大于胎龄儿(男童:β=0.212,95%CI:0.014~0.411)及出生身长(男童:β=0.037,95%CI:0.012~0.063;女童:β=0.027,95%CI:0.001~0.054)与体脂质量指数(FMI)呈正相关(P<0.05)。结论 北京市4区婴幼儿的超重肥胖现状不容乐观,体成分检测可降低肥胖的漏诊和误诊,应在生命早期采取有效的干预措施进行预防和控制。
Abstract
Objective To describe the current prevalence of overweight and obesity among infants in Beijing, and to explore the influencing factors of overweight and obesity based on body composition analysis. Methods A multicenter cross-sectional survey was conducted in Haidian district, Changping district, Shijingshan district and Tongzhou district of Beijing from January to April 2021.Single fetus infants aged 0 to 2 years and without obvious malformations and genetic metabolic diseases were selected, and completed questionnaire survey (infant general demographic characteristics, maternal pregnancy and delivery, infant birth, etc.) and physical examination (infant length, weight and body composition measurement).Finally 896 infants with complete data of questionnaire survey and physical examination were enrolled in this study. Results The prevalence of overweight/obesity diagnosed by weight for height Z score (WHZ) in four districts of Beijing was 9.65% in boys and 4.42% in girls, whereas the prevalence of overweight/obesity diagnosed by body composition analysis was as high as 21.46% and 7.67% in boys and girls, respectively.Fat mass index (FMI) was significantly higher in infants whose mothers were overweight and obese before pregnancy (boys: β=0.222, 95%CI: 0.021 - 0.423; girls: β=0.237, 95% CI: 0.048-0.426) and infants who had larger for gestational age (boys:β=0.212, 95% CI: 0.014 - 0.411) and larger birth length (boys: β=0.037, 95%CI: 0.012 - 0.063; girls: β=0.027, 95% CI: 0.001 - 0.054,P<0.05). Conclusions The prevalence of overweight and obesity in infants in the four districts of Beijing is not optimistic, and the measurements of body composition can reduce the rates of missed diagnosis and inaccurate diagnosis of infant obesity.Therefore, effective intervention measurement should be taken to prevent and control overweight and obesity in the early stage of life.
关键词
超重 /
肥胖 /
身体成分 /
婴幼儿
Key words
overweight /
obesity /
body composition /
infants
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Ng M, Fleming T, Robinson M, et al.Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013[J].Lancet, 2014, 384(9945): 766-781.
[2] Weng SF, Redsell SA, Swift JA, et al.Systematic review and meta-analyses of risk factors for childhood overweight identifiable during infancy[J].Arch Dis Child, 2012, 97(12): 1019-1026.
[3] Lobstein T, Jackson-Leach R, Moodie ML, et al.Child and adolescent obesity: part of a bigger picture[J].Lancet,2015, 385(9986):2510-2520.
[4] Kumar S, Kelly AS.Review of childhood obesity: From epidemiology, etiology, and comorbidities to clinical assessment and treatment[J].Mayo Clin Proc,2017, 92(2):251-265.
[5] Mihrshahi S, Baur LA.What exposures in early life are risk factors for childhood obesity? [J].J Paediatr Child Health, 2018, 54(12):1294-1298.
[6] World Health Organization.WHO Child Growth Standards: Length/height-for-age, weight-for-age, weight-for-length, weight-for-height and body mass index-for-age: Methods and development[R/OL].Geneva. Switzerland.2006.http://www.who.int/childgrowth/standards/technical_report/en/index.html.
[7] Demerath EW, Fields DA.Body composition assessment in the infant[J].Am J Hum Biol, 2014, 26(3):291-304.
[8] 中华医学会妇产科学分会产科学组/围产医学分会妊娠合并糖尿病协作组.妊娠合并糖尿病诊治指南(2014)[J].糖尿病临床, 2014, 8(11): 489-498.
[9] 胡亚美, 江载芳, 申昆玲.诸福棠实用儿科学[M].8版.北京:人民卫生出版社, 2015.
[10] Koletzko B, Godfrey KM, Poston L,et al.Nutrition during pregnancy, lactation and early childhood and its implications for maternal and long-term child health: the early nutrition project recommendations[J].Ann Nutr Metab,2019,74(2):93-106.
[11] 于冬梅, 琚腊红, 李淑娟, 等.2013年中国不同省份儿童超重和肥胖现况[J].卫生研究, 2020, 49(2): 190-194.
[12] Yu Z, Han S, Chu J, et al.Trends in overweight and obesity among children and adolescents in China from 1981 to 2010: a Meta-analysis[J].Arch Pediatr Adolesc Med, 2012, 7(12): e51949.
[13] Song Y, Wang HJ, Ma J, et al.Secular trends of obesity prevalence in urban Chinese children from 1985 to 2010: gender disparity[J].PLoS One, 2013, 8(1): e53069.
[14] Guo Y, Yin X, Wu H, et al.Trends inoverweight and obesity among children and adolescents in China from 1991 to 2015: a Meta-analysis[J].Int J Environ Res Public Health,2019, 16(23): 4656.
[15] Willoughby D, Hewlings S, Kalman D.Bodycomposition changes in weight loss: Strategies and supplementation for maintaining lean body mass, a brief review[J].Nutrients, 2018, 10(12): 1876.
[16] 陈亚华, 毛华芬.鄞州区 0~2 岁婴幼儿超重和肥胖现状及影响因素分析[J].中国慢性病预防与控制, 2018, 26(1): 31-33.
[17] Zhou LY, Deng MQ, Zhang Q, et al.Early-life nutrition and metabolic disorders in later life: a new perspective on energy metabolism[J].Chin Med J,2020,133(16):1961-1970.
[18] Koletzko B, Brands B, Poston L, et al.Early nutrition programming of long-term health[J].Proc Nutr Soc, 2012, 71(3): 371-378.
[19] Stamnes Køpp UM, Dahl-Jørgensen K, Stigum H, et al.The associations between maternal pre-pregnancy body mass index or gestational weight change during pregnancy and body mass index of the child at 3 years of age[J].Int J Obes (Lond), 2012, 36(10):1325-1331.
[20] Gewa CA.Childhood overweight and obesity among Kenyan pre-school children: association with maternal and early child nutritional factors[J].Public Health Nutr, 2010, 13(4):496-503.
[21] Godfrey KM, Reynolds RM, Prescott SL, et al.Influence of maternal obesity on the long-term health of offspring[J].Lancet Diabetes Endocrinol, 2017, 5(1): 53-64.
[22] Vargas-Terrones M, Nagpal TS, Barakat R.Impact of exercise during pregnancy on gestational weight gain and birth weight: an overview[J].Braz J Phys Ther, 2019, 23(2):164-169.
[23] Koletzko B, Brands B, Grote V, et al.Long-term health impact of early nutrition: the power of programming[J].Ann Nutr Metab, 2017, 70(3):161-169.
基金
国家自然科学基金(81973110、82073572);北京市属医学科研院所公益发展改革试点项目(京医研2019-11)
PDF(570 KB)
