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上海地区高出生体质量与儿童肥胖关系的横断面研究
陈涵1,陈畅1,金志娟2,杨友2,江帆2,3,黄红4,刘世建1,3,4*,金星明2
0
(1. 上海交通大学公共卫生学院, 上海 200025;
2. 上海交通大学医学院附属上海儿童医学中心发育行为儿科, 上海 200127;
3. 上海交通大学医学院附属上海儿童医学中心儿科转化医学研究所, 上海 200127;
4. 上海交通大学医学院附属新华医院教育部环境与儿童健康重点实验室, 上海 200092
*通信作者)
摘要:
目的 探讨高出生体质量与儿童肥胖之间的关系,为预防和减少儿童肥胖的发生提供科学依据。方法 采用多阶段分层整群随机抽样调查方法,选取70 284名3~12岁上海儿童作为研究对象,通过问卷调查收集所有研究对象年龄、性别、体质量、身高、新生儿时期数据(包括出生孕周、出生体质量和喂养方式)等信息,分析高出生体质量与儿童肥胖之间的关系。结果 男孩高出生体质量组和正常出生体质量组超重、肥胖及重度肥胖构成比差异均有统计学意义(P均<0.05),女孩高出生体质量组和正常出生体质量组超重、肥胖及重度肥胖构成比差异有统计学意义(P均<0.05)。经多变量logistic回归模型调整年龄及性别因素后,高出生体质量是引起儿童超重(OR=1.41,95%CI 1.33~1.51,P<0.05)、肥胖(OR=1.45,95%CI 1.31~1.62,P<0.05)、重度肥胖(OR=1.51,95%CI 1.35~1.68,P<0.05)的独立危险因素;调整年龄、性别及新生儿特征因素(包括孕周、喂养模式)后,高出生体质量是引起儿童超重(OR=1.40,95%CI 1.31~1.50,P<0.05)、肥胖(OR=1.44,95%CI 1.28~1.61,P<0.05)、重度肥胖(OR=1.42,95%CI 1.25~1.60,P<0.05)的独立危险因素。结论 高出生体质量是儿童超重、肥胖和重度肥胖的重要危险因素。
关键词:  出生体质量  儿童  超重  肥胖症
DOI:10.16781/j.0258-879x.2020.07.0808
投稿时间:2019-10-12修订日期:2020-01-14
基金项目:上海市卫生健康委员会加强公共卫生体系建设三年行动计划(11PH1951202).
Relationship between high birth weight and childhood obesity in Shanghai: a cross-sectional study
CHEN Han1,CHEN Chang1,JIN Zhi-juan2,YANG You2,JIANG Fan2,3,HUANG Hong4,LIU Shi-jian1,3,4*,JIN Xing-ming2
(1. School of Public Health, Shanghai Jiao Tong University, Shanghai 200025, China;
2. Department of Developmental and Behavioral Pediatrics, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;
3. Pediatric Translational Medicine Institute, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200127, China;
4. Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
*Corresponding author)
Abstract:
Objective To explore the relationship between high birth weight and childhood obesity, so as to provide scientific evidence for preventing and reducing childhood obesity. Methods A total of 70 284 Shanghai children aged 3-12 years were selected by multi-stage stratified cluster random sampling method. The age, gender, body weight, height, neonatal period data (including gestational week, birth weight and feeding pattern) were collected by questionnaire, and the relationship between high birth weight and childhood obesity was analyzed. Results There were significant differences in proportions of overweight, obesity and severe obesity between the high and normal birth weight groups (all P<0.05) in both boys and girls. After adjusting for age and gender by multivariate logistic regression model, we found that high birth weight was an independent risk factor for childhood overweight (OR=1.41, 95% CI 1.33-1.51, P<0.05), obesity (OR=1.45, 95% CI 1.31-1.62, P<0.05) and severe obesity (OR=1.51, 95% CI 1.35-1.68, P<0.05). After adjusting for age, gender and neonatal characteristics (including gestational week and feeding pattern), we found that high birth weight was still an independent risk factor for childhood overweight (OR=1.40, 95% CI 1.31-1.50, P<0.05), obesity (OR=1.44, 95% CI 1.28-1.61, P<0.05) and severe obesity (OR=1.42, 95% CI 1.25-1.60, P<0.05). Conclusion High birth weight is an important risk factor for overweight, obesity and severe obesity in children.
Key words:  birth weight  children  overweight  obesity