中国7个城市3~17岁儿童青少年体成分调查

目的描述3~17岁儿童青少年体成分(脂肪组织、非脂肪组织)的发育特征。方法采用分层整群抽样方法,分别抽取南方和北方共计7个城市,包括长春、北京、天津、济南、上海、银川、重庆的3~17岁城市汉族儿童青少年10867例。采用问卷调查收集研究对象基本信息,测量身高、体重,采用双能X线吸收法(DXA)测量身体脂肪组织质量、非脂肪组织质量等。计算BMI、体脂含量百分比(FMP)、脂肪质量指数(FMI)、非脂肪组织质量指数(FFMI)。采用SAS 9.4软件进行数据整理和逻辑核查,采用SPSS 20.0软件进行统计学分析。结果共收集10867例3~17岁儿童青少年数据,其中男生5512人(50.7%)。男生FMP在10~15岁组随年龄增长迅速下降[β=-1.811(95%CI:-1.987^-1.635)],15岁以后变化不明显;女生FMP在3~7岁组随年龄增长呈下降趋势[β=-0.896(95%CI:-1.100^-0.691)],7~12岁变化不明显,12~15岁随年龄增长增速明显[β=0.989(95%CI:0.753~1.224)],15岁以后变化不明显。除9岁组和10岁组以外,女生FMP高于男生(均P<0.05)。男生FFMI在3~17岁各个年龄段均明显高于女生(均P<0.05),11岁以后,女生和男生的FFMI差异变大。男生和女生的FMI随年龄变化的生长曲线有交叉,略有随年龄增长而增加的趋势[男生:β=0.033(95%CI:0.018~0.048);女生:β=0.192(95%CI:0.181~0.204)]。脂肪重聚年龄肥胖组小于超重组和正常体重组;男生不同体重状态组BMI、FFMI随年龄变化情况类似;男生正常体重组FMI随年龄增长略有降低,一直保持在5 kg/m2以下,超重组[β=0.114(95%CI:0.091~0.136)]和肥胖组[β=0.211(95%CI:0.176~0.245)]的FMI有明显随年龄增长而增加的趋势;不同体重状态组男生FMP在10岁以后随年龄增长呈下降趋势[正常体重:β=-0.836(95%CI:-0.924^-0.748);超重:β=-1.090(95%CI:-1.269^-0.910);肥胖:β=-1.144(95%CI:-1.321^-0.967)];不同体重状态组女生的BMI、FFMI、FMI随年龄变化情况类似,在8岁以后呈现随年龄增长而上升的趋势[正常体重组:β=0.174(95%CI:0.165~0.182);超重组:β=0.325(95%CI:0.304~0.346);肥胖组:β=0.447(95%CI:0.406~0.488)];女生FMP的变化12岁以后随年龄增长呈明显增加的趋势[正常体重组:β=0.963(95%CI:0.851~1.074);超重组:β=0.910(95%CI:0.695~1.125);肥胖组:β=0.895(95%CI:0.569~1.221)]。总体上来看,BMI和FMI的相关性很强(男生:r=0.767;女生:r=0.873),不同体重状态儿童青少年BMI和FMI的r不同。结论儿童脂肪组织和非脂肪组织发育特征不同,且存在性别差异。BMI生长曲线和体脂肪的发育特征不完全一致,且存在性别差异,有必要对生长发育中的儿童进行更精准的体成分评估。     

青少年体脂肪分布与骨钙素水平的关系

目的 探讨银川市青少年体脂肪分布和骨钙素水平之间的关系,为指导青少年合理有效的体重控制和预防肥胖、骨代谢相关疾病提供依据。方法 采用现况调查设计,以整群随机抽样的方法抽取银川市12～18岁青少年1 068名进行问卷调查、体格检查及实验室检测。结果 总人群中,体脂肪量(BFM)、躯干FM、四肢FM、体脂百分比(FMP)与骨钙素水平均呈负相关(P均<0.05), 而四肢FMP与骨钙素水平呈正相关(P<0.01)。Logistic回归分析得出,总人群中第三、第二分位组FMP水平提示高水平骨钙素的风险分别是0.28(95%CI:0.13～0.57)、0.44倍(95%CI:0.25～0.76),男性中FMP第四、第三、第二分位水平相较于最低四分位水平,均可较好的预测高水平骨钙素,其风险是正常组的0.2(95%CI:0.05～0.72)、0.21(95%CI:0.08～0.55)和0.45倍(95%CI:0.25～0.82)。无论男女,四肢FMP第四分位水平相较于最低四分位水平可较好预测高骨钙素水平,风险分别是正常组的7.46(95%CI:2.79～19.96)和2.60倍(95%CI:1.36～4.96)。结论 总体上FMP对骨吸收有负面影响,而四肢FMP相反,并且性别不同体脂率对骨代谢的影响也不同。     

Prognostic value of changes in lean and fat mass in alcoholics

Background & aims

The prognostic value of nutritional status and/or lean and fat mass assessed by dual-energy X-ray absorptiometry (DEXA) has been widely analyzed, in both alcoholics and non-alcoholics. However, the prognostic value of changes in fat and lean mass over time in alcoholics has scarcely been studied, nor has the effect of alcohol abstinence on these changes.

Methods

From an initial cohort of 113 alcoholic patients, 70 prospectively underwent two DEXA assessments six months apart. One hundred and five patients (including 66 of those who underwent two DEXA assessments) were followed up for 34.9 ± 36.4 months (median = 18 months, interquartile range = 7.25–53.75 months). During this follow-up period, 33 died (including 20 of those who had undergone a second DEXA assessment).

Results

Forty-two of the 70 patients undergoing a second DEXA assessment had abstained from alcohol. Of these, 69.04% (29) gained left arm lean mass, compared with only 35.71% (10 of 28) of those who had continued drinking (χ² = 7.46; p = 0.006). Similar results were observed regarding right arm lean mass (χ² = 4.68; p = 0.03) and right leg lean mass (χ² = 7.88; p = 0.005). However, no associations were found between alcohol abstinence and changes in fat parameters. Analysis by means of Kaplan–Meier curves showed that loss of total lean mass, right leg lean mass, left leg lean mass and total fat mass were all significantly associated with reduced survival. However, within 30 months of the second evaluation, significant associations were observed between changes of all parameters related to lean mass, and mortality, but no association between changes in fat parameters and mortality.

Conclusions

Loss of lean mass over a period of six months after a first assessment is associated with worse prognosis in alcoholics, irrespective of whether they stop drinking during this period or not. Continued drinking is associated with greater loss of lean mass, but not with changes in fat mass.     

Growth charts for Brazilian children with Down syndrome: Birth to 20 years of age

Background

The growth of youth with Down syndrome (DS) differs from that of youth without DS, and growth charts specific to DS have been developed. However, little is known about the growth of Brazilian youth with DS. The objective of this study was to construct growth charts for Brazilian youth with DS and compare the growth data with the Child Growth Standards of the World Health Organization (WHO) and charts for children with DS from other studies.

人体成分分析及其应用

传统上使用体重指数(BMI)判断体型和营养状况具有其局限性.利用生物电阻抗法(BIA)人体成分分析技术可获得脂肪率、去脂体重指数等数据.我们认为,合适的脂肪率是男性12％ ～22％、女性20％ ～ 30％,中等的去脂体重指数是男性17.0～21.0、女性14.5 ～18.0.人体成分分析较BMI能更好地用于体型判断、营养评估、某些疾病的预后判断和调整用药剂量等.     

Association between sleep quality and physical functioning in adults with Down syndrome: A brief report

BackgroundSleep quality is associated with physical functioning in adults, but this has not been examined in those with Down syndrome (DS). High body mass index (BMI) and accelerated aging, both common in adults with DS, may alter the relationship between sleep quality and physical functioning in this population.ObjectiveTo examine sleep quality indicators and its association with physical functioning in adults with DS, and whether associations are altered by BMI and age.MethodsParticipants were 15 adults with DS (8 women; age 29 ± 14 years). We evaluated sleep quality over seven days with wrist-worn accelerometers and physical functioning with the timed-up-and-go (TUG) and 6-min walk (6 MW) tests. We examined the associations between sleep quality and physical functioning variables using Spearman's rho.ResultsSleep quality indicators were: total sleep time 407 ± 54 min; latency 26.8 ± 21 min; efficiency 73.9 ± 12 %; wake after sleep onset 122.8 ± 65.2 min; number of awakenings 21.0 ± 6.2; and average length of awakenings 6.1 ± 3 min. Total sleep time and average length of awakenings were significantly associated with 6 MW distances (rho = 0.58 and ?0.69; p < 0.05, respectively). After controlling for age and BMI, 6 MW distance was significantly associated with total sleep time, latency, efficiency, and average length of awakenings (rho = 0.56, ?0.73, 0.60, and ?0.87; p < 0.05, respectively). TUG was significantly associated with total time in bed (rho = 0.71); p < 0.05).ConclusionsSleep quality indicators are associated with walking performance in adults with DS. Age and BMI strengthen the relationship between sleep quality and physical functioning.     

儿童少年体脂含量与肥胖指数的相关分析

目的 筛选一种比较准确、可靠的儿童少年肥胖判定方法。方法 对295名7－15岁中小学生，采用水下称重法测定身体脂肪含量（F％），与判定肥胖的5种指数作相关分析。结果 皮体贡数（ISBM）、BMI、皮褶指数（SFI）、劳雷尔指数、克托莱指数与F％都呈正相关，以ISBM法相关程度最高，相关系数男＝0.86；女＝0.80，SFI、BMI次之克长莱指数最低。结论 ISBM法是判定儿童少年肥胖的理想方法。     

Evidence that in healthy young women, a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol plus 2 mg of chlormadinone acetate reduces fat mass

Background

We aimed to evaluate whether a six-cycle treatment with oral contraceptive containing 30 mcg of ethinylestradiol (EE2) plus 2 mg of chlormadinone acetate (CMA) (EE2+CMA) alters body weight (BW) and body composition of healthy young women with normal menstrual cycles. The results in treated subjects were compared to those obtained in nontreated women as control.

Study Design

Multifrequency bioelectrical impedance analysis (MF-BIA) was performed in 48 healthy young women during the follicular phase of their menstrual cycle. Of this group, 24 women were treated with EE2+CMA, and the MF-BIA was repeated at the third and sixth cycle of treatment. The remaining 24 women were submitted to the same examinations after three and six cycles without any treatment. Total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass (FM) and fat-free mass (FFM) were calculated. Waist-to-hip ratio (WHR), BW, blood pressure, and the plasma concentrations of electrolytes were also measured at each visit.

Results

Mean FM significantly (p<.05) decreased in the EE2+CMA group from basal levels of 14.23±1.03 to 13.51±1.09 and 12.71±1.02 kg at the third and sixth cycle of treatment, respectively. Stable values were seen in the control group. During observation, other parameters (BW, WHR, TBW, ECW, ICW, FFM) remained unchanged in all subjects.

Conclusions

EE2+CMA reduces FM without altering TBW, ICW, ECW. These preliminary results suggest that progestational activity of CMA could balance both fluid retention and weight gain elicited by EE2.