重庆城区婴幼儿超重与肥胖状况及影响因素的研究

目的：了解重庆城区婴幼儿超重与肥胖现况及其危险因素,为儿童肥胖早期干预提供依据。方法：采用分层整群抽样的方法,对生后1月龄的2139名儿童进行3、6、9、12和18月龄的生长监测、评估和问卷调查。以18月龄是否超重与肥胖为应变量进行多元回归分析。结果：（1）婴儿超重与肥胖检出率生后前半年增长迅速,6月龄达26.04%,之后逐渐降低,至18个月龄时为15.89%。（2）Logistic回归分析显示父亲营养状况、儿童出生时、6月龄、9月龄和12月龄的营养状况、3月龄喂养方式、12月龄蔬菜进食频次、18月龄甜饮料添加频次以及18月龄上床时间共9个因素与18月龄儿童超重与肥胖显著相关。结论：重庆城区婴幼儿超重与肥胖现状突出,存在多种因素共同作用,应给予早期综合干预。     

两种标准筛查儿童超重和肥胖的比较

目的 探讨更适合中国儿童的超重、肥胖初筛标准.方法 对广西南宁地区13万余儿童(年龄7～18周岁)进行流行病学调查,参照国内、国际两种儿童超重及肥胖标准进行分析比较.结果 大多数年龄组超重及肥胖儿童国内标准的检出率均高于国际标准,肥胖的发生率在7～10岁组升高,男童超重及肥胖的检出率高于女童.结论 使用国内的儿童超重及肥胖标准可能更有利于我国儿童青少年超重、肥胖的早期干预.     

出生体重与5至8岁儿童超重和肥胖关联的队列研究

目的以回顾性队列研究探讨出生体重与5~8岁儿童超重和肥胖的关系。方法利用上海市闵行区所辖的13家社区卫生服务中心3~12岁儿童的体格检查数据库,截取5~8岁儿童的身高和体重数据进行分析。体检时行问卷调查生育史、出生体重、妊娠情况和出生后喂养史。按照出生体重分为:2 500 g(低出生体重儿)、~3 000 g、~3 500 g、~4 000 g和≥4 000 g组(巨大儿)。采用多元logistics分析评估出生体重与5~8岁儿童超重和肥胖的关系,并调整相关因素的影响。结果 99 897名5~8岁儿童进入分析,超重发生率为10.1%,肥胖发生率为5.0%。11.4%的儿童为低出生体重,7.3%为巨大儿;出生体重2 500 g、~3 000 g、~3 500 g、~3 500 g、~4 000 g和≥4 000 g组超重检出率分别为8.4%、7.6%、9.2%、11.5%和14.5%;肥胖检出率分别为4.7%、3.9%、4.4%、5.9%和7.9%。2简单相关分析发现,~3 500 g、~4 000 g和≥4 000 g组出生体重与儿童体重呈正相关(P0.000 1),在调整了性别、年龄、身高、分娩史、孕周、喂养史和身高后,仍具有显著相关性。3与出生体重~3 500 g组相比,~4 000 g组超重和肥胖的发生率增加31%和43%,~4 500 g组超重和肥胖的发生率增加76%和103%;~3 000 g组发生超重和肥胖的风险最低(RR=0.80,95%CI:0.73~0.88,P0.000 1;RR=0.87,95%CI:0.77~0.98,P0.000 1),调整了年龄、性别、孕周和产式等因素后,仍具有相关性;5、6、7和8岁儿童~4 000 g和≥4 000 g组发生超重和肥胖的风险相近;2 500 g组肥胖的风险RR为1.07(95%CI:0.79~1.43),P=0.27。结论出生体重对5~8岁儿童超重和肥胖的影响呈非线性关系。出生体重3 500 g儿童5~8岁超重和肥胖的风险显著增高。     

超重肥胖儿童青少年代谢综合征流行现状调查

目的 了解上海市浦东新区川沙地区超重肥胖儿童青少年中代谢综合征(MS)的流行现状和临床特点.方法 对432例7～15岁超重肥胖儿童青少年进行体格测量和血液生化检测.应用Cook定义诊断MS,具有下列5项中至少3项者诊断为MS:腹型肥胖、高血压、高血糖、高甘油三脂(TG)血症和低高密度脂蛋白胆固醇(HDL-C)血症.结果 腹型肥胖、高血压、高血糖、高TG血症和低HDL-C血症的总检出率分别为85.9%、44.4%、13.4%、48.6%和9.0%.具有0、1、2和3项及3项以上MS组分者分别占4.4%、28.3%、36.3%和31.0%.约95%的个体至少有1项MS组分异常,约60%～70%的个体至少有2项异常.共检出MS134例,检出率为31.0%.结论 川沙地区超重肥胖儿童青少年多存在明显的代谢紊乱,MS的流行已相当严重,接近发达国家水平.     

9~12岁超重/肥胖男童血脂代谢谱研究

目的 探讨9~12岁超重/肥胖男童的血脂代谢谱变化特征及儿童超重/肥胖发生的可能机制。方法 将招募的72名9~12岁男童根据体重指数（BMI）分为对照组（n=42）和超重/肥胖组（n=30）。采集清晨空腹静脉血,对受试者的BMI、腰臀比、身体成分及血脂进行测量,同时采用超高效液相色谱与四极杆飞行时间质谱联用的代谢组学检测方法测试血清脂质化合物,并对数据进行统计分析和可视化。结果 超重/肥胖组男童的腰臀比、体脂百分数和三酰甘油水平显著高于对照组（P < 0.05）,高密度脂蛋白胆固醇水平显著低于对照组（P < 0.05）。代谢组学分析筛选出两组150种具有显著差异的脂质化合物,主要包含甘油脂类（40.7%）、甘油磷脂类（24.7%）、脂肪酰基类（10.7%）和鞘脂类（7.3%）。大多数甘油脂类水平在超重/肥胖组呈显著上调,而大部分甘油磷脂和鞘脂类出现下调。关键差异脂质被显著富集到2个KEGG代谢通路中,分别为醚酯代谢以及萜类生物骨架合成通路（P < 0.05）,并可能进一步影响下游的辅酶Q及其他萜类的生物合成代谢（P=0.06）。结论 9~12岁超重/肥胖男童的脂质代谢谱紊乱,绝大部分甘油脂类含量增加,甘油磷脂和鞘脂下调,并可能存在醚酯代谢以及萜类甚至辅酶Q的生物合成紊乱。     

儿童单纯性肥胖并高脂血症的影响因素及干预措施

为减少儿童单纯性肥胖并高脂血症，并提高其防治率，通过查阅1998—2007年的相关资料分析，发现儿童单纯性肥胖并高脂血症的主要影响因素是不良的饮食习惯和生活方式、缺乏运动等，并提出相关的干预措施。     

长沙市开福区小学生肥胖现状及影响因素分析

目的：了解长沙市开福区小学生超重、肥胖情况及单纯性肥胖的影响因素,为小学生肥胖的防治工作提供科学依据。方法：随机抽取长沙市开福区7~12周岁小学生4 140名,按照体重指数(BMI)法判定出单纯性肥胖,将肥胖和正常儿童设为肥胖组和对照组,对影响小学生肥胖的有关因素进行分析。结果：①长沙市开福区小学生超重及肥胖检出率分别为9.76%和7.39%,男女生肥胖率分别为9.37%和5.13%。②与正常小学生相比,肥胖小学生的BMI,腰围(WC),腰臀比(WHR),体脂百分比(%BF),收缩压(SBP),血清甘油三酯(TG)和低密度脂蛋白胆固醇(LDL-C)明显升高,高密度脂蛋白胆固醇(HDL-C)明显降低。③肥胖小学生的WC,WHR与TG,LDL-C的偏相关系数大于BMI,%BF与其的偏相关系数。④儿童肥胖的危险因素可归结为常暴饮暴食、看电视时间长、进餐速度快、常吃油腻食物,而喜欢运动、运动时间长具有保护作用。结论：长沙市开福区小学生肥胖的发生率在国内处于高水平,控制儿童肥胖有助于慢性疾病的早期预防,预防儿童肥胖关键在于普及营养保健知识、注意平衡膳食和增加体力活动。     

52例肥胖和超重儿童糖耐量及胰岛素释放试验分析

目的 了解肥胖和超重儿童糖代谢及胰岛细胞功能状况。方法 对52例单纯性肥胖与超重儿童进行口服糖耐量试验,并测定其血糖及胰岛素水平。计算胰岛素抵抗指数(IR),胰岛素敏感指数(IS),服糖后30min胰岛素增加值与血糖增加值的比值。并查甘油三酯、肝脏B超。体重指数(BMI)与IR之间、不同BMI组之间、糖耐量减低组与对照组之间进行比较。结果 发现糖尿病1例(1．9％),IGT者5例(9．6％)。IR≥2．8为胰岛素抵抗,占76．9％。BMI与IR之间无相关关系。不同BMI组之间IR、IS、服糖后30min胰岛素增加值与血糖增加值的比值差异均无统计学意义。糖耐量减低组与对照组之间IR、IS差异无统计学意义,服糖后30min胰岛素增加值与血糖增加值的比值之间差异有统计学意义。甘油三酯升高19例(37％),脂肪肝16例(53％)。结论 肥胖与超重儿童普遍存在胰岛素抵抗和敏感性下降,其与BMI程度无关。肥胖伴糖耐量减低儿童除胰岛素抵抗外存在明显的B细胞功能减退。许多肥胖和超重儿童同时存在脂代谢紊乱。     

��ѧ������������ʹ����ע��ȱ�ݶද�ϰ�

目的探讨中学生互联网过度使用(IOU)与注意缺陷多动障碍(ADHD)的关系。方法采用网络成瘾诊断问卷(YDQ)、长处和困难问卷父母版(SDQ)、注意缺陷多动障碍诊断量表父母版(ADHDDS-P)对64例互联网过度使用中学生和64名对照中学生进行评定和比较,并依据美国精神障碍诊断与统计手册第4版(DSM-Ⅳ)中的ADHD诊断标准进行诊断性访谈。结果(1)IOU组符合DSM-Ⅳ中ADHD诊断标准的学生有14例,其中注意缺陷为主型5例,多动冲动为主型1例,混合型8例;对照组中符合ADHD诊断标准的学生有3例,均为混合型。(2)SDQIOU组多动注意不能、品行问题、情绪症状、困难总分等因子的得分均高于对照组,在亲社会行为因子上的得分显著低于对照组(P<0.01或P<0.05);(3)ADHDDS-PIOU组注意缺陷、多动/冲动因子得分和总分均显著高于对照组(P<0.01或P<0.05);(4)条件Logistic回归分析发现注意缺陷、多动注意不能是IOU的危险因素,亲社会行为是IOU的保护因素。结论互联网过度使用中学生存在着较多的注意缺陷多动障碍,其可能是造成中学生互联网过度使用的危险因素。     

Risk profiles for overweight/obesity among preschoolers

Background

The epidemic of overweight/obesity among U.S. children has led to an alarming increase in health-related consequences, including early-onset diabetes and cardiovascular disease. Recent research has identified the independent contribution of several maternal and child factors to the development of childhood overweight/obesity. Few studies, however, have examined risk profiles of childhood obesity.

Aim

This study used classification and regression tree (CART) analysis to examine the combined effect of maternal and child factors in generating risk profiles for overweight/obesity among preschoolers.

Study design

Data from the Early Childhood Longitudinal Study-Birth Cohort (ECLS-B) study were used. The sample was comprised of preschool children. CART and logistic regression models were built and compared.

Results

Children who were overweight/obese at two years of age had an increased risk of being overweight/obese at four years of age. Children born to overweight/obese mothers were more likely to be overweight/obese by age four, even if their BMI at two years of age was normal. Children with high birth weight (≥ 4000 g.) were also more likely to be overweight/obese at age four years if they were born to mothers with a normal pregravid BMI, but were of a lower socioeconomic status. Among preschoolers whose mothers were black or white and who had a high pregravid BMI, breastfeeding duration and parity played an important role in determining their risk of being overweight/obese.

Conclusions

Classification tree analysis confirms and extends current knowledge of preschool overweight/obesity by providing preliminary risk profiles that are structured within the context of prenatal and postnatal maternal and child characteristics.     

Prevalence of overweight and obesity in primary school children in Port Said city

BackgroundThe highest prevalence rates of childhood obesity have been observed in developed countries, however, its prevalence is increasing in developing countries as well.ObjectivesTo estimate the prevalence of overweight and obesity among primary school children, aged from 6 to 12 years and to estimate risk factors of obesity and overweight, defined by body mass index (BMI).MethodsA cross-sectional study was carried out at Port Said city during the second term of school year 2010/2011. The researcher took the anthropometric measurements inside the nurse’s room in the school and gave a questionnaire to the students to be answered by one of the child’s parents. The questionnaire included questions related to socioeconomic status, life style (physical activity and eating habits) and family history of overweight and obesity.ResultsEight hundred and fifty-two students participated in this study. Prevalence of overweight and obesity was 17.7% and 13.5% respectively. The rate of obesity was the highest at the age of 7–8 years (grade 2) and decreased with an increase in age, while overweight increased with an increase in age to be the highest at the age of 9–10 (grade 4) and 10–11 (grade 5). Socioeconomic class, faulty dietary habits, sedentary life, low level of physical activity and positive family history of overweight and/or obesity were significantly associated with student’s BMI.ConclusionThis study found a relatively high prevalence of overweight and obesity among children aged 6–12 years in Port Said city. Decreased rate of obesity with an increase in age in our study, signifies that faulty feeding habits were the highest at lower ages.     

Prevalence and risk factors for overweight and obesity in Portuguese children

AIM: To identify risk factors for overweight and obesity in Portuguese children. METHODS: A cross-sectional study of children 7 to 9.5 y old was performed between October 2002 and June 2003. A total of 2,274 girls and 2,237 boys were observed. Weight and height were measured, and parents filled out a questionnaire about family characteristics. Overweight and obesity, using age- and sex-specific body mass index (BMI) cut-off points as defined by the International Obesity Taskforce, were used. RESULTS: After adjustment for age and sex, the odds ratio for childhood obesity increased by television viewing (reference 0-2 h; 2-3 h: 1.51; 3-4 h: 1.72; 4 h: 1.63), paternal obesity (reference <18.5 kg/m(2); 25.0-29.9: 3.06; 30.0: 7.09), maternal obesity (reference <18.5 kg/m(2); 25.0-29.9: 9.06; 30.0: 18.13) and birthweight (reference <2,500 g; 2,500-3,000 g: 1.55; 3,000-3,500 g: 1.87; 3,500-4,000 g: 2.13; 4,000 g: 2.74), and decreased by sleeping duration (reference 8 h/d; 9-10 h/d: 0.44; 11 h/d: 0.39), paternal education (reference primary school; secondary: 0.91; university: 0.42), maternal education (reference primary school; secondary: 1.13; university: 0.56), being a single child (reference yes; no: 0.56) and family size (reference one child; two children: 0.59; three children: 0.44; more than four children: 0.37).CONCLUSION: Our data support the perspective that education about energy intake and energy expenditure should be used much earlier in those families with high-risk children, namely those with high parental BMI or high birthweight. Protective factors were parental education and family size.     

中学生徒手心肺复苏掌握现状及培训效果分析

目的：分析中学生对徒手心肺复苏急救知识掌握现状及培训效果。方法采取随机分层整群抽样的原则,抽取长沙市15所中学的7687名中学生,通过现场理论授课和模拟人现场操作相结合的方式对中学生进行心肺复苏知识的培训。培训的内容包括CPR抢救对象、怎么判断患者需要进行CPR、多长时间可引起大脑不可逆损伤、2010年心肺复苏的标准化流程、胸外按压的部位、胸外按压的深度及心脏按压与人工呼吸的比例7个关于徒手心肺复苏的知识点。分析培训前后中学生对徒手心肺复苏知识点的知晓率,问卷调查中学生接受急救知识培训的意愿和途径。结果7687名学生进行了培训和问卷调查,其中男生3778名（49.15％）,女生3909名（50.48％）。中学生获取急救知识的主要途径为书本,其次为电视、网络和学校。培训前,徒手心肺复苏的7个知识点中,中学生对徒手心肺复苏抢救对象和心脏按压部位的知晓率超过50％,其他知识点知晓率均低于50％。通过培训,中学生对徒手心肺复苏知识点知晓率均提高到了75％以上,培训前后各知识点知晓率的差异有统计学意义（ P＜0.01）。结论长沙市15所学校中学生对徒手心肺复苏的知识严重匮乏,通过现场授课和模拟人操作的培训,中学生对徒手心肺复苏知识的知晓率明显提高。     

Prevalence of overweight and obesity in 5- and 12-year-old Finnish children in 1986 and 2006

Objective: To investigate the prevalence and the trends of overweight and obesity in Finnish 5- and 12-year-old children in 1986 and 2006.
Design: Retrospective cross-sectional study.
Subjects and methods: Anthropometric data were collected retrospectively from health examinations in Tampere and in three rural municipalities. The size of the 5- and 12-year-old cohorts were 2108 in 1986 and 4013 in 2006, respectively. The body mass index (BMI) was calculated. Overweight and obesity was estimated using the International Obesity Task Force cutoff values (ISO BMI).
Results: The prevalence of overweight (ISO BMI >25) and obesity (ISO BMI >30) in 5-year-old boys in 2006 was 9.8% and 2.5% and in girls 17.7% and 2.5%, respectively. At the age of 12 years, the corresponding figures in boys were 23.6% and 4.7% and in girls 19.1% and 3.2%. Between 1986 and 2006, the prevalence of overweight in 12-year-old children had increased 1.8 fold in boys (p < 0.001) and 1.5 fold in girls (p = 0.008). Overweight was significantly more common in rural than in urban areas.
Conclusion: During the last 20 years the prevalence of overweight has markedly increased in 12-year-old Finnish children, but remained nearly unchanged in 5-year-old children.     

Is the prevalence of overweight and obesity declining among 4‐year‐old Swedish children?

Aim:  To investigate the trend in overweight and obesity prevalence among 4-year-old Swedish children.
Methods:  Height and weight data registered at the regular health check up at the child health centres in the county of Västerbotten during the years 2007/2008 (2225 boys and 2156 girls) were analysed and compared with data from 2002/2003 (2231 boys and 2176 girls). Overweight and obesity were estimated using the International Obesity Task Force cut-off values (ISO BMI).
Results:  In both boys and girls, overweight prevalence (ISO BMI > 25) decreased over the 5-year period, boys from 17.2% to 14.2% and girls from 22.3% to 19.0%. Among girls, there was also a decrease in obesity prevalence (ISO BMI > 30) from 5.7% to 3.1%.
Conclusion:  The result of this study indicates that the overweight and obesity epidemic among Swedish pre-school children may be levelling off.     

Excess weight in adolescents and associated factors: data from the ERICA study

ObjectiveTo estimate the prevalence of excessive weight and to identify associations with socioeconomic, demographic, biological, and lifestyle factors in adolescents.MethodsIt is a cross-sectional school-based study, with a stratified and complex sample. The evaluated individuals were adolescents (2404), aged 12–17 years old, participating in the Study of Cardiovascular Risk Factors in Adolescents (ERICA). Demographic, socioeconomic, biological, anthropometric, and lifestyle variables were assessed. Poisson regression was used to verify the association between excess weight and independent variables.ResultsThe prevalence of excessive weight was 26.3% in the study population, being 16.3% for overweight and 10% for obesity. In the multivariate analysis (hierarchical model), were associated with excessive weight: private education network, a higher number of televisions in the residence, eating habits related to the breakfast consumption, snacks purchase in the canteen, snacks in front to screens consumption and consumption of carbohydrates and lipids, in addition to age group (12–14 years) and sexual maturation (post-pubertal).ConclusionsThe prevalence of excessive weight among the school adolescents studied is high, with a value higher than the national average and the results of previous studies with adolescents. Its distribution is associated with different factors, which are socioeconomic, demographic, biological, and related to lifestyle, reinforcing the complexity of this condition, which deserves a broad coping approach, involving not only individual efforts but social and public ones as well.