Physical activity, overweight and central adiposity in Swedish children and adolescents: the European Youth Heart Study

Background  

The aim of this work was to study the associations of physical activity (PA) and other factors predisposing to overweight, with overweight and central adiposity in children and adolescents.     

成都市6111例儿童血压三年的追踪观察

本文对成都市6111例儿童血压进行三年后的纵向研究。结果为:城市与农村儿童血压均值随年龄增长而上升;城市各年龄组血压上升速率不同,城市女性13岁后增加不显著;农村男、女组血压均比三年前有显著性上升(P<0.01);农村组与城市组血压均值相比大多数无明显差异,可能与近三年农村儿童体重增加较快有关。本文进一步证实心率、体重、身高是影响血压的因素,尤其是心率这一因素可作为研究血压的必测指标。     

腹膜透析患者退出原因及其相关社会因素调查分析

目的通过对腹膜透析(PD)患者退出相关原因的分析,探讨防治对策。方法回顾性调查2006年7月～2011年12月在泰安市中心医院腹透中心进行腹膜透析的患者,分在透和退出两组,统计他们的性别、原发病、付费方式、退出原因,χ2检验法分析不同付费方式、不同性别在两组间的差异。结果 104例腹膜透析患者,在透58例,退出37例,转肾移植9例,退出率为35.58%。退出组医保患者比率低于在透组(P<0.01),女性比率高于在透组(P<0.05)。结论腹膜透析患者的退出和死亡受多种因素的影响,心血管事件是死亡的主要原因,经济困难、女性等因素均容易导致退出。     

Cardiorespiratory fitness is associated with features of metabolic risk factors in children. Should cardiorespiratory fitness be assessed in a European health monitoring system? The European Youth Heart Study

The question as to whether fitness should be assessed in a European health monitoring system, perhaps from the early stages of life onwards, remains to be answered. We aimed to examine the associations between cardiorespiratory fitness and metabolic risk factors in children. A total of 873 healthy children from Sweden and Estonia aged 9–10 years (444 girls and 429 boys) were randomly selected. A maximal ergometer bike test was used to estimate cardiorespiratory fitness. Additional cardiovascular risk factors were assessed. Significant differences among cardiorespiratory fitness quartiles for the sum of five skinfolds, insulin resistance, triglycerides, and total cholesterol (TC) and high-density lipoprotein cholesterol (HDLc) ratio were shown in girls whereas in boys, the sum of five skinfolds and insulin resistance were significantly different. The lowest sum of five skinfolds and insulin resistance was shown in the highest cardiorespiratory fitness quartile in girls and boys, and the lowest values of triglyceride and TC/HDLc values in the highest cardiorespiratory fitness quartile was observed only in girls. Cardiorespiratory fitness was negatively associated with a clustering of metabolic risk factors in girls and boys. The results add supportive evidence to the body of knowledge suggesting that cardiorespiratory fitness in children is an important health marker and thus should be considered to be included in a pan-European health monitoring system.     

A prospective study of food variety seeking in childhood, adolescence and early adult life

This prospective study of food variety seeking among children was conducted between 1982 and 1999, with a follow-up in 2001-2002. Two- to three-year-old children were given a free choice of lunch foods in a nursery canteen. Their food choices were recorded and used to calculate early variety seeking scores, globally and by food group (vegetables, animal products, dairy products, starchy foods and combined dishes). The same subjects (n=339) were contacted in 2001-2002, when they were: 17-22 (n=89), 13-16 (n=68), 8-12 (n=99) and 4-7 years of age (n=83). Follow-up variety seeking, globally and by food group, and food neophobia were evaluated using questionnaire instruments. Variety seeking at follow-up increased with early variety seeking and to a lesser extent with age, and decreased with food neophobia. Early and follow-up variety seeking scores were highly related for dairy products and vegetables. Follow-up variety seeking for animal products was higher for boys and increased with age for boys, but not for girls. For each food group, variety seeking at follow-up was related to food neophobia. This study suggests that the acquisition of food repertoire may be influenced by food exposure and food choice behaviours before the age of 4.     

地震致伤残住院儿童少年创伤后应激障碍随访研究

创伤后应激障碍(PTSD)指个体经历强烈精神创伤后出现的精神障碍~([1]),主要表现为反复闯入意识、梦境的创伤体验、高度惊觉状态、与社会隔离和回避行为以及注意力不集中、创伤性事件回忆困难等.患者社会功能受损,有的终身丧失工作和生活能力.本研究以从地震灾区因伤残转运到医院住院治疗的儿童少年患者这一特殊群体为对象,探讨PTSD检出率、症状特征及其影响因素.     

脑卒中患者生存率及其影响因素的7年随访研究

目的对脑卒中患者7年随访，描述患者病后生存情况，并分析生存的影响因素。方法以1995年11月至1996年12月天津医科大学总医院神经内科就诊的脑卒中新发病例189例为研究对象，随访患者的复发、死亡及其他结局。整个随访工作2003年10月完成。应用Kaplan—Meier法进行生存率分析。应用Cox比例风险模型对影响患者生存与复发的因素进行单因素和多因素分析。结果随访期间，共82例患者死亡，其中因脑卒中（包括首发与复发）死亡58例，因心脏病死亡8例。患者1年生存率为79．86％，3年生存率为65．46％，7年生存率为57．46％。影响患者生存的主要因素有：年龄（RR=1．065，P〈0．001），首次发病前参加体育锻炼（RR=0．308，P〈0．001），既往有高血压病史（RR=1．785，P〈0．05）和脑卒中病史（RR=2．493，P〈0．001），与病情严重程度有关的因素如脑损害面积（RR=1．031，P〈0．001）；患者的生存情况还与出院时情况，以及出院后的康复与治疗、复发情况有关系；研究还发现，社会心理因素诸如对康复有无信心、病后有无压抑感与负面生活刺激、亲友帮助等因素对于患者的生存也有作用。结论既往有高血压病史与脑卒中病史，发病时脑损伤情况严重对于脑卒中患者的生存影响较大；发病前坚持锻炼，出院后坚持康复与治疗者预后好；复发患者生存率比未复发者低；社会心理因素对生存影响也有较大作用。     

北京郊区某农村乙型肝炎病毒感染的随访研究

对北京郊区某农村的全体人口进行了乙型肝炎病毒(HBV)感染的6年随访调查(随访率78.4%)。发现HBsAg,抗-HBs,抗-HBc阴转率分别是每年2.9%,2.1%,1.2%。HBsAg和抗-HBs的阴转率似有随年龄增长而增加的趋势。滴度对标记的阴转有显著性影响,滴度越高,阴转率越低。抗-HBe阳性似乎有利于HBsAg、抗-HBs、抗-HBc保持稳定;抗-HBc阳性有利于抗-HBs保持稳定。可以认为,影响HBV感染标记转归的根本因素是HBV在体内复制的程度。HBV易感者在6年中有20.3%受到HBV的感染,大部分感染的来源似乎不是在家庭内。     

Biological cardiovascular risk factors cluster in Danish children and adolescents: the European Youth Heart Study

BACKGROUND: The aim of this study was to determine whether the number of participants with multiple coronary heart disease (CHD) risk factors exceeded the number expected from a random distribution. METHODS: A cross-sectional study of 1020 randomly selected boys and girls, 9 and 15 years old, was conducted. Risk factors were total cholesterol, HDL-cholesterol, triglyceride, serum insulin, and blood pressure. Physical fitness was assessed from a maximal cycle test and body fat from the sum of four skinfolds. Risk factors selected in the analysis were those related to the metabolic syndrome. RESULTS: More participants than expected had four or five CHD risk factors. Four risk factors were found in 3.03 (95% confidence interval (CI): 2.24-4.10) times as many participants as expected from a random distribution and five risk factors were found in 8.70 (95% CI: 4.35-17.4) times as many participants as expected. Fifty (5.4%) had four or five risk factors and in these individuals physical fitness was 1.2 standard deviation (SD) lower and body mass index (BMI) 1.6 SD higher than mean values for the population. CONCLUSION: Clustering of risk factors for the metabolic syndrome was found in children and adolescents. Low levels of physical fitness and raised BMI in these individuals indicate that lifestyle factors such as physical activity and diet may influence the development of these unhealthy risk profiles.     

湘潭市城区7～18岁儿童青少年生长发育变化趋势分析

[目的]分析湘潭市儿童青少年1985—2005年生长发育趋势,为制定干预措施提供依据。[方法]用市城区5所中学、4所小学,1985年、1995年和2005年7～18岁儿童青少年(儿少)体质调研资料,分析其身高、体重、胸围、BMI和肺活量的变化趋势,并进行比较。[结果]20年来城区儿少的身高、体重、胸围和BMI均明显增长,肺活量呈下降趋势(前后10年分别下降76～83 ml和196～231 ml)。生长发育趋势有明显的年龄、性别和阶段特征。[结论]湘潭市7～18岁儿少生长发育呈明显长期趋势,但肺功能发育迟滞或倒退。提示新形势下教育、卫生部门防治儿少疾病任务艰巨。     

河北省固安县北斜村HCV感染者三年随访研究

笔者对４２例抗０ＨＣＶ阳性者进行了三年随访研究，发现血清ＡＬＴ异常者占１８．１％￣２６．２％，ＨＣＶ ＲＮＡ阳性率为８０％。三年间抗－ＨＣＶ年阴转率仅０．９５％，抗－ＨＣＶ抗体几何平均滴度１６０左右，１９９１年１９９４年检测结果表明抗－ＨＣＶ ＧＭＴ值无明显差异，抗体滴度与血清ＡＴＬ水平以及ＨＣＶ ＲＮＡ无关。     

儿童少年肥胖危险因素研究

使用Ｃｏｘ比例风险模型对８９８名儿童少年致肥因素进行了历史前瞻性研究，以探讨我国现阶段造成儿童肥胖的主要危险因素。结果指出，父母体块指数、食敏旺盛、１岁底肥胖史、喜吃高热量食物和肥胖前运动少是造成儿童肥胖发生的主要因素。     

某火力发电厂接触煤尘工人职业健康状况十年前后对比分析

目的长期追踪火力发电厂煤尘对作业工人健康的影响情况。方法调查187名在职火力发电厂燃料车间工人为接尘组和80名非接触尘毒职工为对照组,分别比较10年前后的职业健康状况。同时测定生产环境中粉尘浓度及二氧化硅含量。结果生产环境粉尘中游离SiO2含量3．48％,粉尘浓度0．5～37．4mg／m^3,合格率82．16％。接尘组职业健康体检主要阳性结果中慢性咽炎、鼻炎、肺通气功能减退等检出率十年后明显增加,小气道功能减退出现得比较早。结论火力发电厂低浓度煤尘对长期作业工人健康的主要影响是引起呼吸道慢性炎症和肺功能减退。应加强防护措施。     

0~2岁婴幼儿先天缺陷患病率的随访研究

本文随访观察了16 107名婴幼儿在0~2岁期间先天缺陷的患病情况。发现2岁时先天缺陷总患病率水平较出生时增加了69%,随着观察时间的延长,各类先天缺陷患病率增加幅度不同。2岁时先天性心脏病患病率较出生时增加了4.3倍,肠胃道及腹壁畸形患病率增加了1.5倍,此二类先天缺陷的顺位在出生时分别为第8位与第5位,当观察期延长到三个月时,其顺位已越居第一位与第二位。一些属外观明显畸形的先天缺陷患病率增加不明显或无增加。     

中国7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系

目的  探讨7~17岁儿童青少年宏量营养素摄入与超重肥胖的关系。方法  1997—2011年基于“中国居民健康与营养调查”的6轮调查数据,纳入膳食及BMI数据完整的7~17岁儿童青少年为研究对象。依照中国肥胖问题工作组制定标准判定超重肥胖,采用Logistic回归分析模型分析宏量营养素摄入与儿童青少年超重肥胖的关系。结果  最终纳入6 360名研究对象,其中7~＜12岁儿童青少年3 529人(55.5%),男生3 360人(52.8%),超重肥胖1 060人(16.7%)。校正相关混杂因素后,与脂肪供能比 < 25%组相比,≥30%组增加20%肥胖风险(OR=1.20, 95% CI：1.03~1.41, P=0.023);与蛋白质供能比 < 10%组相比,≥15%组增加61%肥胖风险(OR=1.61, 95% CI：1.25~2.04, P < 0.001);与碳水化合物供能比 < 55%组相比,55%~ < 65%组降低20%肥胖风险(OR=0.80, 95% CI：0.68~0.95, P=0.011),≥65%组降低21%肥胖风险(OR=0.79, 95% CI：0.66~0.94, P=0.010);脂肪及蛋白质供能比越高、碳水化合物供能比越低,发生超重肥胖的风险越高(P < 0.05);男生摄入过量蛋白质更可能发生肥胖(P=0.034)。结论  儿童青少年摄入过量脂肪和蛋白质可增加超重肥胖发生风险。     

血管内皮功能与胰岛素抵抗和代谢综合征关系的随访研究

目的探讨血管内皮功能与胰岛素抵抗（IR）和代谢综合征（Ms）发生的联系。方法2000年筛查出的单纯超重和肥胖者[体质指数（BMI）≥25kg／m21583例，测量腰围、血压，测定血脂、血糖，计算BMI、腰臀比、HOMA—IR以及内皮依赖性血管舒张（EDD）功能。7a后对上述人群进行随访，并复查上述指标。结果7a后共发生MS者177人，占随访对象的33．78％。按基线资料分组结果显示，MS的累积发生率在EDD异常组和EDD异常并IR组分别为38．14％和48．11％，明显高于IR组的25．00％（P〈0．05和P〈0．01）和EDD正常并IR组的13．48％（均P〈0．01），IR组高于EDD正常并IR组（P〈0．05）。随访前后比较，EDD异常组的EDD较初访时增加（P〈O．05），而IR组和EDD异常并IR组较初访时降低（P〈0．05）。EDD异常组和EDD异常并IR组HOMA—IR较初访时升高（P〈0．01和P〈0．05）。Logistic分析显示，基线时EDD异常发生MS的风险是EDD正常者的4．17倍，伴有IR的人群发生MS的风险是不伴IR人群的3．21倍，同时具备EDD异常和IR者发生MS的风险是两者都不具备者的5．64倍。结论内皮功能障碍可能是IR和MS各种心血管危险因素发生和聚集的共同病因。     

Relations of total physical activity and intensity to fitness and fatness in children: the European Youth Heart Study

BACKGROUND: It is unclear how the amount and intensity of physical activity (PA) are associated with cardiovascular fitness (CVF) and body fatness in children. OBJECTIVE: We aimed to examine the associations of total PA and intensity levels to CVF and fatness in children. DESIGN: A cross-sectional study of 780 children aged 9-10 y from Sweden and Estonia was conducted. PA was measured by accelerometry and was expressed as min/d of total PA, moderate PA, and vigorous PA. CVF was measured with a maximal ergometer bike test and was expressed as W/kg. Body fat was derived from the sum of 5 skinfold-thickness measurements. Multiple regression analysis was used to determine the degree to which variance in CVF and body fat was explained by PA, after control for age, sex, and study location. RESULTS: Lower body fat was significantly associated with higher levels of vigorous PA, but not with moderate or total PA. Those children who engaged in >40 min vigorous PA/d had lower body fat than did those who engaged in 10-18 min vigorous PA/d. Total PA, moderate PA, and vigorous PA were positively associated with CVF. Those children who engaged in >40 min vigorous PA/d had higher CVF than did those who accumulated <18 min vigorous PA/d. CONCLUSIONS: The results suggest that PA of vigorous intensity may have a greater effect on preventing obesity in children than does PA of lower intensity, whereas both total and at least moderate to vigorous PA may improve children's CVF.