新疆儿童脂肪重聚时间与早期喂养方式的关系

目的 比较新疆地区新生儿不同喂养方式对儿童脂肪重聚(adiposity rebound,AR)年龄的影响,为儿童保健提供策略。方法 本研究以新疆乌鲁木齐市、克拉玛依市、阿勒泰市和伊宁市四个城市13所幼儿园为研究现场,从2014年4月开始,每6个月一次测量所有在读儿童身高及体重,共随访4次,通过体质指数(BMI)变化曲线最低点获得儿童AR时间。在基线时,对在读儿童家长进行问卷调查,收集母亲分娩方式、儿童出生体重、出生后4个月母乳喂养情况、家庭收入等信息。结果 调查3~6岁儿童883名,男446名、女437名;汉族426名、维吾尔族275名、哈萨克族182名;超重/肥胖率为16.6%,该人群AR为(5.26±0.91)岁;与汉族相比,维吾尔族、哈萨克族以母乳喂养为主(P＜0.001),家庭月收入高的家庭以人工喂养为主(P=0.022);通过多重线性回归分析控制上述因素后,人工喂养组儿童AR年龄小于4个月母乳喂养组儿童AR年龄,平均小0.165岁(B=-0.165,t=-2.15,P=0.032)。结论 母乳喂养可以推迟AR年龄,从而可能减少儿童后期超重/肥胖发生。

Relation between feeding patterns and timing of adiposity rebound in offspring in Xinjiang

Objective To compare the effects of breast feeding positions of mothers on the timing of adiposity rebound (AR) in offspring,and to provide scientific basis for local children's healthcare policy. Methods A total of 13 kindergartens from Urumqi city,Kelamayi city,Altay city and Yining city were selected as study fields.From April in 2014,height and weight of the children from those kindergartens were measured every six months.A total of four follow-ups were made.AR values of all children were estimated by identifying the lowest point of BMI trending curves in four follow-ups.At baseline,parents of children were investigated by questionnaire to collect data on mode of delivery,birth weight,breast-feeding status in the first four months,and family monthly income,etc. Results A total of 883 children aged from 3 to 6 years old were investigated.Of them,boys 446 and girls 437,Han 426,Uyghur 275 and kazak 182.Prevalence of obesity or overweight among these children was 16.6%.Mean AR age was(5.26±0.91) years old.Breast-feeding was more frequent in mothers of Uyghur and Kazakh ethnicity compared to those of Han ethnicity(P＜0.001).Artificial feeding was more frequent among families with higher monthly income compared to those of lower monthly income(P=0.022).After adjusted for factors above using multi linear regression analysis,the mean AR age of children who were given artificial feeding was lower by 0.165 years than those who were given breast feeding (B=-0.165,t=-2.15,P=0.032). Conclusion Breast feeding may delay the AR age and reduce the occurrence of obesity or overweight in late childhood.