母乳喂养时长对儿童脂肪重积聚时间的影响

  目的  研究儿童出生后母乳喂养时长对于儿童脂肪重积聚发生时间的影响，为生命早期养育照护和肥胖预防提供科学依据。  方法  选取上海市闵行区2019年9月入学的6 148名小学一年级学生为研究对象，回顾性获得1~80月龄时的身长(身高)和体重检查记录，采用自然3次样条函数拟合体质量指数(BMI)的生长轨迹，计算脂肪重积聚时间。通过多元线性回归模型和广义相加模型分析出生后母乳喂养持续时长与脂肪重积聚时间的关系。  结果  研究对象的平均母乳喂养时间为(3.71±3.28)个月。男童母乳喂养时长≤4个月的报告率为69.63%，女童为70.45%。母乳喂养时长与脂肪重积聚时间存在正向线性关系男童:B值(B值95%CI)=0.16(0.02~0.30)，女童:B值(B值95%CI)=0.34(0.18~0.51)，总体:B值(B值95%CI)=0.23(0.12~0.34)](P值均 < 0.05)。  结论  母乳喂养时长独立影响脂肪重积聚发生时间，在24月龄内延长母乳喂养时长可能有助于推迟儿童脂肪重积聚时间，从而帮助降低生命后期超重肥胖的发病风险。

Effect of breastfeeding duration on age at adiposity rebound in children

  Objective  To explore the effect of breastfeeding duration on age at adiposity rebound, and provide a scientific theoretical basis for identifying early life factors of obesity in children and adolescents, while promoting early intervention.  Methods  In September 2019, first graders from a primary school in Minhang District, Shanghai, were selected to participate in this study, and their growth information was retrospectively collected. The natural cubic spline function was used to fit the body mass index trajectory of the subjects from 1 to 80 months, and age at adiposity rebound was calculated. A total of 6 148 subjects were selected, and complete data of adiposity rebound timing and breastfeeding duration were obtained. A multiple linear regression model was used to analyze the relationship between these two variables.  Results  The average breastfeeding duration of all children included in the study was (3.71±3.28) months, and most of the subjects (69.63% for male and 70.45% for female) were breastfed for less than 4 months. A positive linear relationship was found between them male, B=0.16(0.02-0.30), female, B=0.34(0.18-0.51), total, B=0.23(0.12-0.34), P < 0.05]. The linear relationship was determined using the multivariate model.  Conclusion  Breastfeeding duration independently affected age at adiposity rebound. Prolonging the duration of breastfeeding within 24 months of age may help to delay the timing of adiposity rebound, and thus reduce later risks of overweight and obesity.