中国儿童青少年生长长期趋势及其公共卫生意义

目的:分析中国大城市儿童青少年1979至2005年的生长长期趋势,为制定宏观干预策略措施提供科学依据.方法:来自16个省/直辖市7～18岁汉族中、小学生,分析其身高、体重、体重指数(BMI)增幅和不同阶段增速.结果:26年来男、女平均身高增幅为6.5和4.7 cm,体重增幅为8.9和5.2 kg.男、女增速均以1985至1995年期间最快,身高分别达每10年增加3.8和3.0 cm;体重分别达每10年增加4.7和3.1 kg;该长期趋势迄今仍保持强劲.青春期发育年龄持续提前,身高生长突增峰值(女12岁和男14岁分别达每10年3.3和2.4 cm)不断增长,对长期趋势贡献最大.男、女成年身高分别增长3.2和2.1 cm,增幅为每10年1.2和0.8 cm.近20年来BMI分布曲线加速右移,提示儿童肥胖流行增势迅猛.结论:我国正出现儿童期生长加速、青春期提前、成年身高增长和身体比例变化等迅猛的全方位生长长期趋势.不仅应看到该趋势对提高我国儿童少年体质健康水平的积极意义,还应高度关注该趋势在引发成年期慢性疾病(尤其如高血压、高血脂、2型糖尿病等代谢综合征疾病危险)等方面的消极影响.

Secular growth trends in the Chinese urban youth and its implications on public health

Objective:To analyze the secular growth trends of the Chinese urban youth from 1979 to 2005,in order to make national intervention strategies and measures to improve their physical fitness and health.Methods:Subjects were sampled from 16 provincial-capital cities in China.They were all Han primary and secondary school students aged 7 to 18 years.The increments of stature,weight and BMI,and the increments per decade of these indicators at different stages were analyzed.Results:In recent 26 years,the overall increments were 6.5 and 4.7 cm for stature,and 8.9 and 5.2 kg for weight,for boys and girls,respectively.Swiftest rates were found in the period of 1985-1995,with the increments which were as high as 3.8 and 3.0 cm/decade for height,and 4.7 and 3.1 kg/decade for weight,for boys and girls respectively.These trends are still strong at present,without any tendency of going to the plateau.Advanced puberty plays the most contributing role in these trends,with the peak height rates being 2.4 cm/decade for girls at the age of 12 and 3.3 cm/decade for boys at the age of 14,respectively.The increments of adult height were 3.2 and 2.1 cm,while the rates were 1.2 and 0.8 cm/decade,for males and females,respectively.The distributing curves of BMI show an accelerating tendency of going to the right side,which suggests that the prevalence of childhood obesity is increasing rapidly.Conclusion:China is now experiencing an overall and positive secular trend,which is reflected not only by the accelerating physical growth in childhood,advanced puberty,and steady increments of adult height,but also by the dramatic changes of body shape.We should not only feel proud of the achievements of these secular growth changes and the active socioeconomic influences,but also pay much attention to their negative effects,especially those that may induce the dangers of hypertension,hyperglycemia,type 2 diabetes mellitus and other adulthood diseases,as well as the disease risks of metabolic syndrome that may even occur early in childhood and adolescence.