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儿童单纯性肥胖相关危险因素的性别差异

Gender differences in the relative risk factors in children with simple obesity

摘要:

目的 分析儿童青少年单纯性肥胖症相关危险因素的性别差异.方法 采用横断面研究,以5所学校2 852名6~16岁中小学生为调查对象,测量其身高、体质量,并发放自填式调查问卷,内容包括年龄、性别、出生体质量、监护人教育程度、6个月内喂养方式、父母亲肥胖及慢性病史、饮食因素和运动因素,以上内容填写完整的2 396名学生纳入研究,根据体质量指数(BMI)分为正常组和超重肥胖组,分别对男女童组行单因素统计分析,有统计学意义的危险因素进一步行多因素Logistic回归分析.结果 高出生体质量只在男童中显示为危险因素,其发生肥胖的危险性是出生体质量正常的1.78倍(95% CI 1.18 ~2.67,P=0.006).诊断为超重肥胖的父亲,其子女发生超重肥胖的危险性分别是体质量正常组的1.70倍和1.91倍(P=0.000),而母亲相应为1.86倍和2.32倍(P =0.000).父亲至少患有1种慢性病者仅对男童超重肥胖有影响(OR=1.45,95%CI 1.05 ~2.01,P=0.024).饮食方面,偏荤的女童容易发生肥胖(OR=1.85,95%CI 1.06 ~3.21,P=0.030),同时,进食速度在10 min以下的男童和女童患超重肥胖的危险性是25 min以上的3.93倍和2.82倍(P<0.05).运动方面,女童组显示:寒暑假每周大于0.5h的户外运动次数为0~1次的女童患超重肥胖的危险性是每周户外运动次数为8次女童的2.32倍(95% CI 1.15 ~4.67,P=0.018);男童组显示:学习日放学后户外基本不运动的男生患超重肥胖危险性是户外运动大于1.0h男童的2.56倍(95% CI 1.65 ~ 3.97,P=0.000).结论 男女童单纯性肥胖共有的危险因素包括父母亲肥胖遗传史和进食速度,且母亲遗传效应更明显;男童独有的危险因素包括高出生体质量、父亲患有慢性病(高血压、糖尿病、脂肪肝、血脂代谢异常中至少1种)、学习日放学后基本不运动;女童独有的危险因素包括饮食摄入蔬菜少、荤菜多、寒暑假每周>0.5h的户外运动低于5次.

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abstracts:

Objective To analyze gender differences in the relative risk factors in children with simple obesity.Methods The cross-sectional survey included 2 852 children from 5 schools between 6 and 16 years old as the investigation subjects.Their height and weight were measured and self-administered questionnaires were delivered,including age,gender,birth weight,education of the guardians,feeding way in the first 6 months,history of parent's obesity and chronic disease,and diet and exercise factors were also investigated.Two thousand three hundred and ninety-six students who had completed the questionnaire contents were included in the study.According to body mass index (BMI),they were divided into normal weight group and overweight and obesity group,respectively.For both boys and girls,firstly single factor statistical analysis was carried out,then further multi factor Logistic regression analysis for those statistically significant risk factors.Results High birth weight was only boys' risk factor and the risk of obesity was 1.78 times the normal birth weight groups(95% CI 1.18-2.67,P =0.006) ;the risks of obesity for the boys and girls whose fathers were obese or overweight were 1.70 times and 1.91 times the normal weight fathers respectively(P =0.000).Accordingly,the risks of obesity for the boys and girls whose mothers were obese or overweight were1.86 times and 2.32 times,respectively (P =0.000).The fathers had at least 1 kind of chronic disease affecting boys (OR =1.45,95% CI 1.05-2.01,P =0.024).In terms of diet,the girls who liked meat but not vegetables were prone to be obese (OR =1.85,95% CI 1.06-3.21,P =0.030).At the same time,the risks of obesity for the boys and girls whose eating duration lasted less than 10 minutes were 3.93 times and 2.82 times those whose eating duration lasted 25 minutes (P < 0.05).In terms of exercise,the findings showed that the risk for overweight or obesity in girls whose outdoor sports exercise lasted for at least 30 minutes but less than two times per week in summer and winter vacation was 2.32 times the girls whose outdoor sports exercise was more than 8 times per week (95% CI 1.15-4.67,P=0.018) ;the findings also showed that the risks for overweight or obesity in boys who almost didn't do exercise in the average school day was 2.56 times the boys who exercised for at least 60 minutes each day (95% CI 1.65-3.97,P =0.000).Conclusions The common risk factors for simple obesity in both girls and boys include the history of parents' obesity and eating speed and mothers' genetic effect which are more obvious.Risk factors for simple obesity in boys only include high birth weight,history of fathers chronic diseases (at least one disease among hypertension,diabetes,fatty liver,metabolic disorder of serum lipids),and they almost have no sports from Monday to Friday after school;otherwise,risk factors for simple obesity in girls only include lower consumption of vegetables than meat,outdoor sports no more than half an hour,less than 5 times weekly in winter and summer vacation.

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作者: 冯海霞 [1] 万燕萍 [1] 周一泉 [1] 张晓敏 [1] 徐仁应 [1] 陆丽萍 [1] 陈之琦 [1] 吴颖洁 [1] 蒋莹 [1]
期刊: 《中华实用儿科临床杂志》2014年29卷19期 1471-1475页 ISTICPKUCA
栏目名称: 消化营养性疾病
DOI: 10.3760/j.issn.2095-428X.2014.19.009
发布时间: 2019-01-11
基金项目:
世界健康基金会资助项目 上海市小儿消化与营养重点实验室
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