中国儿童保健杂志 ›› 2020, Vol. 28 ›› Issue (11): 1271-1275.DOI: 10.11852/zgetbjzz2020-0452

• 临床研究与分析 • 上一篇    下一篇

学龄期肥胖儿童骨密度水平及影响因素研究

张金1, 张田1, 孙慧慧1, 商然1, 师伟佳1, 邓宇鲲2, 何跃辉3, 万乃君1   

  1. 北京积水潭医院1小儿内科; 2 超声科; 3 社区保健科,北京 100035
  • 收稿日期:2020-02-20 修回日期:2020-03-27 发布日期:2020-11-10 出版日期:2020-11-10
  • 通讯作者: 万乃君, E-mail:wann6971@163.com
  • 作者简介:张金(1987-),女,河北人,住院医师,硕士学位,主要研究方向为儿童生长发育、肥胖儿童健康管理。联系电话:张金 18810532964,Email:zjdct@163.com
  • 基金资助:
    北京市医院管理中心儿科学科协同发展中心专项经费资助(XTZD20180401)

Study on bone mineral density level and its influencing factors in obese school-age children

ZHANG Jin1, ZHANG Tian1, SUN Hui-hui1, SHANG Ran1, SHI Wei-jia1, DENG Yu-kun2, HE Yue-hui3, WAN Nai-jun1   

  1. 1 Department of Pediatrics; 2 Department of Ultrasound; 3 Department of Community Medicine, Beijing Jishuitan Hospital, Beijing 100035, China
  • Received:2020-02-20 Revised:2020-03-27 Online:2020-11-10 Published:2020-11-10
  • Contact: WAN Nai-jun, E-mail:wann6971@163.com

摘要: 目的 了解学龄期肥胖儿童骨密度水平,探究影响骨密度变化的因素。方法 于2018年10月-2019年10月招募北京积水潭医院小儿内科96例6~12岁肥胖儿童为研究对象进行问卷调查,空腹胰岛素、血清钙、血维生素D、血脂检测和体成分、双前臂尺桡骨远端骨密度测量、腹部超声检查。采用SPSS 25.0软件进行统计学分析。结果 96名学龄期肥胖儿童平均年龄(9.10±1.88)岁,左、右前臂尺、桡骨远端骨密度比较,差异无统计学意义(P>0.05),男、女童骨密度比较,差异无统计学意义(P>0.05)。10~12岁组肥胖儿童骨密度明显高于6~7岁组和8~9岁组,差异有统计学意义(H=13.917,P<0.05)。学龄期肥胖儿童骨密度与年龄、肌肉量均呈正相关关系(r=0.359、0.315,P<0.05),与总胆固醇、甘油三酯、低密度脂蛋白、钙均呈负相关关系(r=-0.311、-0.203、-0.246、-0.207,P<0.05)。奶及奶制品、含糖碳酸饮料、中等强度运动、阳光直射时间会影响肥胖学龄期儿童骨密度,差异有统计学意义(P<0.05)。多元线性回归分析显示,阳光直射时间为骨密度的独立影响因素(β=0.036,t=2.836,P<0.05)。结论 学龄期肥胖儿童骨密度随年龄增长而增加,膳食、环境因素对骨密度水平有重要影响。

关键词: 肥胖, 学龄期儿童, 骨密度

Abstract: Objective To investigate changes and influencing factors of bone mineral density (BMD) in school-aged children with obesity. Methods A total of 96 school-age children (aged 6 to12 years) who visited the pediatric department of Beijing Jishuitan Hospital from October 2018 to October 2019, were enrolled in this study to complete a questionnaire survey.A series of physical examination were performed for these participants, including body composition, BMD of both distal ulnar and radius, abdominal ultrasound, blood level of lipids, calcium, vitamin D and fasting insulin.SPSS 25.0 software was used for statistical analysis. Results The average age of 96 children was (9.10±1.88) years old.There was no significant difference on BMD between left and right distal ulnar and radius, or between boys and girls (P>0.05).BMD of 10- to 12-year-old children was significantly higher than that in children aged 6-7 years and 8-9 years(H=13.917,P<0.05).Age and muscle mass were both positively correlated with BMD of obese school-age children (r=0.359, 0.315, P<0.05), while the levels of total cholesterol, triglyceride, low density lipoprotein-cholesterol and calcium were negatively related to BMD (r=-0.311, -0.203, -0.246, -0.207, P<0.05).Milk and dairy products, carbonated beverage, moderate exercise, sunlight exposure and sedentary time were found to be influencing factors of BMD (P<0.05).Multiple linear regression analysis showed that sunlight exposure time was an independent factor affecting BMD(β=0.036, t=2.836, P< 0.05). Conclusion BMD increases with age for obese school-aged children.Dietary and environmental factors are important contributors to ensure the healthy growth of BMD.

Key words: obesity, school-age children, bone mineral density

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