Table of Content

10 December 2018, Volume 26 Issue 12

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Vitamin D deficiency and childhood obesity

GUO Xi-rong

2018, 26(12):  1280-1283.  DOI: 10.11852/zgetbjzz2018-1647

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Vitamin D(VD) deficiency and childhood obesity have become two public health problems.With the increasing recognition of the extra-bone effects of VD, the relationship between VD and childhood obesity has become a hot research topic.In recent years, more and more studies have demonstrated that VD deficiency is associated with obesity and other metabolic diseases.The serum level of VD in obese population is significantly lower than that in normal weight population.And maternal VD deficiency during pregnancy is closely related to the overweight of offspring, VD supplementation for obese population helps lower body mass index.However, the causal relationship between VD deficiency and obesity is still unclear, and the underlying mechanism has not been fully elucidated either.This review summarizes the epidemiological characteristics of VD deficiency and childhood obesity, the correlation and the underlying mechanism.

Physical activity patterns of preschool children and its correlation with children′s overweight/obesity

WU Hai-jun, TAN Zhi-jun, LIANG Ying, JIANG Xun, XU Tong, ZHANG Hao, YUAN Jing, SHANG Lei

2018, 26(12):  1284-1288.  DOI: 10.11852/zgetbjzz2018-0493

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Objective To explore the correlation between preschool children′s physical activity patterns and overweight/obesity, in order to provide reference for preschooler′s physical activity interventions. Methods A self-designed questionnaire on physical activities and their influencing factors of preschoolers was filled out by preschoolers from April to July 2017.The physical activity patterns of preschool children were explored by factor analysis.And the correlation between physical activity patterns and children′s overweight/obesity was analyzed by Logistic regression analysis. Results Three common factors were selected by factor analysis and named as skill training activity pattern, preschool group activity pattern and family outdoor activity pattern, and the cumulative variance contribution rate was 35.4%.After controlling the family and demographic characteristics, the risk of overweight/obesity with factor score≥P₇₅ was higher than that with factor score<P₂₅ in skill training activity pattern (OR=2.633,95%CI:1.066-6.504); The risk of overweight/obesity with factor score≥P₇₅ was lower than that with factor score<P₂₅ in family outdoor activity pattern (OR=0.747,95%CI:0.387-0.984). Conclusion The skill training activity pattern is a risk factor of overweight/obesity in preschool children, while the family outdoor activity pattern is a protective factor of overweight/obesity.

Correlation analysis between adipocytokines and different metabolic indicators between Xinjiang    Uygur and Han ethnic groups in Zhengzhou

Kaiser Parrita

2018, 26(12):  1289-1292.  DOI: 10.11852/zgetbjzz2017-1376

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Objective To understand the relationship between adipocytokines and different metabolic indicators in Xinjiang Uygur and Han adolescents in zhengzhou city and their relationship, in order to provide data support for the healthy development of adolescents. Methods A total of 1 464 Xinjiang Uygur students from 5 schools in Zhengzhou city were selected as participants. At the same time, 1 582 Han students were randomly selected from 5 primary schools to test their physical health indicators and blood indicators, and the results between the two groups were compared. Results The levels of body mass index(BMI), waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, blood glucose, steady-state insulin evaluation index, leptin and fat cell fatty acid binding protein of Xinjiang Uygur pupils in mainland China were significantly higher than those of Han students (t＝9.213, 3.726, 16.604, 3.126, 8.561, 5.496, 7.439, 9.154, 4.017, P<0.01). The levels of high-density lipoprotein cholesterol, adiponectin of Han were higher than Uyghur students (t＝-13.137, -8.198, P<0.01). Multiple linear regression analysis showed that students′ adiponectin level was correlated with age, gender, ethnicity, BMI, waist circumference and steady-state insulin evaluation index (P<0.05). And students′ leptin level was correlated with age, gender, ethnicity, BMI, waist circumference, systolic blood pressure, diastolic blood pressure, triglyceride, high-density lipoprotein cholesterol and steady-state insulin evaluation index (P<0.05). Also, the level of fatty acid binding protein of the fat cell was correlated with the ethnic, BMI, waist circumference, triglyceride and steady-state insulin evaluation index (P<0.05). Conclusion There are significant differences on the distribution and correlation of adipocytokines and different metabolic indicators between Xinjiang Uygur adolescents and Han students in zhengzhou city.

Study on the thyroid stimulating hormone level in children and adolescents with overweight and obesity

ZHOU Xin-he, ZHENG Wen-wen, ZHANG Hang, ZHENG Chao

2018, 26(12):  1293-1296.  DOI: 10.11852/zgetbjzz2018-0082

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Objective To analyze the correlation between thyroid stimulating hormone (TSH) and overweight and obese children and adolescents, in order to provide reference for clinical intervention and treatment. Methods Children and adolescents aged 3-18 years who took health examination in the Second Affiliated Hospital of Wenzhou Medical University from April 2016 to April 2017 were selected into the study. Totally 385 children were enrolled, including 183 controls,116 overweight children and 83 obese children. Clinical data and thyroid functions of three groups were compared and analyzed. Results The levels of TSH, alanine aminotransferase(ALT), triglyceride(TG), cholesterol(TC),low density lipoprotein(LDL), uric acid(UA), fasting insulin(Fins), HOMA index (HOMA-β, HOMA-IR) gradually increased among control, overweight and obesity groups (P<0.05). Different degrees of thyroid dysfunction were found in 15.30% of the children with overweight and obesity. The obesity rate was significantly higher in high TSH group (P<0.01). With the increasing of TSH concentration, the incidences of ALT, GGT, TG showed gradually ascending trends respectively, while HDL decreased on the contrary. Multivariate Logistics regression analysis showed that TSH might not be an independent risk factor of overweight and obesity in children and adolescents. Conclusions In the children and adolescents with overweight or obesity, there were some metabolic abnormalities such as increasing level of liver enzymes, hyperlipidaemia, hyperuricemia. Meanwhile, obesity group tends to develop thyroid dysfunction, with higher level of TSH. Moreover, the increasing of TSH level might be an adaptive change after obesity.

Study of the intestinal microbial diversity in obese children by illumina amplicon sequencing of 16SrDNA Tag

WU Ya, FANG Yuan-yuan, CHEN Yan-hui, YANG Li-qi, WANG Jian-qing

2018, 26(12):  1297-1300.  DOI: 10.11852/zgetbjzz2018-1011

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Objective To study the composition and characteristics of intestinal microorganisms in obese children by illumina amplicon sequencing of 16SrDNA Tag, in order to provide basis for further related research. Methods Totally 59 obese children and children with normal weight were enrolled in this study, and their feces were collected.16SrDNA method was used to detect the composition and difference of intestinal flora in different groups. Results There was no significant difference on intestinal microbial diversity between obese and normal weight children(P>0.05), but significant differences on distribution and quantity were found(P<0.05).At the phylum level, Firmicutes, Bacteroidetes and Acidobacteria were the most abundant flora in children′s intestinal microbial community.The number of Verrucomicrobia in normal weight group was significantly higher than that in obese group.At the genus level, it was found that the number of Dorea was significantly higher in obese group than that in normal weight group, while the number of Akkmermansia was significantly higher in normal weight children. Conclusion The change of intestinal flora distribution pattern and quantity is closely related to the occurrence of obesity.

Analysis of the correlation between single nucleotide polymorphism of FABP2 gene G54A and obesity in children

HU Dan, LI Hong-xia, HE Rong

2018, 26(12):  1301-1303.  DOI: 10.11852/zgetbjzz2018-1219

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Objective To investigate the association between fatty acid binding protein 2(FABP2)G54A polymorphism and childhood simple obesity. Methods A total of 80 simple obesity children from Chongqing No.3 and No.4 People Hospitals of Chongqing City were enrolled in obesity group, and 80 normal healthy children were selected as the control group according to the 1∶1 pairings from January 2014 to February 2017. PCR technology was used to detect FABP2 gene G54A polymorphism in both groups.Blood biochemical indicators were detected and compared.And the relationship between FABP2 gene G54A gene polymorphism and childhood simple obesity was analyzed by Logistic regression analysis. Results There were no significant differences on serum levels of total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), fasting blood glucose (FBG) and fatty acid (FFA) between obesity group and control group (P>0.05). The serum levels of triglyceride (TG), leptin, cortisol and visceral fat specific serine protease inhibitors in obesity group were significantly higher than those in control group (P<0.05),but the adiponectin (APN) level in obesity group was significantly lower than that in control group (P<0.05). The FABP2 gene G54A allele frequency of A (43.13%) in obesity group was significantly higher than that in control group (27.50%) (P<0.05); Serum TG(OR＝1.528,95%CI:1.221~4.007), leptin(OR＝1.694,95%CI:1.381~4.214), increased cortisol levels(OR＝1.664,95%CI:1.360~4.815) and allele A(OR＝1.773,95%CI:1.468~5.598), as well as the decreased level of APN(OR＝0.728,95%CI:0.517~0.839) were risk factors for simple obesity in children (P<0.05). Conclusion The G54A polymorphism of FABP2 gene A is an independent risk factor for simple obesity in children.

Analysis of the influencing factors for overweight/obesity of 3 to 6-year-old children in Pudong New Area, Shanghai

LIANG Rong, YANG Ling-li, YANG Hui-lin, LI Xiao-hua, WANG Ting-xue

2018, 26(12):  1304-1307.  DOI: 10.11852/zgetbjzz2018-0831

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Objective To learn about the situation and the influencing factors of overweight/obesity children aged 3~6 in Pudong New Area, Shanghai, in order to provide some new thoughts to prevent and control overweight/obesity in children. Method A total of 3 789 preschool-age children were asked to fill out self-designed questionnaires or with the help of researchers in Pudong New Area, Shanghai from March to April in 2018.And the key factors for children′s growth and development were investigated. Results Totally 528(13.9%) children were detected as overweight in 3 789 children, and 575(15.2%) children were obese.Single factor Chi-square analysis and multiple Logisitc analysis showed that the high-risk factors for obesity included high birth weight, childrens′ father with high body mass index(BMI) and with profession as office worker, as well as with high education, parents thought their children were overweight, children with a good appetite, children with behavior of watching electrical products while eating, taking more meat and having meals less than 15 minutes.When compared with normal BMI group, the high-risk factors in children whose BMI was in P₅₀-P₈₅ of the overall children were highly similar to those in overweight/obesity children. Conclusions It is a challenge to control childhood obesity for children management, the change of parents′ unhealthy lifestyle as well as fathers′ attention to children rearing.In order to prevent the occurrence of overweight/obesity children effectively, it is suggested to focus on normal children with BMI in P₅₀-P₈₅of the overall normal children.

Investigation on psychosocial characteristics of children with juvenile rheumatoid arthritis in Xi′an

XU Yan, YANG Yuan-yuan

2018, 26(12):  1308-1311.  DOI: 10.11852/zgetbjzz2018-1646

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Objective To describe psychosocial behavior problems and family function of children with juvenile rheumatoid arthritis (JRA), and to explore the risk factors of behavioral problems,in order to provide scientific basis for family-oriented intervention. Methods Totally 56 children diagnosed with JRA and their parents in the Fifth Hospital of Xi′an were selected as the case group from June 2013 to June 2014.And 52 health children were as the control group.Caregivers were asked to fill out the Child Behavior Checklist (CBCL) and Feetham Family Functioning Survey (FFFS) during the hospitalization of children.Psychosocial behavior problems and family function of the case group and control group were analyzed and compared. Results JRA children had higher scores on introverted factors、extrovert factors and behavior problems than healthy children, and their social capacity and school performance were also worse than those of healthy children(P<0.05).Compared with healthy family, three subscales of FFFS(1.30±0.79,1.21±0.68,2.20±1.10) and the total d score(1.60±0.67)in JRA children were significantly higher than those of normal family(0.98±0.32,0.79±0.31,0.93±0.37) and 0.90±0.31(P<0.05).Meanwhile, the function, structure and economic status had obvious effect on behavioral problems in children. Conclusion Behavioral problems in JRA children are prevalent, leading to the impact of family function.And family function will in turn affect the diagnosis and treatment of children.So it is necessary to assess family-related factors and develop family-oriented interventions in order to improve children′s psychosocial function and the normalcy of their families.

Prevalence of overweight and obesity in children and adolescents aged 6-18 years in Shandong province

LIU Yi-hua, FU Mao-sun, WANG Lu, HAN Li-zhen

2018, 26(12):  1312-1316.  DOI: 10.11852/zgetbjzz2018-343

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Objective To investigate the prevalence of overweight and obesity among children and adolescents aged 6-18 years in Shandong province, in order to provide basis for the development of strategies and measures for the prevention and control of overweight and obesity in children and adolescents. Methods Data were extracted from physical examinations of primary and secondary school students of Shandong province in 2015.A total of 9 583 576 children aged 6-18 years were included in this study.The prevalence of overweight and obesity among school-age children in Shandong province was examined by age, gender and region, based on four national and international criteria.The agreement between the national criteria and the international one was also analyzed. Results Based on the national, international obesity task force (IOTF), centers for disease control and prevention (CDC) and world health organization (WHO) standard criteria, the prevalence rate of overweight in the above criteria was 17.5%,16.6%,13.9% and 17.6%,respectively; and the prevalence rate of obesity in the above criteria was 13.1%,7.2%,11.4% and 10.8%, respectively.The prevalence rates of overweight and obesity in boys were higher than those in girls, and higher in urban areas than those in rural areas.The prevalence rates of overweight and obesity kept stable rising with age in children aged 6-11 years, but the rates decreased rapidly in adolescents aged 12-18 years.There was high agreement among the national criteria and the three international criterias, with the corresponding weighted kappa values of 0.82 (China vs.CDC), 0.70 (China vs.IOTF) and 0.83 (China vs.WHO), respectively. Conclusion Childhood obesity has become an important public health issue in Shandong Province, more attention should be paid by the whole society.

Effects of dietary propionate and butyrate on fat metabolism in obese mice

WANG Yuan-yuan, FAN Xiu-qin, YAO Hong-yang, CHANG Xue-lian, FAN Chao-nan, LI Ping, QI Ke-min

2018, 26(12):  1317-1321.  DOI: 10.11852/zgetbjzz2018-0785

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Objective To investigate the effect of exogenous short-chain fatty acids (SCFAs) on fat metabolism in high-fat-diet induced obese mice. Methods Totally 40 male C57BL/6J mice aged three to four weeks were divided into four groups, and were fed with the normal-fat diet,high-fat diet,high-fat diet with propionate or butyrate for 4 months, respectively.At the end of the experiments, the blood, epididymal and subscapular fat and the liver were collected.Plasma triglyceride (TG) and total cholesterol (TCH) were measured, and hepatic and adipose tissue morphology were examined.Meanwhile, the mRNA expressions of fat metabolism associated genes were assayed by RT-PCR, including the adipose triglyceride lipase (atgl), hormone-sensitive lipase (hsl), acyl CoA:diacylgycerol acyltransferase 2 (dgat2), carnitine palmitoyltransferase (cpt) and uncoupling protein-1 (ucp1). Results Compared with the normal diet group, the body weight, plasma concentrations of TG and TCH, and fat accumulation in the liver significantly increased in the high-fat diet group (P<0.05). Supplementation of propionate or butyrate to the high-fat diet inhibited the increase in body weight and lipid droplet accumulation in the liver, and reduced plasma TG and TCH levels (P<0.05).The RT-PCR analysis showed that the mRNA expressions of atgl, hsl, and cpt1c in both the epididymal fat and liver in high-fat diet group significantly decreased compared with the normal diet group, while the dgat2 expression significantly increased (P<0.05). Supplementation of propionate or butyrate to the high-fat diet increased the mRNA expressions of atgl, hsl, and cpt1c, and reduced the dgat2 expression in the epididymal fat and liver (P<0.05).However, the expression of these genes in the subscapular fat was not affected by dietary propionate or butyrate supplementation (P>0.05). Conclusion Dietary supplementation of propionate and butyrate might inhibit the body weight gain in high-fat-diet induced obese mice by promoting TG lipolysis and oxidation.

Expression and significance of Mcl-1 in islet cell apoptosis of rats with high-fat diet

WANG Si-si, WANG Li, YI Xiao-qing, LI Dan, XIAO Yan-feng

2018, 26(12):  1322-1326.  DOI: 10.11852/zgetbjzz2018-0648

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Objective To analyze the expression level of myeloid cell leukemia-1(Mcl-1) and its correlation with cell apoptosis through the establishment of a high-fat diet induced obese rats model, in order to research islet cells injure mechanism. Methods A total of 72 male Sprague-Dawley rats with specific pathogen free (SPF) weaned were randomly assigned to two groups by 1∶2.Finally 24 rats were in normal diet group and 48 rats in high fat diet group.The rats were killed at the end of the 8,16,20,24 weeks of high-fat diet.After that, the obese rats were sieved out and prepared for following experiment.The obese rats were set up as obese group and the normal diet rats were control group.The serum level of free fatty acids was tested by ELISA to analyze the lipid metabolism in obese rats.The microstructure of pancreas was observed by electron microscope.The protein expression of Mcl-1 was examined by immunohistochemical method, and the mRNA level of Mcl-1 was detected by real-time PCR to explore the possible mechanism of obesity β-cell damage in rats.TUNEL method was used to detect islet cell apoptosis situation of the two groups. Results 1) The serum level of free fatty acids of obese rats was significantly higher than that of the control group after high-fat diet for 20 weeks (P<0.01).2) Electron microscope showed that beta-cells in obese group were hyperplastic, and some appeared apoptosis.3) The protein expression level of Mcl-1 was significantly lower in obese group after high-fat diet for 20 weeks (P<0.05).4) Compared with control group, the mRNA level of Mcl-1 was significantly lower in obese group after high-fat diet for 16 weeks (P<0.05).5) The apoptosis rate of the obese group increased significantly than after high-fat diet for 20 weeks (P<0.01).6) The islet cell apoptosis rate of rats was positively correlated with serum FFA(r＝0.536,P<0.01), and negatively correlated with Mcl-1 gene expression(r＝-0.776,P<0.01). Conclusions Islet β-cell morphological abnormalities existed in obese rats, and the expression level of Mcl-1 gene decreases in obese rats.Moreover, rats′ islet cell apoptosis rate was negatively correlated with Mcl-1 gene expression.It is indicated that islet β-cell is damaged in obese rats, and the mechanism might be associated with mitochondrial apoptosis pathway.

Circadian clock and obesity

YU Ting, LI Xiao-nan

2018, 26(12):  1327-1331.  DOI: 10.11852/zgetbjzz2018-1170

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The circadian rhythms of physiology and behaviors are driven by an intrinsic machinery called the circadian clock, which generates rhythms with a periodicity of about 24 hours.Accumulating evidence suggest that the disruption of circadian rhythms is closely related to the development of obesity and its clinical complications.However,the mechanism is incompeletely understood.Researches indicate that the circadian clock regulates metabolism and energy homeostasis by affecting rhythmic release of various endocrine hormones and adipokines.Further study on the interaction between the circadian clock and obesity may provide new ideas and therapeutic strategies for the prevention and treatment of obesity,especially childhood obesity

Research review of body composition in children and adolescents

WANG Lu-lu, ZHANG Qian

2018, 26(12):  1332-1335.  DOI: 10.11852/zgetbjzz2018-1168

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Based on two-compartment models and multi-compartment models, this review focuses on currently applied methods for measurement of body composition in children and adolescents, including body density, anthropometry, bioelectric impedance analysis, dual-energy X-ray absorptiometry, computerized tomography and magnetic resonance imagine. Moreover, the review summaries the principles, advantages and disadvantages. The applications of these methods in measurement of body composition in children and adolescents and factors that affect measuring results are also discussed.

Review on appropriate feeding for premature/low birth weight infants

HUO Yan-yan, CHEN Jin-jin

2018, 26(12):  1336-1339.  DOI: 10.11852/zgetbjzz2018-0549

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Premature/low birth weight infants are at high risk of infancy growth restriction, development retardation and infectious diseases.Appropriate feeding provides material basis for healthy development, influencing short-term growth and disease outcome, and facilitating long-term health.This review will combine the related guidelines of nutrition management for premature/low birth weight infants to elaborate appropriate feeding and refine feeding recommendations, in order to help preterm/low birth weight children produce the same body composition of the healthy fetus, meet the needs of growth and development, as well as long-term health.

Systematic review on the association between birth weight and childhood obesity

CHANG Rui-xia, LIANG Fang, LU Yong-bin

2018, 26(12):  1340-1345.  DOI: 10.11852/zgetbjzz2018-0964

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Objective To explore the relationship between birth weight (BW) and the risk of childhood obesity, in order to provide evidence for the prevention of childhood obesity. Method Studies on birth weight and childhood obesity were identified by searching major electronic databases (PubMed, Elsevier and Web of Science) by the medical subject headings and key words, and a Meta-analysis was conducted to assess the dose-response relationship between childhood obesity and birth weight. Results A total of 32 studies including 548 348 subjects were enrolled in this study.Compared with reference birth weight (2 500-4 000 g), high birth weight(≥4 000 g) was risk factor for childhood obesity (OR=1.77, 95%CI:1.66-1.89).There was significant dose-response relationship between birth weight and the risk of childhood obesity, which suggested that the risk of childhood obesity increased 1.1% with the birth weight increasing every 100 g.When the birth weight increased to 3 575 g, the risk of obesity in children was statistically significant (OR=1.08, 95%CI:1.00-1.17, P=0.046).And the risk of obesity increased obviously when birth weight was higher than 3 575 g. Conclusions There is a significant J-dose-response relationship between birth weight and childhood obesity risk.When children′s birth weight exceeds 3 575 g, the risk of childhood obesity significantly increased.

Analysis of the correlation between sleep and overweight and obesity in middle school students in Urumqi, China

WU Guo-bao

2018, 26(12):  1346-1349.  DOI: 10.11852/zgetbjzz2018-0346

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Objective To understand the sleep status of middle school students in Urumqi and its correlation with overweight and obesity, in order to provide support for effective control of overweight and obesity in middle school students. Methods A total of 8 242 middle school students from 20 secondary schools in Urumqi were randomly selected to investigate their sleep status from March to April 2016, and their relationship with overweight and obesity was analyzed. Results The sleep quality score of middle school students in Urumqi was 4.97±2.48; The detection rate of sleep quality problems was 28.44%, and it was significantly lower in boys (26.36%) than that in girls (30.43%) (χ²=16.66, P<0.01).The average sleep time of middle school students was (8.18±1.16) h/d, and the detection rate of sleep insufficiency was 48.24%.The overweight/obesity rate of middle school students was 15.47%, and it was significantly higher in boys, urban areas, junior high schools (χ²=191.04,11.21,44.36, P<0.01).Multiple regression analysis showed that gender, age, sleep time were related to body mass index (BMI) in secondary students (P<0.05).Sleep time was negatively correlated with BMI, while age was positively correlated with BMI.Logistic regression analysis showed that sleep time insufficiency in middle school boys was a risk factor for overweight and obesity (OR=1.23, 95%CI:1.04-1.47,P=0.02), boys′ sleep quality was not found correlated with overweight and obesity.Meanwhile, there was no statistical relationship between sleep quality and overweight and obesity in girls. Conclusions There is a close relationship between sleep time and BMI in middle school students.Insufficient sleep of boys may be a risk factor for overweight and obesity.

Analysis on obesity and related chronic diseases among primary and secondary school    students in Pudong New Area of Shanghai

SHEN Li-na, BAI Pin-qing, FU Ling-fei, CHEN Bo, HU Hui, SHEN Hui-ping

2018, 26(12):  1350-1353.  DOI: 10.11852/zgetbjzz2018-0911

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Objective To investigate the obesity status and related chronic diseases among primary and secondary school students in Pudong New Area of Shanghai, in order to provide reference for the development of relevant prevention strategies. Methods A multi-stage stratified random sampling method was used to selected the primary and secondary school students from September to November 2015.Totally 609 students filled out questionnaires, took physical examination and got biological sample collected. Results The overall overweight rate of students in Pudong New Area was 13.96% and the obesity rate was 11.28%.Meanwhile, the obesity rate of boys was significantly higher than that of girls.The overall detection rates of hypertension, impaired fasting glucose (IFG) and diabetes mellitus (DM) were 21.84%, 0.66% and 0.16%, respectively.The average fasting blood glucose (FBG) was (5.0±0.5) mmol/L.The overall detection rate of dyslipidemia was 5.25%, and the abnormal rates of total cholesterol (TC), total triglyceride(TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) were 3.12%,2.46%,0.16% and 2.63%, respectively. Conclusions Nutrition-related chronic diseases such as overweight and obesity, hypertension, diabetes and dyslipidemia are prevalent among primary and secondary school students in Pudong New Area.More attention should be paid to and effective health interventions are necessary.

Analysis on the obesity and lifestyle of school-age children in Changping district, Beijing in 2017

LU Dan, GUO Hong-xia, LIU Yu-hong, ZHANG Jue, LIU Xiao-pei, WANG Jin-fei

2018, 26(12):  1354-1357.  DOI: 10.11852/zgetbjzz2018-1124

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Objective To investigate the prevalence of obesity and current status of lifestyle of school-age children in Changping district, Beijing, and to analyze their correlation, in order to provide reference for prevention and treatment of obesity in school-age children. Methods A stratified cluster and random sampling was applied to select 1 260 school-age students from 8 primary schools of Changping district from April to September 2017.Questionnaire on Lifestyle of School-age Children in Changping was adopted, and meantime students′ height and weight were measured. Results The detection rate of school-age obesity in children from Changping district was 15.08%.The rate in rural area (15.33%) was higher than that in urban area (14.81%),but the difference was not significant (χ²=0.07,P＞0.05).While the obesity rate of boys (17.51%) was significantly higher than that of girls (12.29%) (χ²=6.67,P＜0.05).Multifactor Logistic regression indicated that eating fast food more than 3 days (OR=2.66,95%CI:1.43～4.95), fast eating speed(OR=1.73,95%CI:1.23～2.42), exercise for at least 60 minutes each day less than 3 days (OR=1.74,95%CI:1.20～2.51) and taking physical training after class less than 3 days(OR=1.49,95%CI:1.03～2.15) over the past week were the risk factors for preschool children obesity. Conclusions School-age children obesity in Changping district is prevalent, which is closely correlated with unhealthy lifestyle, including frequent eating of western-style fast food, fast eating speed and lack of physical training.So it is suggested to take comprehensive measures for obesity prevention and treatment from the perspectives of rational diet, physical activities and behavioral modification.

Analysis on the correlation of waist circumference, hip circumference and anthropometric    parameters in children aged 3-6 years in Nanjing

JIANG Wei, CHEN Ling, FU You-juan, LI Xi-ling, ZHANG Xiao-mei, LÜ He-yun, YE Mei, WU Hong, TONG Mei-ling

2018, 26(12):  1358-1360.  DOI: 10.11852/zgetbjzz2018-0374

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Objective To measure the levels of waist circumference, hip circumference and waist-to-hip ratio of children aged 3-6 years in Nanjing, and to analyze the correlation among these indexes and anthropometric parameters. Methods A total of 4 300 children aged 3-6 years were enrolled by using stratified random cluster sampling method, and the waist circumference and hip circumference were measured. Results Both the waist circumference and the hip circumference of boys and girls increased with the age growth, while the waist-hip ratio decreased with the age growth. The average waist circumference of boys was 49.4~54.5 cm and girls was 47.5~53.2 cm; The average hip circumference of boys was 53.3~62.5 cm and girls 53.0~60.9 cm; The average waist-hip ratio of boys was 0.87~0.96 cm and girls 0.87~0.90 cm.The waist circumference, hip circumference and waist-to-hip ratio of children were significantly different among different age and gender groups(P＜0.05).The waist circumference was positively correlated with body weight, height and BMI, so was hip circumference.The waist-to-hip ratio decreased with age, and was negatively correlated with height and hip circumference. Conclusions The waist circumference and hip circumference of children aged 3-6 years in Nanjing are different in different age and gender groups.Waist circumference, hip circumference and waist-to-hip ratio of children are related to body weight, height and BMI.

Analysis of serum vitamin D level in children aged 2-6 years in urban area of Xi′an in summer

YOU Jia, TIAN Hui-zhen, CAO Chun-hong, CHEN Yan, HE Yu-ying, ZHENG Jing-jng

2018, 26(12):  1361-1363.  DOI: 10.11852/zgetbjzz2018-0548

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Objective To investigate the serum 25-hydroxyvitamin D[(25-(OH)D]in children aged 2~6 years in urban of Xi′an in summer, and to analyze related factors, in order to strengthen attention of late vitamin D(VD) deficiency and insufficiency. Methods A total of 615 children who took physical examination in Xi′an Maternal and Child Health Hospital from July to September 2017 were enrolled in this study.Self-designed questionnaires were filled out by parents under informed consents.3 ml of limosis vein blood was collected and the serum VD was measured by liquid chromatography tandem mass spectrometer made in Co.AB,USA(API4000).Finally 471 questionnaires were received. Results The average level of 25-(OH)D in 615 children was (32.81±7.93) ng/ml.The rate of abnormal VD level(including VD deficiency and VD insufficiency) was 38.9% (239/615), which was statistically higher than that of southern China(χ²=14.65,P＜0.001),but was not significantly different from those of Toronto, Canada and northern China(χ²=1.79,2.45,P＞0.05).The rate of VD deficiency was statistically lower than that of South Carolina, US(χ²=14.2,P＜0.001).There was no significant differences on outdoor time among VD deficiency group, VD insufficiency group, VD sufficiency group and desired level of VD group(F=0.784,P=0.503).Children in desired level of VD group took VD more frequently than other three groups(P＜0.001). Conclusions VD is at low level of normal interval in children aged 2-6 years in urban area of Xi′an in summer, and VD deficiency and insufficiency is common in such population.So proper outdoor time and VD supplementation will help to facilitate children′s growth.

Analysis of dynamic changes in macronutrients and energy of human milk from mothers at early stage of premature

ZHENG Qian, LONG Wei, ZHANG Lin, WANG Huai-yan

2018, 26(12):  1364-1368.  DOI: 10.11852/zgetbjzz2018-1106

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Objective To study the dynamic changes in macronutrients and energy in human milk from mothers at early stage of premature infants, in order to explore the necessity of providing individualized nutrition support for premature infants. Methods A total of 140 human milk samples were collected from 70 women who delivered preterm infants from January to December 2017.Macronutrients and energy were tested using MIRJS human milk analyzer.The difference on the macronutrients and energy in different genders, maternal age, delivery mode, colostrum and transition milk group were analyzed and the changes were observed. Results 1) The protein level in colostrum from mother of premature was higher than that of transitional milk (P<0.01), while the fats, carbohydrates and energy were significantly lower in colostrum (P<0.05).2) The colostrum from mothers of premature infants with a gestational age of ≤30 weeks had significantly higher levels of protein than those of 30⁺¹-33⁺⁶ weeks and ≥34 weeks group (P<0.05).And the energy level in colostrum of ≤ 30 weeks group were significantly lower than that of 30⁺¹-33⁺⁶ weeks group (P<0.05), while the differences on fats and carbohydrates were not significant (P>0.05).3) The proteins, fats and energy levels in transition milk groups at different gestational age groups were not significantly different(P＞0.05).While the carbohydrates significantly increased with the older of gestational age [(6.28±0.57), (6.61±0.43), (6.36±0.81) g/100 ml), P=0.04].4) No significant difference was found on the content of macronutrients and energy in groups with different maternal childbearing age, delivery modes, infants′ gender and birth weight.5) The protein levels in breast milk were continuously declining while the fats, carbohydrates and energy levels were continuously increasing after linear fit.The tuning days of protein, fats, carbohydrates and energy levels were in the eleventh, ninth and fourteenth day after birth. Conclusions The levels of macronutrients and energy in milk from mothers of premature infants vary significantly between colostrum and transitional milk.Micronutrient and energy levels are not correlated with mothers′ childbearing age, delivery mode, infants′ gender and birth weight.Moreover, the proteins and ratio of protein/calorie are low in early stage of premature, and the compositions vary from person to person.Therefore, the protein content and calorie density of breast milk should be targeted to strengthen, and further study is warranted to explore the timing and composition of premature infants′ human milk additives.

Survey on physical growth and development of children aged 1 month to 7 years in Xi′an

ZHENG Xing-rong, MA Guo-yan, ZHANG Shui-ping

2018, 26(12):  1369-1372.  DOI: 10.11852/zgetbjzz2018-0494

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Objective To know about the physical growth and development of children aged 1 month to 7 years in Xi′an, in order to provide guidance for the growth and development. Methods Stratified cluster sampling method was adopted to investigate the physical growth and development of children aged 1 month to 7 years in Xi′an in 2015. The weight, height (length), head circumference and sitting height, chest circumference and waist circumference of children were collected. Totally 25 997 children were investigated and were classified into 21 age groups. Results The gap on the height increase among children aged 1 month to 3 years and the gap on the weight and chest circumference change among children aged 3 to 7 years were relatively large. There were differences on each index among urban, suburban and suburban counties groups between male and female at different age stages, mainly including body weight from 1 to 3 months, height above 15 months, head circumference from 1 to 5 months, chest circumference and waist circumference from 3 to 7 years old. The weight, height and sitting height of male and female in all age groups except 5.5-year-old girls were higher than the results of the nine cities survey, while head circumference, chest circumference and waist circumference were slightly lower than the results of the survey (P＜0.05). The weight for age Z score and height for age Z score were significantly higher than WHO standard, and Z value of children′s height and weight was 0.40-1.19. Conclusions Significant difference on physical growth and development of children aged 1 month to 7 years in Xi′an between suburban and urban areas still exists. Children′s physical growth and development is at a high level in the country and higher than the WHO standards.

Correlation study on plasma level of 25-hydroxyl vitamin D and central precocious puberty in children

ZHOU Jing-jing, ZHANG Qian, LING Yu

2018, 26(12):  1373-1374.  DOI: 10.11852/zgetbjzz2018-0345

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Objective To test the level of 25-hydroxyl vitamin D [25(OH)D] in children with central precocious puberty (CPP), and to analyze the correlation between sex hormones and 25(OH)D. Methods A total of 182 CPP children diagnosed in endocrinology department were enrolled in this study in 2015, and 200 health children at the same age were selected as control group.Plasma level of 25(OH)D was tested by electrochemical analysis, and the correlation between 25(OH)D level and luteinizing hormone (LH)/peak follicle-stimulating hormone (FSH) were analyzed. Results The level of 25(OH)D was significantly lower in CPP group than that in control group [(55.7±16.9) nmol/L vs.(66.5±20.1) nmol/L, t=5.70, P<0.05].The level of 25(OH)D was negatively related to LH/FSH peak(r=-0.74, P<0.05).The proportion of vitamin D deficiency in CCP group(39.7%) was significantly higher than that of control group(22.2%), while the proportion of vitamin D sufficiency(16.3%) was significantly lower than that of control group(33.3%) (P<0.05). Conclusions Because of the early bone growth and development of children with early puberty, vitamin D is in high demand.So in the treatment of sexual precocity, the importance of vitamin D should be strengthened, and regular monitoring of 25(OH)D levels and vitamin D supplements are recommended.

Study on the influencing factors and effect of comprehensive intervention on developmental language delay in children

SHEN Xia-hui, CAO Ai-hua, LI Sha-sha, QIAN Jing

2018, 26(12):  1375-1379.  DOI: 10.11852/zgetbjzz2018-1007

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Objective To investigate the influencing factors and effect of comprehensive intervention on developmental language delay in children. Methods A total of 61 children with developmental language delay aged 18-35 months were chosen and 55 normal children were matched by gender and age from September 2017 to March 2018.Children with developmental language delay were divided into two groups, with 31 children in comprehensive intervention group and 30 children in family language intervention group.Early Language Development Process Scale and Family Environment Questionnaire were used to access children′s language development level and home environmental factors. Results Parents′ child-bearing age, home address, feeding type, parents′ education level, time spending on electronic products each day were found relative with children′s language development problems(P<0.05).Logistic regression analysis showed that more-time to interact with children(2~4 h/d OR=0.542, 95%CI:0.352~0.866;≥4 h/d OR=0.211,95%CI:0.105~0.402), more-educated mothers(high school OR=0.685, 95%CI: 0.495~0.947; college and more-educated experience OR=0.468, 95%CI:0.157~0.785)and breast feeding(OR=0.702, 95%CI:0.538-0.886)were protective factors for developmental language delay, while spending on electronic products≥1 h/d(OR=3.582,95%CI:2.314-5.761)was a risk factor.There was significant statistical difference between the comprehensive intervention group and the control group after 3 months of intervention(P＜0.05). Conclusion Children′s language development is closely related to family language environment, and comprehensive intervention proves to be a better method to treat language delayin children.

Clinical observation on the changes of pulmonary ventilation function and height in children with uncontrolled asthma

WU Hua-jie, SHI Zhao-ling, LI Jing-xian, WU Shi-yu, LI Cong-cong, SUN Xin

2018, 26(12):  1380-1383.  DOI: 10.11852/zgetbjzz2018-1301

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Objective To observe the changes of pulmonary ventilation function, fractional exhaled nitric oxide (FeNO) and height in children with uncontrolled group and well-controllled group of moderate asthma. Methods Children with moderate asthma from January 2017 to June 2018 were collected, and were divided into uncontrolled asthma group (50 cases with intermittent use of ICS combined with Menglusite) and well-controlled group (50 cases with regular use of ICS combined with Menglusite). Meantime, 50 cases with non-asthmatic children were selected into the control group. After 6 months and 12 months of treatment, the uncontrolled group and the well-controlled group performed FEV1, PEF, and FeNO tests, and the height of three groups of children was measured. Results After 6 months and 12 months of treatment, FEV1 and PEF were significantly lower in uncontrolled group than those in well-controlled group (P<0.05). And FeNO in uncontrolled group did not decrease significantly and was higher than that in well-controlled group (P<0.05).After 12 months of treatment, the height of children in well-controlled group was not significantly different compared with that of the control group (P>0.05), while the height of children in the uncontrolled group was significantly lower than that of the control group (P<0.05). Conclusion Irregular use of drugs leads to poor asthma control, resulting in hyperractivity of airway and ventilation dysfunction, and is also an important factor affecting the height of children.

Correlation studyon vitamins A, D, E levels with recurrent respiratory tract infections in children

ZHEN Hong, DAI Yi, DU Wu-jie, DENG Yin-ye, LI Liu-qing, WEN Zhi-hong

2018, 26(12):  1384-1386.  DOI: 10.11852/zgetbjzz2018-0140

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Objective To investigate the association of serum levels of vitamin A, D and E with recurrent respiratory tract infections(RRTIs). Methods Children aged 6 months-15 years in People′s Hospital of Guangxi Zhuang Autonomous Region were enrolled to finish a face-to-face survey from January to December 2017. Totally 171 children with RRTIs were selected as the RRTI group, whereas 156 health children were used as control group. Blood samples were collected, and high performance liquid chromatography (HPLC) was used to measure serum levels of vitamin A and E. The serum level of 25(OH)D₃ was tested by chemiluminescence. The differences on serum levels of vitamin A, D, E were analyzed between RRTI group and control group. Results The average levels of vitamin A[(0.30±0.06) mg/L vs.(0.39±0.07) mg/L], vitamin D₃ [(72.41±25.59) nmol/L vs.(84.84±29.96) nmol/L] and vitamin E [(8.90±2.32) mg/L vs. (9.72±2.61)mg/L] in RRTI group were significantly lower than those in control group(P＜0.01).The deficiency and insufficiency rate of vitamin A、D₃, and vitamin E insufficiency rate in RRTI group were significantly higher than those in normal control group (P<0.05). Logistic regression analysis showed that vitamin A level lower than 0.3 mg/L (OR=19.225,95%CI: 9.136-40.453) and vitamin D₃ level lower than 50 nmol/L(OR=2.891,95%CI:1.186-7.044) increased the risk of RRTIs in children. Conclusion The insufficiency of vitamin A and D₃ may be critically associated with RRTIs of children.

Effect of zinc supplementation on blood zinc, immune globulin, complements and    inflammatory cytokines of children with rotavirus enteritis

ZHOU Xiong-fei, ZHENG Jun

2018, 26(12):  1387-1390.  DOI: 10.11852/zgetbjzz2018-0344

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Objective To analyze the effect of zinc supplementation on the levels of zinc, immune globulin, complements and inflammatory cytokines of children with rotavirus enteritis(RE). Methods A total of 82 children with RE were randomly divided into the zinc supplementation group (42 cases) and RE group (40 cases) from October 2015 to October 2017.The routine treatment group was given conventional therapy and the zinc supplementation treatment group was treated with oral zinc gluconate tablets 20 mg/d for 14 days additionally.And 102 healthy children were collected as control group at the same time.The levels of zinc, immune globulin, complements and inflammatory cytokines among three groups were tested and compared after treatment. Results Compared with control group, the levels of zinc, immunoglobulin G(IgG), immunoglobulin A(IgA), immunoglobulin M(IgM), complement 3(C3), complement 4(C4) and interleukin-2(IL-2) were obviously lower in children with RE before treatment (P<0.05), while the levels of tumor necrosis factor alpha(TNF-α) and interleukin-8 (IL-8) increased in two RE groups(P<0.05).After treatment, the levels of zinc, IgG, IgA, IgM, C3, C4 and IL-2 had significantly increased (P<0.05), while the TNF-α and IL-8 decreased in two RE groups (P<0.05).Compared with the routine treatment group, the levels of zinc, IgG, IgA, IgM, C3, C4 and IL-2 increased after treatment(P<0.05),while the TNF-α and IL-8 decreased in the zinc supplementation group(P<0.05).Moreover, the duration of symptom in the zinc supplementation group was significantly lower than that in the routine treatment group (P<0.05).There were no obvious adverse reactions in two RE groups during treatment. Conclusion Zinc deficiency is prevalent in children with RE, with decreasing level of IgG, IgA, IgM, C3, C4 and increasing level of inflammatory factors.Zinc supplementation can increase serum levels of zinc, IgG, IgA, IgM, C3, C4 and IL-2, decrease serum TNF-α, IL-8 and the duration of symptoms.

Study on status and potential school influencing factors for knowledge, attitude and behaviors    regarding nutrition and food safety among junior middle school students

TAN Xue-qing, YU Xiao-ming, WANG Yu-qing, SHI Yan-qin, ZHANG Ting-hao, WANG Jia

2018, 26(12):  1391-1393.  DOI: 10.11852/zgetbjzz2018-0463

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Objective To investigate knowledge, attitudes and current behaviors regarding nutrition and food safety among junior middle school students, in order to provide suggestions for the future development of nutrition and food safety education. Method By using cluster random sampling and qualitative research, a total of 2 652 students were interviewed using questionnaires from 29 schools in Beijing, Chongqing, Haerbin and Hubei Province from November 2016 to October 2017. Results The average score on knowledge was 9.54±1.866, with the awareness rate was 81.1%; 97.2% of the students agreed that it was important to provide nutrition and food safety education in school;73.6% of the students ate breakfast everyday,12.9% of students drunk sugared beverages everyday in the past week,31.1% of the students never or seldom see the food packaging.Multivariate analysis showed that student receiving health education had higher score of knowledge, attitude and behaviors regarding nutrition and food safety. Conclusion The knowledge and behaviors regarding nutrition and food safety of junior middle school students need to be improved, and school health education will be an effective way to improve students′ health knowledge and behaviors.