Table of Content

10 February 2020, Volume 28 Issue 2

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Challenges and opportunities for childhood obesity prevention and control in China

MA Guan-sheng, ZHANG Yu

2020, 28(2):  117-119.  DOI: 10.11852/zgetbjzz2020-0048

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Medical nutrition therapy for the obesity of children and adolescents with HCH management mode

HONG Li , LIU Yun-man, ZHOU Lu-lu, YU Xiao-dan

2020, 28(2):  120-122.  DOI: 10.11852/zgetbjzz2019-0005

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Obesity has become a serious global public health problem. By 2014,12.2% of school-age children over 7 years old in China were overweight and 7.3% were obese,with a total of 34.96 million children. This number could increased to 50 million by 2030. Medical nutrition therapy of obesity in children and adolescents includes active screening of high-risk groups and comprehensive intervention involving diets,physical exercises and lifestyle change of obesity children and adolescents. Shanghai Children′s Medical Center-Shanghai Weifang Community Service Center Joint Nutrition Clinic adopts the "Hospital-Community-Home (HCH)” management mode to carry out the comprehensive medical nutrition therapy for the obesity of children and adolescents in Shanghai.It is proved that this management already obtains good effects,and it is worthy for further application and promotion.

Cohort study on the effect of overweight in early childhood on obesity in adolescents in Zhongshan

ZHOU Shuang, HUANG Si-zhe, LI Qin, LI Feng-hua, CHEN Chao-jun, WANG Hai-jun

2020, 28(2):  123-127.  DOI: 10.11852/zgetbjzz2019-0370

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Objectives To investigate the incidence of obesity in children and adolescents aged 7 and 18 years in Zhongshan,and to explore the influence of overweight in early childhood on obesity in adolescents. Methods Data were from a retrospective cohort of 2 188 students from the first grade in primary school to the first grade in high school in Zhongshan.The weight and height of children in the first grade of primary school were measured in 2005 and were followed up annually for ten years.Overweight and obesity were defined using the standards of Screening for Overweight and Obesity among School-age Children and Adolescents (WS/T586-2018),the prevalence and incidence of obesity were calculated.χ²test and log-binomial model were used to analyze the impact of overweight in early childhood on obesity in adolescents. Results The detection rate of obesity in children of first grade was 4.89%,which reached to 6.99% in the fourth grade and 4.43% in the first grade at high school.The annual incidence of obesity decreased from 1.83% in the second grade in primary school to 0.74% in the first grade in high school.Overweight children in the first grade in primary school were 8.85 times as likely as normal-weight children to become obese in the first grade in high school (cumulative incidence for 9 years:41.33% vs.4.67%,RR=8.85,95%CI:6.12-12.78). Conclusion High incidence of obesity is more likely to occur in early childhood from the first grade in primary school to the first grade in high school.Overweight in early childhood obviously increased the risk of obesity in adolescents.Prevention of obesity should be implemented from the early life of children,especially in overweight children.

Trends of overweight and obesity prevalence among students aged 7 to 13 years old in a district of Shanghai

CAO Zhi-juan, CHEN Yao, YE Zhou-feng, LI fen-fen, WANG Shu-mei

2020, 28(2):  128-130.  DOI: 10.11852/zgetbjzz2019-0802

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Objective To describe the trend of obesity prevalence in children under the new criteria of "Overweight and Obesity Screening for School-age Children and Adolescents",So as to provide clues for intervention and prevention. Methods Totally 929 students were selected as the subjects in September 2018.The trends of obesity prevalence and body mass index Z(BMI-Z) score were described from the first grade of primary school (7 years old) to the first grade of junior middle school (13 years old). Results The average age of the subjects ranged from 6.91 to 13.58 years old.Under the new criteria,the prevalence of obesity and prevalence of overweight or obesity in the first grade of primary school (seven years old) were at a peak,the prevalence of obesity was as high as 28.52% among boys,15.59% among girls.In general,the prevalence of obesity,overweight or obesity decreased with age among both boys and girls.The prevalence of obesity decreased from 28.52% to 15.55%,and the prevalence of overweight or obesity decreased from 48.83% to 39.68% among boys.The prevalence of obesity decreased from 15.59% to 8.56% and the prevalence of overweight or obesity decreased from 33.81% to 21.66% among girls.BMI-Z score showed a trend of increasing firstly and then decreasing slightly (the peak point was in the fifth grade of primary school). Conclusions Under the new criteria,the obesity situation of primary school students is severe,especially in the first grade of primary school,which is the peak period of obesity.This strengthens the urgency of childhood obesity prevention work.Primary school as an important barrier for childhood obesity intervention,should be further strengthened.

Evaluation of overweight and obesity rate among school-age children in Pudong New Area of Shanghai by different methods and standards

GAO Mei-ying, XUE Kun, GUO Hong-wei, YUAN Chen-chen, BAI Pin-qing

2020, 28(2):  131-134.  DOI: 10.11852/zgetbjzz2019-0983

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Objective To analyze the status quo of overweight and obesity among school-age children in Pudong New Area of Shanghai,so as to provide direction for further screening overweight school-age children and preventing school-age children from obesity. Method A total of 1 738 school-age children in Pudong New Area of Shanghai were randomly selected for physical measurement and questionnaire survey in October 2017.Different standards of BMI,waist circumference and waist-to-height ratio were used to evaluate the overweight and obesity status of school-age children. Results Using BMI criteria for overweight and obesity assessments would leave out children at risk of central obesity,and the missing rate was 7.6%-16.2%.Moreover,2.8%-10.9% of school-age children with systemic obesity would be neglected only using the criteria of central obesity.The overweight and obesity rate of school-age children was the highest (28.6%-39.4%) in the suburban central town of Pudong New Area,Shanghai.The systemic overweight and obesity rate of boys was 26.2%-35.5%,which was apparently higher than that of girls,(18.1%-26.4%).Significantly,the study found that the proportion of girls with above-normal waists (254/766) was similar to that of boys (316/946) (χ²=0.011,P>0.05).In addition,the overweight and obesity rate of first-and second- grade children was significantly lower than that of third grade(P＜0.05). Conclusions School-age children should be screened for both systemic and central obesity criteria,so as to prevent overweight and obese as soon as possible.Besides,corresponding intervention strategies are suggested to be formulated.

Mechanisms of S100A6 mediated by RAGE on vascular endothelial injury in obese children

ZHANG Hui, LIU Chun-yan, WEI Dan

2020, 28(2):  135-138.  DOI: 10.11852/zgetbjzz2019-0530

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Objective To investigate the mechanism of calcium binding protein A6 (S100A6) mediated by terminal glycosylation product receptor (RAGE) on vascular endothelial injury in obese children,in order to provide the basis for further targeted treatment programs. Methods Totally 91 obese children admitted to Shiyan Maternal and Child Health Hospital from July 2015 to July 2018 were divided into injury group (n=43) and non-injury group (n=48) according to the presence or absence of vascular endothelial injury.Meanwhile,45 healthy children who underwent physical examination in this hospital during the same period were selected as control group.Serum levels of S100A6 and free RAGE (sRAGE) were measured on the day of admission in all three groups.The levels of vascular endothelial injury markers including vascular endothelial adhesion molecule-1 (sVCAM-1),soluble cell adhesion molecule-1 (sICAN-1) and von Willebrand factor (vWF) were measured by ELISA. Results The levels of serum S100A6 and sRAGE in the injured group were significantly higher than those in the non-injured group and the control group (P<0.05).The serum levels of sVCAM-1,vWF and sICAN-1 in the injured group were higher than those in the non-injured group and the control group (P < 0.05).Pearson linear correlation analysis showed that S100A6 and sRAGE levels were positively correlated with sVCAM-1,vWF and sICAN-1 levels(P<0.05). Conclusions Compared with normal children and obese children without vascular endothelial injury,the serum levels of S100A6 and sRAGE are significantly increased in obese children with vascular endothelial injury,which may be related to the increase of sRAGE leading to the increase of S100A6,thereby further increasing sVCAM-1,vWF and sICAN-1 levels.

Study on the correlation between cell death-inducing DNA fragmentation factor 45-like effector C     expression in adipose tissue and insulin resistance in obese children

CHANG Yi-nan, TAN Xin-rui, XIAO Yan-feng, WANG Min

2020, 28(2):  139-143.  DOI: 10.11852/zgetbjzz2019-0199

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Objective To evaluate the expression level of cell death-inducingDNA fragmentation factor45-like effector C(CIDEC) in adipose tissue of obese children and its correlation with lipolysis and insulin resistance. Methods A total of 42 children who underwent surgery for non-inflammatory diseases such as hernia and cryptomchidism in the Second Affiliated Hospital of Xi′an Jiaotong University and Xi ′an Children′s Hospital were selected in this study from July 2014 to September 2016,and were divided into obesity group and control group.The body mass index (BMI),waist circumference,blood pressure,blood lipids,fasting blood glucose,serum free fatty acid (NEFA) and insulin resistance index (HOMA-IR) of children were measured.Meanwhile,western blot and RT-PCR were applied to detect the expression level of CIDEC,tumor necrosis factor-α(TNF-α),peroxisome proliferators-activated receptors (PPARγ).And the associations among TNF-α,NEFA,HOMA-IR and CIDEC were studied by Pearson correlation analysis. Results 1) Indexes in obese children,including BMI,waist circumference,systolic blood pressure (SBP),diastolic blood pressure (DBP),HOMA-IR and NEFA,were significantly higher than those in normal controls(P＜0.05),while HDL-C was relatively lower in obese group.2) The expression level of CIDEC mRNA and protein in adipose tissue of obese group decreased (P<0.01),while the expression of TNF-α mRNA increased (P<0.01).3) Correlation analysis showed that the expression level of CIDEC mRNA in adipose tissue was negatively correlated with the levels of TNF-α mRNA,HOMA-IR,NEFA (r=-0.583,-0.560,-0.606,P＜0.05). Conclusions TNF-α causes adipocyte lipolysis,thereby leading to insulin resistance,possibly resulting from down-regulating the expression of CIDEC.

Clinical study of relationship between bone mineral density andrelated factors of bone metabolism in children

SHEN Zhao-xia, PAN Yuan-yuan, HUANG Rong, ZHOU Ya-nan, LI Rong, PENG Lu-ting, CHEN Meng-ying, LI Xiao-nan

2020, 28(2):  144-147.  DOI: 10.11852/zgetbjzz2019-0200

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Objective To investigate the relationships among bone mineral density,body composition and bone metabolism related factors in normal and obese children and adolescents such as serum 25-hydroxyvitamin D [25-(OH)D],serum alkaline phosphatase(ALP),blood calcium,blood phosphorus,in order to provide reference for clinical assessment. Methods Children aged 6 to 15 years in health examination clinic and obese children′s clinic in Nanjing Children′s Hospital Affiliated to Nanjing Medical University were enrolled in this study from August 2017 to September 2018. Bone density was measured using an ultrasonic bone density meter,meanwhile the body composition and various factors related to bone metabolism were measured. Results Totally 1 138 children were enrolled in this study,of whom 606 were in normal body weight group and 532 were in the overweight and obesity group.The detection rate of insufficient bone density was 22.5%(14.7% in normal group and 31.4% in obesity group).And the average bone mineral density in the obesity group was significantly lower than that in normal group (P<0.001).Correlation analysis showed that bone mineral density was negatively correlated with body mass index (BMI) in the normal group (P<0.001),and was positively correlated with 25-(OH)D level (P=0.001).The bone mineral density of obese children was negatively related to BMI,waist-to-height ratio (W/H),percentage of fat mass (FM%) (P<0.001),and was positively related to skeletal muscle% (P=0.008) and 25-(OH)D level(P=0.001).However,bone mineral density was not associated with serum levels of ALP,calcium or phosphorus in normal or obese children (P>0.05). Conclusions Insufficient 25-(OH)D level and obesity,especially abdominal obesity,have impact on the increase of bone density.Serum calcium,phosphorus and ALP levels are not related to bone mineral density in children.

Sensory integration disorder and its related factors among preschool children in amontanic county of Hubei province

YU Li-li, LI Dong, LI Ju, JI Hong-xian, LI Xiao-wen, GUO Huai-lan, DING Hong-cheng, ZHANG Dong-yun, WANG Jing

2020, 28(2):  148-151.  DOI: 10.11852/zgetbjzz2019-0257

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Objective To investigate the status of sensory integration disorder (SID) and its related factors among preschool children in a montanic county of Hubei province,in order to provide scientific basis for the intervention of SID among preschool children in this area. Methods A cluster sampling method was used to select five kindergartens from east,west,south,north and middle of the county from October to November 2017.Semi-structured questionnaires were conducted in children aged 3 to 6 years,including the Scale for the Development of Sensory Integration and its basic information.Multivariate Logistic regression model was adopted to analyze risk factors for SID. Results Among the 710 children,396 had SID,with the prevalence rate of 55.8% (mild 30.3%,severe 25.5%).There was significant difference on SID rate between boys and girls (χ²=10.688,P<0.05).After adjusting some confounding factors,Multi-factor analysis showed that boys (OR=1.636,95%CI:1.177-2.273,P=0.003),eating snacks (OR=1.672,95%CI:1.158-2.412,P=0.006),picky eating behavior (OR=1.535,95%CI:1.097-2.147,P=0.012) were risk factors for SID,while loving sport was a protective factor for SID (OR=0.460,95%CI:0.253-0.836,P=0.011).Meanwhile,the risk for SID increased with the increasing of age (OR=0.769,95%CI=0.632-0.934,P=0.008). Conclusions SID of preschool children in montanic county is associated with sex,age,eating habits and exercise status.So it is supposed to give targeted prevention and control measures for preschool children in different sex and age groups.

Relationship between homocysteine and insulin sensitivity in rats with intrauterine growth restriction and its possible mechanism

ZHANG Hui, WANG Xin-li, HAN Tong-yan, XING Yan, PIAO Mei-hua

2020, 28(2):  152-155.  DOI: 10.11852/zgetbjzz2019-0881

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Objectives To analyze the relationship between homocysteine (Hcy) and insulin resistance in rats with intrauterine growth restriction,to discuss the possibility of affecting Hcy level by changing early diet,therely influencing insulin sensitivity,and to explore possible molecular mechanisms. Methods 1)The model of intrauterine growth retardation(IUGR) rats was established by low-protein and caloric restriction in the second and third trimester of pregnancy.IUGR newborn pups were randomly divided into dietary intervention group and non-intervention group.Lactating female rats of dietary intervention group were fed with high folate and vitamin B₁₂. Lactating female rats of non-intervention group were fed with normal diet.All of newborn pups were weaned on the 21st day after birth and then fed with normal diet to 120 days.2)On the 120th day after birth,fasting plasma gluoose(FPG),fasting insulin (FINS)and Hcy of the rats in three groups were measured.Insulin resistance index(IRI) were calculated to evaluate insulin sensitivity.The relationship between Hcy and IRI was disscussed.3)On the 120th day after birth,skeletal muscle tissues were collected from rats of the three groups,phosphatidylinositol 3-kinase(PI3K) and phosphatase and tension homologuedeleted on chromosome 10(PTEN)protein expression levels in phosphatidyl inositol 3-kinse /protein kinase B (PI3K/AKT) insulin signaling pathway were determined by using western blotting.The relationship between Hcy and protein expression was disscussed. Results 1)On the 120th day,FPG,FINS,IRI and Hcy levels in dietary intervention group were significantly lower than those in non-intervention group,but were higher than those in control group (P<0.05).2)The Hcy level of the three groups was highly positively correlated with IRI (r=0.937,P<0.05).3)On the 120th day,Hcy was negatively correlated with PI3K protein expression(r=-0.88) and positively correlated with PTEN protein expression(r=0.85) in IUGR rats,both of which were statistically significant (P<0.05). Conclusions Maternal lactation can serve as a window period for early postnatal nutrition intervention.Supplementation with folic acid and vitamin B₁₂ can reduce the Hcy level of IUGR offspring Meawhite,Hcy level is highly positively correlated with insulin resistance,and the change of Hcy is closely related to the expression of key molecules in the PI3K/AKT insulin signaling pathway in the skeletal muscle of IUGR offspring.

Research advances on childhood obesity intervention

ZHANG Dan, LI Xiao-nan

2020, 28(2):  156-160.  DOI: 10.11852/zgetbjzz2019-1445

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Obesity has become a common public problem threatening human health,so it is imperative to take effective prevention and control measures.This paper reviews the intervention strategies of nutrition intervention,physical activity intervention,behavioral intervention,digital technology,drug therapy and surgical treatment from the perspective of childhood obesity intervention.

Research advances on body composition and obesity in children and adolescents

LI Song-ting, ZHONG Yan

2020, 28(2):  161-164.  DOI: 10.11852/zgetbjzz2019-0952

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Body composition refers to the amount of fat,protein,inorganic salt,water and their percentages in human body.Recent research shows body composition measurement can provide significant guidance for the obesity assessment as well as intervention therapy and prevention of obesity-related diseases among children and adolescents.By measuring body composition,it is possible to distinguish out-of-standard body components which helps make a more targeted plan for weight control.This review summarizes the progress of applying body composition measurement in childhood and adolescent obesity research,and discuss the practical value of body composition measurement in the assessment of obesity,intervention and related diseases in children and adolescents.

Research progress on sleep disorders in children

GE Fei-fei, ZHANG Di, YAO Hui-ling, WANG You-peng

2020, 28(2):  165-166.  DOI: 10.11852/zgetbjzz2019-0604

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Children′s sleep is an important and dynamic process that affects many aspects of health and development.At present,children′s sleep time is shortened,due to various factors such as long-term use of electronic devices,disharmony of family relationships,poor sleep habits of caregivers,asthma history,mental illness history,etc.And many sleep disorders may occur,such as narcolepsy,abnormal sleep,periodic limb movement disorder,restless legs syndrome.At the same time,sleep quality has a cyclical relationship with the diseases of various systems,so the treatment and research of sleep disorders in children should be paid attention to in clinic.

Review of the family-mediated intervention models and effects on children with autism spectrum disorders

GE Dong-mei, DAI Ying

2020, 28(2):  167-171.  DOI: 10.11852/zgetbjzz2019-0458

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With the increasing prevalence rate of autism spectrum disorders (ASD) worldwide,a series of intervention models appear,which create new possibilities for the prognosis of ASD children.Among them,the family-mediated intervention mode has attracted more and more attention,but it is still short of formal and systematic one at home.By reviewing different family-mediated intervention models and effects on ASD children at home and abroad,this review aims to provide some guidance for the domestic family-mediated intervention models in the future.

Effect of Vitamin A supplementation on allergic disease:systematic review and meta-analysis

CHEN Qin-zhu, XU Wang-guo

2020, 28(2):  172-177.  DOI: 10.11852/zgetbjzz2019-0612

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Objective To assess the evidence of therapeutic effects of vitamin A on allergic disease. Methods Databases were searched for collecting the randomized controlled trials (RCTs) of the effects of vitamin A supplementation on allergic disease in human models from inception to September 30th,2018.Studies were critically appraised,and meta-analyses were then performed using RevMan5.3 software. Result Supplementationof vitamin A increased the risk of girls′atopy (P<0.05) and the responses of delayed-hypersensitivity (P<0.05),while significant differences were not found in wheeze or eczema between the experimental group and control group (P>0.05). Conclusion Vitamin A supplementation may increase the risk of allergy,its effect on wheeze and eczema is controversial.

Study on the prevalence and prediction of overweight and obesity among children and adolescent aged 7 to 17 years from 2012 to 2017 in Tongzhou district,Beijing

ZHANG Yao

2020, 28(2):  178-182.  DOI: 10.11852/zgetbjzz2019-0539

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Objective To analyze the trend of overweight and obesity in children aged 7 to 17 years in Tongzhou district of Beijing during the 2012-2017 school year,in order to provide scientific basis for prevention and control of obesity in primary and secondary schools in this district. Method The physical examination data of students from 2012 to 2017 were used to analyze the trend of overweight and obesity. Results The detection rate of overweight and obesity among students was 14.90%,and 18.00% in 2017 which was higher in boys than that in girls.In 5 years,the two relevance ratios were higher in urban areas than those in rural areas,boys than girls,and the average growth rate of overweight and obesity were higher in rural areas than those in urban areas.The detection rate of overweight in middle and high schools was higher than that in primary schools,and the detection rate of obesity in middle and primary schools was higher than that in high schools.The average growth rate of overweight and obesity in high school was the fastest,1.99% and 5.23% respectively.Using time series analysis,it was predicted that the detection rate of overweight and obesity among students in this district was 14.42% and 14.07% in 2022. Conclusion The detection rate of overweight and obesity among adolescents is on the rise in Tongzhou district,especially in 2016-2017.And the two relevance ratios were significantly higher than those in the past four years.Measures should be taken to reduce the two relevance ratios and control the average growth rate.

Associations between dietary diversity and micronutrients intakes in school-age children

DAI Yi-ming, GUO Jian-qiu, ZHANG Ji-ming, XIAO Hong-xi, WU Chun-hua, ZHOU Zhi-jun

2020, 28(2):  183-186.  DOI: 10.11852/zgetbjzz2019-0258

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Objective To explore the relations between dietary diversity and micronutrient intakes in school-age children in a rural area of China,in order to provide scientific basis for guiding children′s scientific diet to promote children′s health. Methods Totally 442 children aged 6-7 years in Sheyang Mini Birth Cohort Study were enrolled.24 h dietary recall survey was conducted to evaluate nutritional status.Micronutrient intakes and dietary diversity were calculated according to Chinese Food Composition Tables (CFCT) 2004 and 2009.Weight and height of children were measured and obesity was defined based on sex- and age-standardized body mass index.Multivariable regression models were preformed to examine associations of dietary diversity with micronutrient intakes and childhood obesity. Results The intakes of micronutrients was lower than age-specific Chinese Dietary Reference Intakes (DRIs) (2013 edition).Mean values of three Dietary Diversity Scores were lower than those in several studies (DDS:6.69±1.59; DDS₁₀:4.94±1.51; FVS:16.79±7.53) in China.Dietary Diversity Score was significantly positively associated with micronutrients intake (DDS:β=0.14-1.28; DDS₁₀:β=0.17-1.58; FVS:β=0.04-0.25,P<0.05).No significant association was observed between dietary diversity and childhood obesity. Conclusions The findings suggest that Dietary Diversity Score could act as an effective indicator for micronutrient intake in children.

Correlative study on body mass index with sex hormone,leptin and adiponectin in girls with central precocious puberty

ZHANG Jian, ZHOU Hong-juan, GAO Jin-ping, ZHAO Qin

2020, 28(2):  187-190.  DOI: 10.11852/zgetbjzz2019-0201

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Objective To investigate the effects of body mass index (BMI) on serum levels of sex hormones,leptin and adiponectin(APN) in girls with central precocious puberty,in order to provide reference for appropriately analyzing GnRHa test result and illustrating the possible mechanism of leptin and adiponectin in adolescent development of obese children. Methods Totally 90 cases of idiopathic central precocious puberty girls who completed the gonadotropin-releasing hormone analogue (GnRHa) test in the Affiliated Zhangjiagang Hospital of Soochow University from 2016 to 2018 were selected.According to body mass index (BMI),the participants were divided into normal weight group (n=40),overweight group (n=30) and obesity group (n=20).Serum levels of follicle stimulating hormone (FSH),luteinizing hormone (LH),estradiol (E₂),testosterone (T),leptin,APN were tested.The correlations between BMI and various hormone levels were analyzed by Spearman correlation analysis. Results The peaks of LH and APN in the overweight and obesity groups were significantly lower than those in the normal group (P<0.05),which was also significantly lower in obesity group than those in overweight group (P<0.05). The leptin level in the overweight group and obesity group was significantly higher than that in normal group (P<0.05).Moreover,obesity group had significantly higher levels of leptin than overweight group (P<0.05).There were positive correlations between BMI and E₂,T and leptin levels (r=0.213,0.250,0.484,P<0.05),and had negative correlations with LH peak and APN levels (r=-0.417,-0.525,P<0.05). Conclusion It is supposed to take BMI into account when analyzing the result of the GnRHa agonist test and the levels of obesity-related hormones in girls with precocious puberty.

Relationship between nutritional iron deficiency anemia and gender with nationality in premature infants aged 2 years in Urumqi

GAO Yue, LIU Xin-hua, LIAO Jian-jun, LV Chun-yan, WANG Jin-peng

2020, 28(2):  191-194.  DOI: 10.11852/zgetbjzz2019-0767

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Objectives To investigate the condition of iron deficiency anemia(IDA) in premature infants from 0 to 2 years old,and to investigate the related factors of IDA. Methods Totally 208 premature infants born in Urumqi city from June 2015 to December 2016 were selected as the subjects of the study.Premature infants from 0 to 12 months and those old from 1 to 2 months old were tested for total blood type 5 and trace elements at 6 months and 18 months old respectively.The incidence of IDA among premature infants was compared by age,sex and ethnicity. Results The incidence of IDAin children under one year old was higher than that of premature infants aged 1 to 2 years(P＜0.05).There were no significant differences on the IDA incidence and iron deficiency rate between female and male premature infants(P>0.05) However,the incidence of small cell hypopigmentation in female premature infants were higher than that in male premature infants,the difference was statistically significant(P＜0.05).There were no significant differences on the incidence of IDA and small cytochrome in preterm infants of different ethnic groups(P>0.05).The differences on iron deficiency rate were statistically significant among different ethnic groups(P＜0.05),of which the Kazakh incidence rate was the highest(44.44％). Conclusions Premature infants are more prone to IDA.To prevent and reduce the occurrence of IDA in premature infants,a unified ferrum nutritional supplement plan should be formulated according to local conditions,and children′s health,scientific feeding and nutrition education should be strengthened for parents of ethnic minorities.

Follow-up study on mental and motor development of physical growth in island area of Zhoushan

XU Jun-qiu, LIAN Hong-yu

2020, 28(2):  195-198.  DOI: 10.11852/zgetbjzz2019-0286

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Objective To explore the physical development status and catch-up growth of premature infants aged 0 to 2 years old. Methods Totally 258 premature infants and 4 149 full-term infants were enrolled in Zhoushan Maternal and Child Health Care Hospital from 2013 to 2015.The body weight,height and head circumference of the subjects were measured and analyzed at corrected age of 6,12,18 and 24 months. Results 1) Weight of boys aged 1 to 8 months and girls aged 1 to 6 months among preterm group were significantly lower than those of the control group(P＜0.05).Length of boys and girls among preterm group in 1-month,3-months,6-months,8-months and 18-months group,girls in 1-year and 2-years old group were significantly less than those of the control group(P<0.05).Head circumference of boys and girls among preterm group in 1-month,3-months and 6-months,boys in 1-year old,16-months and 2-years old group were significantly less than those of the control group(P＜0.05).2) The body weight,height and head circumference of premature infants decreased gradually from 12 to 18 months of age.The catch-up growth velocity until corrected age 1 year old of weight and 18 months of head circumference of premature girls were faster than those of full-term infants,The body length growth rate was faster than that of full-term girls until corrected age 24 months. Conclusions Most preterm infants can achieve catch-up growth by improving their nutritional status,and catch-up growth of weight is better than length.It is suggested that attention should be paid to the role of nutrition and feeding in promoting the height of premature infants,and intervention and guidance should be selected to promote the height of preterm infants.

Analysis of related influencing factors and control strategies of childhood obesity and its influence on the incidence of diabetes

HUANG Jin-yan

2020, 28(2):  199-202.  DOI: 10.11852/zgetbjzz2019-1155

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Objective To analyze the related influencing factors and control strategies of childhood obesity and its impact on the incidence of diabetes,so as to provide theoretical basis for the prevention and control of childhood obesity. Methods Totally 836 children who were examined in Fifth Hospital of Shenyang from May 2012 to January 2018,were studied as subjects.The incidence of obesity in the subjects was investigated,and the correlations between the sex,age,school and life habits of all the subjects and the incidence of obesity were analyzed.Obese children were treated as the observation group and normal children were used as control group.The differences on fasting blood glucose,postprandial 2 h blood glucose(2 h PBG),impaired fasting glucose(IFG),glucose tolerance(IGT) and diabetes incidence were compared between the two groups. Results Of the 836 children,89 were obese,231 children were overweight,516 children had normal BMI index,and the incidence of obesity was 10.65%.The main factors affecting childhood obesity were sex(OR=6.415,95%CI:2.714~12.684,P=0.027),age(OR=9.328,95%CI:2.413~10.152,P=0.003),residence (OR=6.413,95%CI:2.748~8.503,P=0.015),breakfast location(OR=6.349,95%CI:2.692~8.419,P=0.009),weekend activity time(OR=14.928,95%CI:4.210~15.384,P<0.001).Thelevel of FPG and 2 hPBG of the observation group were significantly higher than those of the control group(P<0.05),and the incidence of IFG,IGT and diabetes in the observation group were significantly higher than those in control group(P<0.05). Conclusions The occurrence of childhood obesity is closely related to many factors in the outside world and itself.Moreover, obesity may also induce diabetes,which threatens the safety of children.Clinically,the specific factors that induce the development of childhood obesity should be controlled.thereby ensuring the healthy growth of children and improving their quality of life.

Quality of life of children aged 3 to 6 years and analysis of its influencing factors in Lu′an City,Anhui Province

PENG Chun-yan, CHU Chang-shan, LIU Cheng-xian, GUO Lei

2020, 28(2):  203-206.  DOI: 10.11852/zgetbjzz2018-1238

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Objective To understand the quality of life of preschool children in Lu′an City,Anhui Province and to analyze its influencing factors,so as to effectively guide children′s health care work. Methods A total of 2 512 children aged 3 to 6 years were enrolled in this study,and Pediatric Quality of Life Inventory (PedsQOL) 4.0 was filled out by their parents from May to July in 2016. Results 1) Univariate analysis showed the overall score of PedsQOL 4.0 and the scores of four dimensions in 5 to 6-year-old children,including physical functioning,emotional functioning,social functioning and school functioning,were significantly higher than those in 3-year-old children and 4-year-old children (P＜0.05).2) The score of PedsQOL 4.0 in healthy children was significantly higher than that in children with chronic disease,injured within two weeks (P＜0.01).3) The score of PedsQOL 4.0 in children with mother company was significantly higher than that in children without mother company(P＜0.01).4) The score of PedsQOL 4.0 in children with their own house was significantly higher than that in children dwelling in a renting house (P＜0.01).5) Multiple linear regression analysis showed that there were four significant factors influencing the four dimensions of quality of life,including whether sick/injured or not over the last two weeks,chronic disease,age and whether living with their mother or not(P＜0.05 or < 0.01). Conclusions Children′s physical condition and mother company are key factors affecting children′s quality of life.Therefore,it is of great significance to strengthen children′s health care and promote the education on parent-child relationship.

Correlation between vitamin D deficiency and platelet parametersof children in Dongguan

YI Quan-ying, ZHANG Zhen-hong, WANG Xin, XIE Gui-fang, KUANG Min, LIAO Ping

2020, 28(2):  207-210.  DOI: 10.11852/zgetbjzz2019-0681

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Objective To understand the status of vitamin D(VD) deficiency of children in Dongguan and the relationship between vitamin D deficiency and platelet parameters. Methods A retrospective survey was used, and 2 337 children aged 6 months-14 years were selected from the Department of Child Health Care.Blood routine and serum 25-hydroxyvitamin D[25-(OH)D] test have been done to analysis the incidence of vitamin D deficiency and its correlation with platelet parameters. Results The deficiency rate and insufficient rate of VD in children was 14.46% and 25.03%,respeltirely. VD deficiency rate and insufficient rate were highest in school-age group,followed by preschool group and infant group,The insufficient rate of VD in boys was lower than that in girls(P<0.05),but there was no significant difference on VD deficiency rate between different genders.With the increasing of age,25-(OH)D level and platelet(PLT) count decreased,mean platelet volume(MPV) and platelet distribution width(PDW) increased,and the difference was statistically significant(P<0.05).There were no statistically significant differences on 25-(OH)D level and platelet parameters between different genders(P>0.05);There were statistically differences on PLT count,MPV and PDWamong VD deficiency group,VD insufficient were and normal group,while the difference between VD deficiency group and VD insufficient group was not statistically significant(P>0.05) The results of multi-classification Logistic regression analysis showed that VD deficiency and insufficient were correlated with age increasing,MPV increasing and PDW decreasing. Conclusions The deficiency rate and insufficient rate of VD in children are high.With the increasing of age,the rate of VD deficiency increases gradually,so the intervention needs to be strengthened.In addition,the deficiency of VD may be correlated with the increase of MPV and the decrease of PDW.

Investigation on vitamin A level in 6 766 children aged 0 to 14 years in Fushun

XU Ying, SU Yan-qi, LANG Hui-li, ZHANG Yu-wei

2020, 28(2):  211-214.  DOI: 10.11852/zgetbjzz2019-0463

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Objective To investigate the serum level of vitamin A in children aged 0 to 14 years in Fushun city,so as to provide reasonable scientific basis for vitamin A supplementation and reference for clinical diagnosis and treatment. Methods Totally 6 766 healthy children aged 0 to 14 years,who took physical examination in Fushun Mining Bureau General Hospital,were recruited in this study from January,2015 to December,2018.Serum vitamin A level was tested by high performance liquid chromatography. Results The detection rates of subclinical vitamin A deficiency and suspicious subclinical vitamin A deficiency were 17.85% (1 208/6 766) and 43.26%(2 927/6 766).There was significantly difference on serum vitamin A level from 2015 to 2018(P＜0.05).The detection rates of suspicious subclinical vitamin A deficiency and subclinical vitamin A deficiency were 45.3% and 10.5%,respectively,significantly lower than before.There was no significant difference on serum vitamin A level between boys and girls (P＞0.05).But significant difference existed among different seasons(P＜0.05),and vitamin A level was highest in autumn.There was also significant difference on serum level of vitamin A among different age groups (P<0.05).Serum vitamin A deficiency rate gradually decreased with the increasing of age.Serum level of vitamin A in children under 1 month old and aged 1 to 6 months was significantly lower than that in other age groups.However,vitamin A level of children aged 6 to 14 years was in the normal range. Conclusions Serum vitamin A level of children aged 0 to 14 years in Fushun is still lower,especially in infants aged 0 to 6 months.Thus,more attention should be paid to the dietary structure adjustment and rational vitamin A supplementation in order to prevent vitamin A deficiency.

Study on the correlation between vitamin D level and eczema in early life of infants

DENG Sha-sha, YE Kan, SHEN Yan, SONG Yuan

2020, 28(2):  215-218.  DOI: 10.11852/zgetbjzz2018-1263

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Objective To make clear the correlation between serum 25-(OH)D₃level and the development of eczema in early life of infants,so as to provide evidence for vitamin D supplementation in early infancy. Methods Totally 605 infants who took physical examination inSuzhou Municipal Hospital were recruited in this study from November 2016 to October 2017.The baseline data were collected by questionnaires survey,and SCORAD table was used to assess the severity of eczema.The level of 25-(OH)D₃was tested by immune colloidal gold chromatography through blood samples collected from tip of small fingers. Results The average level of 25-(OH)D₃in 605 infants was (28.48±6.10)ng/ml.Totally 457 children developed eczema(75.5%),of whom 421(65.9%) children were mild,35(5.8%) children were moderate,and one(0.2%) child developed severe eczema.The levels of 25-(OH)D₃(F=21.75,P<0.001)and the incidence rate of eczema(χ²=16.01,P=0.014) in different seasons were significantly different.The level of 25-(OH)D₃ was lowest in winter,but risk of eczema was highest in winter.Moreover,the SCORAD was significantly higher in spring (Z=-3.94, P＜0.001) and winter (Z=-2.72,P=0.039) than that in summer.There was no significant difference on the incidence of eczema among different 25-(OH)D₃ level groups,but the level of 25-(OH)D₃was related to the severity of eczema.The risk of moderate to sever eczema increased with the level of 25-(OH)D₃ (OR=1.063,95% CI:1.001-1.129,P=0.045),while infants with severe eczema had lower rate of vitamin D intake behavior than infants with mild eczema(OR=0.365,95%CI:0.179-0.741,P=0.005).Allergic history of parent increased the risk for severe eczema(OR=2.857,95%CI:1.399-5.837, P=0.004). Conclusion The level of 25-(OH)D₃ is higher in infants with severe eczema,but those who take vitamin D supplementation are less.Further researches are warranted to explore the underlying reasons for this discrepancy.

Study on 25-hydroxy vitamin D level in short stature children with different growth hormone secretion status

CHEN Jin, TAO Lin-hui, LIN Ai-lin, LIN Yun

2020, 28(2):  219-221.  DOI: 10.11852/zgetbjzz2019-0570

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Objective To study the levels of 25-hydroxy vitamin D[25-(OH)D] in short stature children with different growth hormone secretion status, So as to provide theoretical basis for clinicl evaluation. Method Totally 101 children with short stature treated in the department of pediatrics of Taizhou Municiple Hospital from June 2017 to December 2018 were enrolled in this study.and were divided into completely growth hormone deficiency(CGHD)group,part growth hormone deficiency(PGHD)group and idiopathic short stature(ISS)group according to the peak value of growth hormone drug stimulation test.Meanwhile,20 children of normal height were randomly selected as control group.Serum25-(OH)D levels of each group were determined by chemiluminescence. Result Among the 101 children,there were 26 cases in the CGHD group,37 cases in the PGHD group and 38 cases in the ISS group.Levels of 25-(OH)D in the three groups were all significantly lower than those in normal group(P<0.01),and the levels of 25-(OH)D in the CGHD group were significantly lower than those in the PGHD and ISS groups(P<0.05).The incidence rates of vitamin D deficiency and insufficiency in the CGHD,PGHD and ISS groups were higher thanthose in the normal group (P<0.01),and there was no significant difference among the CGHD,PGHD and ISS three groups (P>0.05). Conclusions The level of 25-(OH)D in short stature children with different growth hormone secretion status decreases in different degrees,especially in CGHD group.

Study on the correlation between eating behaviors of preschoolers and nutrition-related knowledge,attitude and practice of preschool educators

YOU Zi-wei, WEN Min, HE Chu-qi, ZHAO Yu-di, ZHOU Wen-jing, SU Yin-hua

2020, 28(2):  222-226.  DOI: 10.11852/zgetbjzz2019-0640

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Objective To explore the correlation between eating behaviors of preschoolers and nutrition-related knowledge,attitudes and practices of preschool educators,so as to provide reference for the early intervention on preschoolers′ eating behaviors. Methods Totally 230 preschoolers from a public kindergarten and a private kindergarten in Hengyang were selected to investigate the eating behaviors of preschoolers and nutrition-related knowledge,attitude,and practice of preschool educators from December 2018 to January 2019.One-way ANOVA,independent sample t-test and multivariate stepwise regression analysis were used to explore the relationship between preschoolers′ eating behaviors and nutrition-related knowledge,attitude,and practice of preschool educators. Results The top three eating behaviors of preschoolers were initiative eating behavior,food fussiness and unhealthy eating habits.There were significant differences on initiative eating behaviors among children of different ages (F=5.394,P＜0.05).Unhealthy eating habits(b=-0.866) and initiative eating behavior(b=1.262) showed negative and positive correlation with preschoolers′ average age in one class,respectively(P＜0.05).External eating(b=0.569) and emotional eating(b=0.527) were positively correlated with nutritional practices of preschool educators (b=0.638,P＜0.05).Preschoolers′ eating behaviors were positively correlated with nutrition-related knowledge,attitude,and practice of preschool educators (P＜0.05). Conclusions Eating behavior problems are common among preschoolers,which could be influenced by nutrition-related knowledge,attitude,and practice of preschool educators.Nutrition training should be conducted among preschool educators and the long-term supervision and feedback mechanism of"homes" education should be established.