Table of Content

10 September 2022, Volume 30 Issue 9

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Professional Forum

Molecular genetic characteristics of growth plate regulation and physical development disorder

HE Xi-yu, HE Xiu-mei

2022, 30(9):  929-932.  DOI: 10.11852/zgetbjzz2022-0852

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The linear growth of children's physique is realized by the proliferation and differentiation of growth plate chondrocytes. The function of growth plate chondrocytes is controlled by intracellular signal pathway, extracellular matrix, growth hormone-insulin-like growth factor axis, secretion factors beside growth plate and external factors (nutritional intake, inflammatory factors). Adult height has great heterogeneity, which is mainly determined by genetic factors and involves multiple functional genes. Growth-related gene variation leads to abnormal differentiation and proliferation of growth plate chondrocytes, which is the genetic and pathological mechanism of children's growth disorders, showing a wide spectrum of clinical manifestations. Understanding the genetic causes and mechanisms of physical development disorders can provide help for precise treatment.

Clinical and molecular genetic study of genetic skeletal disorders in children

CHENG Sheng-quan

2022, 30(9):  933-940.  DOI: 10.11852/zgetbjzz2022-0954

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Genetic skeletal disorders are a group of extremely complex diseases that affect bone development. They can occur in any period from fetal to adult. A total of 461 different skeletal diseases are classified into 42 groups based on clinical, radiographic, and/or molecular phenotypes by the Nosology Committee of the International Skeletal Dysplasia Society in 2019.Pathogenic variants affecting 437 different genes have been found in these disorders. Achondroplasia is the most common genetic bone disease with asymmetrical short stature as the main manifestation, and FGFR3 is its main causal gene. Mucopolysaccharidosis is a group of lysosomal storage diseases caused by the complete degradation of acidic mucopolysaccharides due to enzyme defects. According to the enzyme defects, it can be divided into 7 types. In addition to causing multiplex dysostosis, such diseases often involve multiple systems and organs. Osteogenesis imperfecta and Hypophosphatasia are hereditary bone diseases that affect bone mineral density in children. The former is divided intoⅠto ⅩⅥ types according to genotype and clinical manifestations, and the latter is caused by tissue nonspecific alkaline phosphatase (TNSALP) gene mutation. Pseudoachondroplasia is a genetic bone disease characterized by Multiple epiphyseal dysplasia and short stature. Heterozygous mutations in the cartilage oligomeric protein gene are the only reported pathogenic genes related to its occurrence. Chondrodysplasia punctata is characterized by irregular calcium deposition of epiphyseal cartilage, and it is divided into 5 types according to the inheritance patterns and the severity of clinical phenotype.In a word, the overall incidence of hereditary/genetic skeletal disorders is not low. Due to the extensive development of molecular genetic testing methods, novel pathogenic genetic variants are still being discovered. Only through the profound study of such diseases can new gene therapeutics be found. Yet much more work remains to be done.

Original Articles

Association between maternal intestinal microbiota in the third trimester of pregnancy and infant food allergy

WANG Shuo, LI Xin-yue, WEI Yuan, LIU Lu-yan, LI Zai-ling, ZHANG Hua

2022, 30(9):  941-946.  DOI: 10.11852/zgetbjzz2021-1749

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Objective To investigate the relationship between maternal intestinal microbiota in the third trimester of pregnancy and infant food allergy, so as to provide new ideas for the association between microbial and food allergy. Methods A nested case-control study was adopted. Healthy pregnant women who had regular prenatal check-ups at Peking University Third Hospital from February 2018 to May 2020 and their newborns were selected to establish a maternal and infant cohort, of whom 135 mother-infant pairs met the criteria of this study and were followed up regularly. According to whether the infants had food allergy within 1 year old, 24 pairs were divided in the food allergy (FA) group and 44 pairs in the healthy control (HC) group. Fecal samples were collected from the mothers within 2 weeks before delivery and from the infants at 5 different time points after birth. These samples were analyzed by 16S rDNA sequencing. Results There was no significant difference in α diversity and β diversity of intestinal microbiota in the third trimester of pregnancy between the FA group and the HC group (P>0.05). Compared with the FA group, the relative abundance of Holdemania in maternal intestinal flora in the HC group was significantly increased(Z＝-2.103, P=0.035), while the relative abundance of Clostridium ⅪⅤa (Z＝-2.483, P=0.013), Clostridium Ⅳ (Z＝-2.154, P=0.031), Lactococcus (Z＝-2.147, P=0.032) and Parvimonas (Z＝-2.377, P=0.017) was significantly decreased. Among the intestinal microbiota of infants, there was no statistical significance in the difference between the main microbiota and the differential microbiota of maternal intestinal microbiota in late pregnancy at the same time point (P>0.05). Conclusions The relative abundance level of Holdemania in maternal intestinal microbiota in the third trimester of pregnancy is a potential predictor of food allergy in offspring, but is not associated with the relative abundance of Holdemania in offspring intestinal microbiota. Further studies on the mechanism of maternal intestinal microbiota in late pregnancy affecting offspring food allergy are warranted.

Correlation between maternal depression and 3-month-old infants development status

ZHANG Xiao-tian, ZHANG Yue, DENG Liang-qiong, ZHAO Rong-rong, LI Rong, ZHANG Feng-hua, XU Tao

2022, 30(9):  947-951.  DOI: 10.11852/zgetbjzz2022-0511

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Objective To investigate the association between postpartum depression in mothers of 3-month-old infants and infant developmental levels, in order to provide evidence for improve family nurturing environment and promote early childhood development. Methods Totally 415 mothers and infants were recruited in this cross-sectional study from four maternal and child health care institutions, including Chongqing Maternal and Child Health Hospital, Liuzhou Maternal and Child Health Hospital, Maanshan Maternal and Child Health Hospital and Qingdao Maternal and Child Health Hospital from January to December 2019. Maternal depression was assessed using the Edinburgh Postpartum Depression Scale, and the infant's development was assessed using the Chinese version of the Age Development and Developmental Progress Questionnaire Questionnaire for 3-month-old infants. Results A total of 112 mothers were detected with postpartum depression (27.0%). For infants whose mothers were detected with postpartum depression, the detection rates of abnormal development in communication (CM), gross motor (GM), fine motor (FM), problem solving (CG), personal social (PS) (31.3%, 25.9%, 28.6%, 31.3%, 33.0%) were higher than those whose mothers had no postpartum depression(18.8%, 10.6%, 23.4%, 20.8%, 25.1%), and differences were significant in CM, GM and CG domains(χ²=7.332, 15.331, 4.958, P＜0.05). After controlling for important confounding factors, maternal depression was found to be an independent risk factor for the infant's gross motor development (aOR=2.293, 95%CI:1.240 - 4.243). Conclusions Depressed mood of mothers of 3-month-old infants will increase the possibility of abnormal development of gross motor in infants. Active intervention measures should be taken after delivery to reduce the occurrence of maternal depression and to promote the early healthy development of infant neuropsychological behavior.

Relationship between rs2241423 polymorphism of MAP2K5 gene and intervention effect of childhood obesity

XIAO Wu-cai, LIU Zheng, CHEN Jing, WANG Hui, SONG Jie-yun, ZHOU Shuang, GAO Ai-yu, ZHANG Fang, WANG Hai-jun

2022, 30(9):  952-955.  DOI: 10.11852/zgetbjzz2022-0489

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Objective To explore the relationship between rs2241423 polymorphism of MAP2K5 gene and the intervention effect of childhood obesity. Methods In a cluster randomized controlled trial to study the effect of intervention on childhood obesity in China, 382 children aged 8 to 10 in Beijing were selected as subjects.Saliva was collected to detect rs2241423 polymorphism of MAP2K5 gene, and the interaction between gene and intervention on childhood obesity was analyzed. Results There was an interaction between rs2241423 polymorphism of MAP2K5 gene and intervention on the changes of obesity-related indexes such as BMI, BMI Z-score, waist-hip ratio, and body weight in children (P_{for interaction}=0.034, 0.007, 0.039, 0.036). Compared with the control group, children in the intervention groupcarrying each additional G allele at MAP2K5 rs2241423 locus, BMI decreased by -0.36 kg/m² (95%CI:-0.69 to -0.03 kg/m², P=0.034), BMI Z-score decreased by -0.20 (95%CI:-0.35 to -0.06, P=0.007), waist-hip ratio decreased by -0.01 (95%CI:-0.02 to -0.001, P=0.039), and body weight decreased by -0.84 kg (95%CI:-1.63 to -0.06, P = 0.036), respectively. Conclusion Children who carried the G allele at rs2241423 of MAP2K5 gene are more sensitive to intervention and showed more improvement in BMI and BMI Z-score, waist-hip ratio, and body weight after intervention.

Past changes and future trend of low weight rate of children under 5 years old in Haikou

HUANG Li-hong, SHI Hui-ling, LIN Yao, FU Li-ying, LIU Ying, SHI Liang-sun

2022, 30(9):  956-959.  DOI: 10.11852/zgetbjzz2022-0512

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Objective To analyze the change trend of low weight rate of children under 5 years old in Haikou, and to predict the incidence rate of the low birth weight in the next few years, so as to provide scientific basis for relevant departments to take health care measures for children under 5 years old. Methods Joinpoint regression model was used to analyze the trend of low body weight incidence rate in children under 5 years of age in Haikou from 2010to 2020. Thile the incidence rate of low weight children under 5 years old in Haikou from 2020 to 2025 was predicted by Grey Model(GM) (1,1). Results In 2010—2020 years, the incidence of low weight children in Haikou ranged from 1.42% to 3.42%, showing an increasing trend[APC＝5.54(95%CI:1.6~9.7,P=0.011)]. The incidence rate of low weight in Meilan and Qiongshan district was also increasing during the past years, while it increased first and then decreased in Longhua district, and the trend of incidence rate of low weight is not clear in Xiuying district. The results of GM(1,1) model showed that the incidence rate of low weight among children under 5 years old in Haikou in the next 5 years was 3.25%, 3.37%, 3.50%, 3.62% and 3.75%, respectively. Conclusions The change trends of the prevalence rates of low body weight of children under 5 years old are different in all administrative regions. It is predicted that the incidence of low body weight of children under 5 years old in Haikou City will be on the rise in the next few years. Relevant departments are suggested taking corresponding measures to prevent low body weight in children.

Status of static behavior and its association with overweight and obesity in adolescents from agricultural and pastoral areas of Xinjiang

CHEN Xing-lei, GAO Feng-xia, LIU Feng

2022, 30(9):  960-964.  DOI: 10.11852/zgetbjzz2022-0338

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Objective To understand the status of static behavior for adolescents in agricultural and pastoral areas of Xinjiang, and to evaluate its relationship with overweight and obesity, thus providing references for the intervention of adolescents with overweight and obesity in agricultural and pastoral areas of Xinjiang. Methods From September to November 2019, a stratified cluster sampling method was used to select 1 482 middle school students in agricultural and pastoral areas of Xinjiang, and static behavior, height and weight were tested. Logistic regression analysis and χ² test were used to process the data. Results The proportions of thin, normal, overweight, and obese adolescents in agricultural and pastoral areas of Xinjiang were 18.96%, 71.05% and 9.99%, respectively. There were significant differences in the detection rates of different body types in terms of school stage, ethnicity and age(χ²=8.28, 9.14, 11.52, P<0.05 or <0.01). The proportions of adolescents with their homework time>2 h/d, online time>1 h/d, reading time >2 h/d, commuting time >0.5 h/d, game time >1 h/d, TV time >1 h/d in Xinjiang agricultural and pastoral areas were 88.39%, 81.85%, 87.65%, 83.94%, 84.41% and 84.68%, respectively. There were statistically significant differences in the detection rates of static behaviors among different ethnic groups in homework time, online time, reading time, commuting time, game time and TV time(χ²=35.96, 12.70, 95.35, 38.59, 51.49, 77.02, P<0.05 or <0.01). Logistic regression analysis showed that adolescents with their online time>1 h/d(OR=1.25, 95%CI:1.02 - 1.53), reading time >2 h/d(OR=1.08, 95%CI:1.02 - 1.38), game time >1 h/d(OR=1.37, 95%CI:1.18 - 1.48),TV time >1 h/d (OR=1.19, 95%CI:1.13 - 1.26) had a higher risk of overweight and obesity(P<0.05). Conclusions There is a positive correlation between static behavior and the occurrence of overweight and obesity among Xinjiang adolescents in agricultural and pastoral areas.Reducing static behavior will positively help reduce the occurrence of overweight and obesity.

Mediating and moderating effects of appetite traits and temperament of infants and young children on the association between positive feeding behaviors and body mass index

LIU Yan, LI Zhi-hui, KONG Yan, YIN Chun-lan, YU Gui-ling

2022, 30(9):  965-969.  DOI: 10.11852/zgetbjzz2021-1742

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Objective To explore the mediating effect of infants and young children's appetite traits (food approach, food avoidance) between caregivers' positive feeding behavior (encouraging healthy diet, monitoring and autonomy support) and body mass index(BMI) of infants and young children, as well as the moderating effect of infants and young children's temperament in the first of the pathway, and to provide reference for the development of intervention strategies to improve appetite characteristics and BMI of infants. Method A total of 322 caregivers were selected from the Child Health Care Department of a grade A tertiary hospital in Qingdao city in May 2021, and were surveyed by Comprehensive Feeding Practice Questionnaire, Infants and Young Children's Feeding Behavior Questionnaire, Feeding Strategy Questionnaire, Baby Eating Behavior Questionnaire, Children's Eating Behavior Questionnaire, Infant Behavior Questionnaire and Children's Behavior Questionnaire. Results Only the correlations of food approach, autonomy support and infant and young children's BMI were significant. Detailed, food approach was negatively correlated with autonomy support(r＝-0.769, P＜0.01), positively correlated with infant and young children's BMI(r=0.680, P＜0.01), and autonomy support was negatively correlated with infant and young children's BMI(r＝-0.548, P＜0.01). The direct effect of autonomy support on infant and young children's BMI was not significant (β＝-0.082, P>0.05), but the indirect effect of autonomy support on infant and young children's BMI was -0.416 mainly through food approach. Among the different temperament types of infants and young children, only effortful control moderated the relationship between autonomy support and food approach (△R²=0.031,P<0.01). Specifically, compared with individual with low effortful control, the influence of autonomy support on food approach was less in those with high effortful control autonomy support. Conclusions Food approach plays a complete mediating role between autonomy support and BMI of infants and young children, and effort control plays a moderating role in the relationship between autonomy support and food approach. Therefore, in order to improve BMI of infants and young children, appetite traits of infants and young children should be cultivated at beginning. Medical staff are suggested to provide feeding behavior guidance for caregivers based on effortful control level of infants and young children to improve the appetite traits and BMI of infants and young children.

Clinical study on treatment of obese children with nonalcoholic fatty liver disease by vitamin D

JIANG Xue, GAO Jian, HONG Ze, ZHOU Wen-di

2022, 30(9):  970-974.  DOI: 10.11852/zgetbjzz2022-0367

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Objective To analyze the level of serum 25 hydroxyvitamin D[25 (OH)D] in obese children with non-alcoholic fatty liver disease (NAFLD) and the effect of vitamin D (VD) supplements on NAFLD, and to provide a clinical basis for VD in the treatment of children with NAFLD. Methods 1) From January 2020 to August 2021, 102 obese children aged 6 to 14 years were enrolled in this study and were divided into two groups according to liver ultrasound results:obesity with NAFLD group (n=58) and obesity without NAFLD group (n=44). Meanwhile, 40 healthy children were included as controls. The differences of serum 25(OH)D, lipid, transaminase and homoeostasis model assessment of insulin resistance (HOMA-IR) among the three groups were compared. 2) Fifty eight obese children with NAFLD were randomly divided into VD intervention group and VD non-intervention group.Children of both groups were given diet and exercise guidance, and the VD intervention group was supplemented with calcitriol 800 U/d for 16 weeks additionally. The changes of parameters were compared. Results 1) Serum 25(OH)D level of children in obesity with NAFLD group [(20.94±6.88) ng/ml] was significantly lower than that in obesity without NAFLD group [(24.31±7.69) ng/ml, P<0.05] and healthy control group [(29.19±5.44) ng/ml, P<0.01]. Serum 25(OH)D level was negatively correlated with body mass index (BMI) and HOMA-IR (r=－0.37,－0.71, P<0.01). 2) The detection rate of VD deficiency and insufficiency in obese children with NAFLD (84.48%) was higher than that in obese children without NAFLD (68.18%) and healthy control group (35.00%), and the difference was significant (χ²=25.85, P<0.01). 3) Before intervention, there was no significant difference in parameters between VD intervention group and VD non-intervention group. After 16-week intervention, compared with the VD non-intervention group, serum 25(OH)D level was significantly higher (t=2.22, P<0.05) while the levels of serum lipid, transaminase, BMI and HOMA-IR were significantly lower in VD intervention group (P<0.05). The hepatic pathology also improved after intervention. Conclusions VD deficiency is common in obese children with NAFLD. VD supplementation can effectively improve serum 25(OH)D level, attenuate liver function, hyperlipidemia, insulin resistance and fatty liver.

Basic Experimental Articles

Transcriptomic alterations in the hippocampus of offspring rats with depression-like behavior induced by prenatal stress

HE Wei, SUN Hong-li, HUANG Hui-mei, LI Qing-hong

2022, 30(9):  975-980.  DOI: 10.11852/zgetbjzz2022-0419

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Objective To identify differentially expressed genes (DEGs) and their expression patterns and regulatory mechanisms in the hippocampus of male rat offsprings with depression-like behavior induced by prenatal stress (PS). Methods SD rats were selected to establish a chronic restrained stress model from March to October 2022. Sucrose preference test was implemented for measurement of susceptibility to prenatal stress in offsprings (PS-S).Open field test, forced swimming test, tail hanging test were used to verify the validity of animal model and the efficacy of the screening method, respectively. High-throughput sequencing-based transcriptomic approaches were applied as powerful tools to identify and characterize gene regulatory networks in hippocampus of PS-S offspring rats in this study. After data processing and quality control, bioinformatics analysis was performed to screen and classify DEGs. Results Totally 486 DEGs were identified between PS-S group and control group, of which 230 were up-regulated genes enriched in 20 GO terms, while 256 were down-regulated genes enriched in 17 GO terms. Go terms, such as "gas transport", "hemoglobin complex", "oxygen transport", "oxygen carrier activity", were ranked highest in DEGs. Seven GO terms including "glutamate 5-kinase activity","response to oxygen-containing compound" and "retinol metabolic process" were significantly enriched both in up- and down-regulated genes. KEGG pathway analysis showed that DEGs were mainly enriched in signal pathway such as "tryptophan metabolism", "phagosome", "protein digestion and absorption", "neuroactive ligand-receptor interaction" and "fructose and mannose metabolism". These findings suggested that significant differences in gene expression of TTR, CRABP2, FABP5, AANAT and TPH1 might played a critical role in PS induced depressive-like behavior in offspring rats. Conclusion DEGs involved in retinol metabolic process, retinoid and tryptophan metabolism pathways may contribute to the pathogenesis of prenatal stress-induced depression-related behavioral alterations in rat models.

Review

Novel regulators of growth plate development

ZHANG Su-ping, CHEN Hong, CHEN Rui-min

2022, 30(9):  981-984.  DOI: 10.11852/zgetbjzz2022-0553

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The metaphyseal growth plate of long bones is the structural basis for linear growth and is a dynamic, highly differentiated cartilaginous structure. The proliferation, differentiation, hypertrophy and extracellular matrix formation of chondrocytes are the keys to growth plate development and linear growth. Abnormal growth plate development will lead to short stature, and its mechanism is complex. A variety of regulators regulate growth plate development through different mechanisms. In addition to the classic genes SOX9, ACAN, and RUNX2, in recent years, with the development of genetic testing technology, more pathogenic genes have been discovered. The new regulators are involved in a variety of biological processes, including the extracellular skeleton, intracellular signal transduction, ribosome transcriptional processing, protein ubiquitination modification, and epigenetic modification, enriching the gene regulatory network of short stature. This article reviews the roles of some novel regulatory factors in growth plate development.

Research progress on effects of intrauterine glucose exposure during pregnancy on offspring organ function development

XU Qin-wen, XU Xu-juan, YU Jie, MAO Xin-xin

2022, 30(9):  985-988.  DOI: 10.11852/zgetbjzz2022-0660

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With the increase in the incidence of pregestational diabetes and gestational diabetes, more and more offspring are exposed to intrauterine hyperglycemia, resulting in adverse pregnancy outcomes and possibly negative effects on specific organ functions and long-term organ development. However, there are still relatively few studies on this topic.This article summarizes the adverse effects of intrauterine blood glucose exposure on offspring from the aspects of eye,ear,teeth and genitalia function development,and the development of such organs should be paid attention to and advance intervention measures should be formulated.

Research progress on the evaluation of parental feeding practices in China and abroad

WANG Chang, TONG Lian

2022, 30(9):  989-993.  DOI: 10.11852/zgetbjzz2021-1170

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The most important phase of life is the first few years. Nutritional status in childhood will affect the physical and mental health of the whole life. Nutritional intake is closely related to dietary behavior, and the dietary behavior of children is mainly affected by the feeding practices of their parents. This study reviews the psychometric characteristics and the application of the existing evaluation methods and scales on parents' feeding practices for young children in China and abroad.

Research progress of ghrelin in maintaining metabolism and energy homeostasis

ZHANG Li, LI Dong

2022, 30(9):  994-999.  DOI: 10.11852/zgetbjzz2022-0327

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Ghrelin is a 28-amino acid polypeptide discovered in 1999. It is secreted by X/ A-like cells in the stomach and promotes the release of growth hormone. It is also an appetite stimulating peptide. Ghrelin acts on the Ghrelin-GHS-R axis to maintain metabolism and energy homeostasis. In this review, a series of studies and advances related to ghrelin physiology, pathophysiology, animal experiments and clinical practice are combed. The role of ghrelin in maintaining metabolism and energy homeostasis in the body is introduced, and the possible reasons for the controversial results are analyzed. The importance of detecting method in determining the level and ratio of acyl ghrelin anddes-acylated ghrelin in circulation is emphasized, suggesting that ghrelin has a positive effect on the prevention and treatment of various diseases.

Clinical Research

Prevalence of abdominal obesity among children and adolescents aged 7 to 15 years in Zhengzhou

YAN Ming-ming, LUO Shu-ying, ZHANG Yao-dong

2022, 30(9):  1000-1004.  DOI: 10.11852/zgetbjzz2021-1786

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Objective To investigate the prevalence of abdominal obesity among primary and secondary school students in Zhengzhou, so as to provide reference for the prevention and control of overweight and obesity in urban students. Methods A stratified cluster sampling method was performed to select 6 859 students aged 7 - 15 years in Zhengzhou in 2019. Questionnaire survey and physical examination were conducted among these children. Body mass index(BMI), waist circumference(WC) and waist-to-height ratio(WHtR) were used to analyze the prevalence of overweight, obesity and abdominal obesity among primary and secondary school students. The t test, completely random design χ² test, paired χ² test and weighted Kappa consistency tests were performed with the R 4.0.3 software. Results The overall detection rate of overweight and obesity based on the BMI standard was 14.4% and 10.3%, respectively. The detection rate of abdominal obesity based on WC and WHtR standards was 19.4% and 14.3%, respectively. The detection rates of obesity and abdominal obesity in boys were higher than that in girls under the three criteria(P<0.01). The detection rate of abdominal obesity in students aged 10 - 15 years were significantly higher than that in students aged 7 - 9 years(P<0.01). For the screening of abdominal obesity in primary and middle school students, the Kappa value of WC standard vs. WHtR standard was 0.73, among which, the Kappa values of boys aged 7 - 9 years, 10 - 12 years and 13 - 15 years was 0.84, 0.85 and 0.76, respectively, showing a high degree of consistency. Conclusions The prevalence of overweight, obesity and abdominal obesity among 7- to 15-year-old students in Zhengzhou is not optimistic, especially for boys and primary school students. Comprehensive intervention should be carried out as soon as possible.

Body composition analysis and its correlation with serum uric acid in children aged 8 - 11 years in Taiyuan

ZHANG Yan

2022, 30(9):  1005-1009.  DOI: 10.11852/zgetbjzz2022-0447

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Objective To investigate body composition and serum uric acid level in children aged 8 to 11 years, as well as the differences among different age, sex and body mass index (BMI) groups, and to analyze the correlation between serum uric acid level and various indicators of body composition. Methods From April to December 2020, 306 children aged 8 to 11 who took physical examination in Nutrition Department of Taiyuan Maternal and Child Health Hospital were selected as study subjects. Height and weight of the participants were measured, body composition and serum uric acid level were tested. Then the correlation between body composition and serum uric acid level was analyzed. Results Boys had higher BMI than girls (t=2.253, P<0.05), but there was no significant difference in other body composition indicators between boys and girls (P＞0.05). The consistency of BMI and PBF when diagnosing obesity was higher in girls (Kappa=0.642), which was lower in boys (Kappa=0.438). The consistency of BMI and PBF was highest in 9-year-old boys group (Kappa=0.669) and 11-year-old girls group (Kappa=0.761). Person correlation analysis showed that serum uric acid level was positively correlated with all indicators of body composition. BMI had the most significant correlation with blood uric acid among boys(r=0.579, P<0.001). Among girls, BMI was the highly associated with serum uric acid(r=0.706, P<0.001), followed by the body fat content(r=0.705, P<0.001).Mutivariate linear regression analysis showed that BMI had the greatest effect on the serum uric acid level among all body composition indicators for children aged 8 to 11 years(P<0.05). Conclusions The physical condition of children aged 8 to 11 years in Taiyuan is close to that of the whole country. There is a high consistency between PBF and BMI when screening for obesity in 8- to 11-year-old children. Body composition indicators are related to serum uric acid level, so it is essential to pay more attention to the prevention of early hyperuricemia for children with high BMI.

Current situation and influencing factors of urban preschool children's neglect in Nantong city

DAI Qian-qian, LOU Hai-qin, LIU Wei-wei, CHEN Si-han, SHAN Ling-ling, XU Zhan-bin, ZHANG Hui-ying

2022, 30(9):  1010-1013.  DOI: 10.11852/zgetbjzz2021-1218

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Objective To describe the current situation of urban preschool children's neglect in Nantong city, and to explore its influencing factors, so as to provide theoretical bases for the prevention and treatment of child neglect in this region. Methods Using stratified random cluster sampling method, 9 kindergartens in the urban area of Nantong were selected in January 2021.Totally 1 141 children's parents were investigated with Chinese Urban Children Aged 3 — 6 Years Neglect Evaluation Norm Scale. Results The neglect rate of preschool children in Nantong city was 28.6%, and the neglect degree was 40.21±6.67. The neglect rates of boys and girls were 28.0% and 29.2% respectively, and the neglect degrees were 40.29 ± 6.54 and 40.13 ± 6.80 respectively, the differences were not statistically significant(P＞0.05). There were no significant differences in neglect rate, neglect degree among different age groups(P＞0.05). The neglect rate and neglect degree were higher in non-only child than those of only child(χ²=6.209, t=3.947), lower in higher family monthly income(χ²=28.487, F=25.453), lower in medium socioeconomic status group(χ²=11.595, F=17.215), lower in children whose main caregivers were parents than those of children whose main caregivers grandparents(χ²=19.269, F=5.402), the differences were all statistically significant(P＜0.05). Multivariate Logistic regression analysis showed that the risk of neglect in non-only children were 1.338 times higher than only children, the risk of neglect with family monthly income < 8 000 RMB and 8 000 - 12 000 RMB were 2.183 times and 2.016 times respectively higher than that of children with family monthly income>12 000 RMB(P＜0.05). The risk of neglect in children whose main caregivers were grandparents or maternal grandparents were 1.979 times higher than that in childrenwhose parents are the main caregivers(P＜0.05). Conclusion The neglect of preschool children in Nantong city is common, and the influencing factors are complex, which needs to be paid more attention and be improved by effective measures.

Development and adaptive behavior in children with autism spectrum disorder

YANG YU-Lin, DAI Ying

2022, 30(9):  1014-1018.  DOI: 10.11852/zgetbjzz2021-1435

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Objective To investigate the changes of development and adaptive behavior in children with autism spectrum disorder (ASD) in different years, so as to provide theoretical basis for early identification, diagnosis and rehabilitation training of ASD. Methods The assessment results by Gesell Development Scale and S-M scores of ASD children aged 1 to 5 who were diagnosed for the first time in the Department of Child Health Care of Children's Hospital of Chongqing Medical University in 2015, 2017 and 2019 were retrospectively analyzed. Results There were no significant differences in total development quotient (DQ) of GDS and S-M scores of ASD children in the year 2015, 2017 and 2019 (F=0.920, 0.495,P>0.05). Children with ASD in different years had developmental delay(DD) on different levels, and there were significant differences in scores of DQ in gross motor area (F=9.683, P< 0.05), distribution of DQ in gross motor area and fine motor area (χ²＝22.583, 11.596, P<0.05). The DQ scores of fine motor and social behavior area of girls with ASD were higher than those of boys (Z＝2.023,2.837, P<0.05). There were significant differences in DQ and S-M score in ASD children at different age groups (H=56.557, 185.824, 37.935, 8.038, 68.752, 32.657, P<0.05). Conclusions No significant changes are seen in the level of DD and adaptive behavior for ASD children in recent five years. There are gender and age differences in the development level and social living skills of ASD children, and the retardation of gross motor development has become more and more obvious in recent years. Standardized assessment of development and adaptive behavior should be conducted as soon as possible for ASD children, and the results should be interpreted according to the gender and age of children in order to give comprehensive assessment and precise clinical intervention.

Emotional and behavior problems and dietary behavior problems in preschool children with autism spectrum disorder

WANG An-yun, LIU Zhi-chen, FAN Jing-yi

2022, 30(9):  1019-1023.  DOI: 10.11852/zgetbjzz2021-0671

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Objective To investigate emotional and behavior problems and dietary behavior problems in preschool children with autism spectrum disorders (ASD), and to explore the relationship between them. Methods From August 2020 to April 2021, 150 preschool ASD children were evaluated by parent version of Strengths and Difficulties Questionnaire (SDQ) and Preschoolers' Eating Behavior Questionnaire (PEBQ) to know about their emotional and behavioral problems and dietary behavior problems. The relationship between emotional and behavior problems and dietary behavior problems was analyzed by Logistic regression analysis. Results In terms of the common emotional and behavior problems, the detection rates of peer interaction problems, social behavioral problems and hyperactivity were 86.0%, 72.7% and 51.3%, respectively. The rate of common dietary behavior problems was as follows:lack of the active eating ability (83.3%), picky eating (57.3%), emotional eating (42.0%).Conduct problem was a risk factor for food response problem (OR=3.48, 95%CI:1.04 - 11.63) and emotional eating (OR=6.11, 95%CI=1.56 - 23.86). Social behavioral problems were risk factors for picky eating (OR=3.07,95%CI:1.40 - 6.74)and lack of eating initiative(OR=5.32,95%CI:1.25 - 22.70). Hyperactivity was the risk factor for picky eating (OR=3.40,95%CI:1.65 - 7.00) and bad eating habits(OR=4.29,95%CI:1.55 - 11.88). Conclusions Emotional and behavior problems and dietary behavior problems of preschool ASD children are relatively serious. Emotional and behavior problems are associated with picky eating, lack of the active eating ability, food response problems, bad eating habits and emotional eating in preschool ASD children.

Clinical application of a screening tool for feeding/swallowing difficulties and malnutrition in children with cerebral palsy

SHI Lei, TONG Guang-lei, LI Hong, CHEN Jing, WU Shan-shan

2022, 30(9):  1024-1028.  DOI: 10.11852/zgetbjzz2022-0432

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Objective To verify the effectiveness of a screening tool for feeding/swallowing difficulties and malnutrition in children with cerebral palsy (hereafter referred to as the screening tool) in clinical application. Methods A total of 94 children with cerebral palsy, who were hospitalized in the Department of Rehabilitation Medicine of Anhui Provincial Children's Hospital from January to October 2021, were enrolled in this study. The screening tool, Z-scores, Subjective Global Nutrition Assessment (SGNA), and Eating and Drinking Ability Classification System (EDACS) were used for evaluation. The cut-off value of the screening tool was re-determined, then the consistency and validity indicators were calculated. Results The cut-off value of evaluating malnutrition and feeding/swallowing difficulties was 2 and 3, respectively. The Kappa coefficients of the screening tool with traditional Z-scores classification, Z-scores classification in the 2014 American Society for Enteral and Parenteral Nutrition (ASPEN) consensus statement, SGNA, and EDACS were 0.349 (95%CI:0.177 - 0.521), 0.466 (95%CI:0.288 - 0.644), 0.574 (95%CI:0.409 - 0.739) and 0.747 (95%CI:0.582 - 0.912), respectively. When taking traditional Z-scores classification as reference, the sensitivity and specificity of the screening tool were 80.0% and 63.8%, respectively. When taking ASPEN Z-scores as reference, the sensitivity and specificity of the screening tool were 73.8% and 73.1%, respectively. When taking SGNA as reference, the sensitivity and specificity of the screening tool were 76.6% and 80.9%, respectively. When taking EDACS as reference, the sensitivity and specificity of the screening tool were 72.7% and 97.2%, respectively. The detection rate of severe malnutrition and severe eating disorders screened by ≥3 was 100%. Conclusion The screening tool for feeding/swallowing difficulties and malnutrition can be used to identify nutritional and swallowing problems in children with cerebral palsy, which is helpful for avoiding missed diagnosis of severe malnutrition and severe eating disorders.

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Environmental hormone exposure of precocious girls in Fuyang, Anhui province

BAI Xiang-meng, MAO Guo-shun, LI Li, YU Bing-jie, LU Wen-qing, FAN Zheng-jun, LI Yan

2022, 30(9):  1029-1032.  DOI: 10.11852/zgetbjzz2022-0482

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Objective To investigate the possible role of common environmental hormones in the pathogenesis mechanism of precocious puberty of girls, in order to provide data for further researches on children's exposure to environmental hormones in Fuyang area. Methods Precocious puberty girls visited in Fuyang People's Hospital were randomly selected into this study from October 2020 to April 2021, including central precocious puberty(CPP) group (n=30), peripheral precocious puberty (PPP) group (n=30).Meanwhile, 23 cases healthy girls were selected into the normal control group. A questionnaire survey was conducted on the related ways of environmental hormone exposure. The exposure levels of 15 environmental hormones in urine samples of girls among the three groups were determined by ULTRA performance liquid chromatography-tandem mass spectrometry, and the serum levels of basic sex hormones and thyroid hormones in CPP and PPP groups were determined. Then the exposure levels of environmental hormones in urine samples of girls were analyzed among the three groups. Results There were significance differences in the use of plastic cups,the levels of MEHP and MBP in urine samples among girls in the three groups (χ²=8.111, F=3.741,5.672, P＜0.05). There were no significant differences in the exposure levels of MEHP and MBP in urine between CPP group and normal group (P > 0.05), but significant differences existed in the distribution of exposure levels of MEHP and MBP in urine between PPP and CPP groups, PPP and normal groups (P <0.05). The distribution of MEHP in PPP groups was positively correlated with E2 level (r=0.688, P< 0.05). Conclusions Frequent use of plastic products may lead to the onset of precocious puberty. Girls in Fuyang are generally affected by environmental hormones. Exposure to MEHP and MBP may play an important role in the pathogenesis of PPP and interfere with the secretion of sex hormones of individuals.

Correlation between body mass index and physical health of preschool children in Lishui City

LEI Jun, ZHOU Xiao-yan, HE Jian-yong, JIN Hai-ju, LIU Li-fang, YE Piao

2022, 30(9):  1033-1036.  DOI: 10.11852/zgetbjzz2022-0534

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Objective To analyze the correlation between body mass index (BMI) and physical health indicators of preschool children, in order to provide basis for improving their health condition. Methods From September to October 2020, 3 484 children aged 3 to 6 were randomly selected from 25 kindergartens to take physical measurements and physical fitness tests, including 10-meter round-trip running, tennis long throw, balance beam walking, double-foot continuous jump, standing long jump, seated forward bending 6 items. BMI was assessed according to BMI Standards for Children from 2 to 6 Years Old. Physical fitness was monitored comprehensively according to the National Fitness Measurement Standard Manual (Children Part). The correlation between different BMI and physical health indicators of preschool children was analyzed. Results Among 3 484 children, 1 860 were boys (53.39%) and 1 624 were girls (46.61%). According to BMI evaluation, 77 were wasting (2.21%), 2 765 were normal weight (79.36%), and 424 were overweight (12.17%), 218 people were obese (6.26%), and the difference in BMI distribution between boys and girls was statistically significant (χ² =77.356, P＜0.001). The unqualified rates of physical fitness monitoring in children with wasting, normal weight, overweight and obesity were 38.96%, 7.63%, 13.44%, and 31.65%, respectively. Four groups of children with different BMIs had statistically significant differences in sitting position, standing long jump and tennis throw of physical fitness monitoring (P<0.05), the sitting body flexion of children in the wasting group and the obese group were smaller than those in normal and overweight children. The standing long jump of overweight children was larger than that of the normal and obese children. The tennis throw of the normal weight children scored lower than that of overweight and obese children. Conclusions The physical health status of preschool children in different BMI groups in Lishui City varies greatly between boys and girls. Obese and wasting preschool children have a higher rate of failure in physical fitness monitoring, and it is recommended that preschool children should be kept within a normal weight range in order to improve their physical health.

Effects of calcium and vitamin D supplementation on body length of 2- to 3-year-old children

SONG Xiao-hong, LIU Ying, SHI Jiao, ZHAO Dou-dou, WEI Jun-xiang, ZHANG Nan, WANG Shu-hui

2022, 30(9):  1037-1040.  DOI: 10.11852/zgetbjzz2021-1748

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Objective To investigate the correlation of calcium and vitamin D levels with body length development of 2- to 3-year-old children, so as to provide theoretical basis for the intervention of physical development deviation. Methods A retrospective analysis was performed on the clinical data of 204 children aged 2 to 3 years who underwent routine physical examination in the Department of Child Health of Northwest Women and Children's Hospital from September 2019 to June 2021.Standard physical measurements and previous calcium and vitamin D supplementation were collected retrospectively in the form of a questionnaire, and serum 25-(OH) D level and bone mineral density were measured. Spearman correlation and Logistic multifactor regression analysis were used to analyze the correlation of calcium and vitamin D levels with physical development. Results The median daily dose of vitamin D supplementation was 569.5 U, and the median of serum 25-(OH)D was 35.60 ng/dl in 204 children. The deficiency, insufficiency, sufficiency rates of vitamin D were 1.96%, 0.98% and 97.06%, respectively. No children took in excessive vitamin D. The median bone mineral density(BMD) was P64.0. Univariate Spearman rank correlation analysis indicated that the daily average supplementation doses of vitamin D and calcium were both positively correlated with body length(r=0.172, 0.213, P<0.05), while the bone mineral density was negatively correlated with body length(r=-0.138, P<0.05). Multivariate Logistic regression analysis showed that the average daily calcium supplementation dose was positively correlated with body length, with statistical significance(OR=1.003, 95%CI:1.001 - 1.006, P<0.05), while daily vitamin D supplementation dose and bone mineral density were not found to be significantly related to body length. Conclusion Continuous supplementation of calcium can promote the body length development of 2- to 3-year-old children.