苏州市学龄前儿童肥胖相关危险因素分析

Analysis of the risk factors of obesity among preschool children in Suzhou city

目的初步了解苏州市学龄前儿童肥胖的危险因素,以制定相应的健康教育及干预措施。方法借助苏州市托幼保健管理信息平台中儿童的体检信息,从中随机抽取肥胖儿童和正常体重儿童共223例,采集其口腔黏膜上皮细胞,应用TaqMan-MGB技术进行单核苷酸(SNP)多态性检测,包括瘦素(LEP)基因G132A位点、脂蛋白脂酶(LPL)基因Hind位点和过氧化物酶体增生激活受体γ(PPARG)基因Pro12A1a位点。通过调查问卷的形式获取儿童及其父母的基本情况、身高体重、饮食行为习惯等信息。应用SPSS13.0软件进行统计分析。结果肥胖组儿童父母的体重指数(BMI)明显大于正常组儿童父母的BMI,差异有统计学意义(t=-3.399、-3.977,均P<0.05)。LEP基因G132A位点、LPL基因Hind位点和PPARG基因Pro12A1a位点的基因分型在两组间差异均有统计学意义(χ~2=5.111,9.496、6.053,均P<0.05)。正常组的父母饮食行为习惯较肥胖组的健康,总评分及行为习惯评分差异有统计学意义(t=47、-24.079,均P<0.05)。儿童饮食行为习惯分析结果显示,正常组和肥胖组儿童在"是否与家长同桌共餐","是否运动"以及"进餐持续时间"这3种习惯上的差异有统计学意义(χ~2=5.469、7.150、13.551,均P<0.05),在其他饮食行为习惯上两组差异无统计学意义(χ~2=2.682、0.012、0.303、0.570、0.000、0.000、3.572、0.450、0.028、1.140,均P>0.05)。结论 LEP基因G132A位点、LPL基因Hind位点和PPARG基因Pro12A1a位点为儿童肥胖症的风险基因,针对提高和改善儿童及其父母的不良饮食行为习惯的健康教育及干预措施是预防儿童肥胖症发生的有效措施之一。

Objective To preliminarily explore the factors of obesity among preschool children in Suzhou city,establish corresponding health education and intervention measures.Methods A total of 223 obese and nonobese children were randomly selected based on physical examination data from health management information platform of kindergarten children in Suzhou city.The oral mucosal epithelial cells were collected,Taq Man-MGB technology was used to detect single nucleotide polymorphisms（SNPs） of leptin（LEP） gene G132 A locus,lipoprotein lipase（LPL） gene Hind locus,peroxisome proliferator-activated receptor-γ（PPAR-γ） gene Pro12A1 a locus.The basic information of children and their parents,height and weight,dietary habits and other information were obtained by questionnaire survey.The data was statistically analyzed with SPSS 13.0 software.Results Parental body mass index（BMI） values in obesity group were statistically significantly higher than those in control group（t =-3.399,-3.977,P〈0.05）.There were statistically significant differences in genotyping of LEP gene G132 A locus,LPL gene Hind locus,PPAR-γ gene Pro12A1 a locus between the two groups（χ^2= 5.111,9.496,6.053,P〈0.05）.Parental dietary habits in control group was healthier than that in obesity group,there were statistically significant differences in the total score and behavioral habits score between the two groups（t = 47,-24.079,P〈0.05）.The analysis of children＇s dietary behaviors and habits showed that there were statistically significant differences in sitting at the same table with the parents or not,exercise or not,and meal duration time between the two groups（χ^2= 5.469,7.150,13.551,P〈0.05）,there was no statistically significant difference in other dietary behaviors and habits（χ^2= 2.682,0.012,0.303,0.570,0.000,0.000,3.572,0.450,0.028,1.140,P〈0.05）.Conclusion LEP gene G132 A locus,LPL gene Hind locus,and PPAR-γ gene Pro12A1 a locus are risk genes of childhood obesity,health education and intervention measures targeting to improving unhealthy dietary behaviors and habits of children and their parents are effective measures to prevent the occurrence of obesity in children.