不同稳定体型学龄前儿童身高增长的随访研究

Follow-up study on height growth of preschool children with different stable physique

目的了解学龄前儿童超重、肥胖身高增长特点,为儿童体格发育干预提供依据。方法采取多阶段分层整群随机抽样的方法,在我国7座城市随访儿童的身高和体重,调查儿童的出生日期、性别等。根据WHO《学龄前儿童生长发育标准》进行身高和体质量指数评价,采用方差分析、Wilcoxon秩和检验进行统计分析。结果将基线、第1年和第2年随访时均为体型正常、超重和肥胖的2 479名儿童纳入分析。1年随访后,超重和肥胖儿童身高的年度增长值均>8 cm且高于体型正常儿童,3组间差异有统计学意义(P<0.05);2年随访后,肥胖儿童的身高增幅最高,为15.48 cm,高于超重和体型正常的儿童,3组间差异有统计学意义(P<0.05)。2年随访发现,体型正常、超重和肥胖儿童中,身高<P25的比例逐年减少(12.08%,3.70%,2.21%),身高≥P75的比例逐年增加(35.20%,55.56%,73.48%);超重、肥胖儿童的年度增长值>7 cm的比例分别为40.74%,49.72%,每年的增长幅度均高于体型正常儿童。结论儿童家长和妇幼卫生工作者应重视超重、肥胖儿童的身高增长,学龄前儿童身高与体型的关联仍需深入的探讨。

Objective To understand the characteristic of height growth among preschool children with normal physique, overweight and obese, and in order to provide basis for proper physical growth intervention of preschool children. Methods Cluster sampling method was used and preschool children of kindergartens in 7 cities were selected, height and weight was measured, the information of birth date and sex were collected by parents’ questionnaires. The "WHO Child Growth Standards" was used for evaluate children’ s height and body mass index. ANOVA analysis and Wilcoxon rank sum test were used for statistic analysis. Results There were 2 479 children who were normal weight, overweight and obese at baseline and were followed up for 2 years. The detection rate of <P25 height decreased by years( 12.08%, 3.70%, 2.21%), and ≥P75 height evaluation increased among children with different physique( 35.20%, 55.56%, 73.48%). Compared with normal weight children, overweight and obese children had higher average height, annual height growth value, detection rate of annual height growth value greater than 7 cm, detection rate of ≥P75 height and height annual increase rate. Conclusion Parents and practitioners in MCH should pay attention to the children’ s height growth, especially on overweight and obese children. More in-depth research are needed to explore the relationship between children’ s height and physique.