母乳喂养与儿童青少年肥胖类型的关联

Association between breastfeeding and types of obesity in children and adolescents

目的探讨母乳喂养与儿童青少年肥胖类型的关联,为儿童期不同类型肥胖影响因素的识别和干预提供理论基础。方法采用分层整群抽样方法,在中国7个省市抽取93所中小学校学生进行体格检查和问卷调查,选择母乳喂养等资料完整的30437名7~17岁中小学生作为研究对象。采用无序多分类Logistic回归模型分析母乳喂养与儿童青少年肥胖类型的关联。结果研究对象母乳喂养率为69.8%。母乳喂养组一般性肥胖、单纯腹型肥胖和复合型肥胖发生率依次为7.1%,3.9%和18.7%,非母乳喂养组为7.0%,4.7%和19.5%,差异有统计学意义(χ^2=14.04,P<0.01)。单因素分析发现,以正常组(体质量指数非超重肥胖且腰围<P90)为对照,母乳喂养可降低单纯腹型肥胖的风险(OR=0.81,95%CI=0.72~0.92,P<0.01)。在多因素调整后,母乳喂养仍可降低单纯腹型肥胖的风险(OR=0.76,95%CI=0.67~0.86,P<0.01),并可降低复合型肥胖的风险(OR=0.93,95%CI=0.87~0.99,P<0.05)。结论母乳喂养是儿童青少年单纯腹型肥胖和复合型肥胖的保护因素,应进一步提高中国母乳喂养率。

Objective To explore the association between breastfeeding and the type of obesity in children and adolescents,and to provide a theoretical basis for the identification and intervention of influential factors of different types of childhood obesity.Methods Using stratified cluster sampling method,93 primary and secondary schools in 7 provinces and cities in China were selected for physical examination and questionnaire surveys.Totally,30437 primary and middle school students aged 7-17,with completed information,were selected.A multivariable Logistic regression model was used to analyze the association between breastfeeding and different types of obesity.Results The breastfeeding rate of students was 69.8%.The rates of general obesity,simple abdominal obesity,and combined obesity in the breastfeeding group were 7.1%,3.9%,and 18.7%,the non-breastfeeding group were 7.0%,4.7%,and 19.5%.The differences were statistically significant(χ^2=14.04,P<0.01).Univariate analysis found that breastfeeding significantly reduced the risk of simple abdominal obesity in children and adolescents(OR=0.81,95%CI=0.72-0.92,P<0.01)with normal(BMI non-overweight and obesity and waist<P90)as control group.After adjustment,breastfeeding could still significantly reduce the risk of simple abdominal obesity(OR=0.76,95%CI=0.67-0.86,P<0.01),and combined obesity(OR=0.93,95%CI=0.87-0.99,P<0.05).Conclusion Breastfeeding is a protective factor for children with simple abdominal obesity and combined obesity,and the rate of breastfeeding in China should be further improved.