儿童早期不同阶段生长速度对6岁时糖脂代谢的影响

Effects of growth rate during infancy and childhood on glucose and lipid metabolism at 6 years old

目的评估婴幼儿期快速生长对其6岁时血糖血脂代谢的影响,为有效预防儿童期和成年后发生代谢性疾病提供理论依据。方法选取2017年3月1日—2018年6月30日天津市50所市级管理的幼儿园的大班儿童9 719例为研究对象进行横断面调查。检测儿童身高、体重、空腹血糖、总胆固醇和甘油三酯,并回顾性收集其出生及2岁时的身长与体重等数据。定义两次测量的年龄别体重Z评分差值>0.67为快速生长,分析0-2岁和2-5岁两阶段的快速生长与6岁时血糖和血脂代谢的关系。结果 0-2岁和2-5岁两阶段均为快速生长者在6岁时空腹血糖[(4.78±0.45)mmol/L与(4.66±0.51)mmol/L]和甘油三酯[(0.96±0.44)mmol/L与(0.83±0.34)mmol/L]均高于两阶段均为非快速生长者(P<0.05)。Logistic回归分析结果显示,0-2岁快速生长[OR(95%CI):1.343(1.040-1.733)]、2-5岁快速生长[OR(95%CI):2.697(2.038-3.570)]均为6岁时甘油三酯升高的危险因素(P<0.05)。结论儿童早期快速生长可能与儿童6岁时空腹血糖和甘油三酯升高有关。应重视儿童早期的适宜体重生长。

Objective To assess the impact of rapid growth during infancy or childhood on serum levels of glucose and lipids at the age of 6 years old, to provide theoretical basis for the effective prevention of metabolic disease in childhood and adulthood. Methods From March 1 st, 2017 to June 30 th, 2018, a total of 9 719 children aged six years in senior class of 50 municipal kindergartens in Tianjin were selected by a cross-sectional survey. Body weight, height, serum levels of glucose, total cholesterol and triglycerides were measured. The anthropometry data at birth and at 1 year old was retrospectively collected. Rapid growth was defined as standard deviation higher than 0.67 of weight gain from two measurements. Then the correlations of rapid growth at 0-to 2-year-old, 2-to 5-year-old with blood glucose and lipids levels were analyzed. Results Compared with children with non-rapid growth, children with rapid growth during infancy(from birth up to 2 years old) and childhood(2 to 5 years old) had higher serum levels of glucose [(4.78±0.45)mmol/L vs.(4.66±0.51)mmol/L] and triglycerides [(0.96±0.44)mmol/L vs.(0.83±0.34)mmol/L] at 6 years old(P<0.05). Logistics regression analysis indicated that children with rapid growth during infancy(OR=1.343, 95%CI: 1.040—1.733) and childhood(OR=2.697, 95%CI: 2.038—3.570) increased the risk for higher level of triglycerides(P<0.05). Conclusions Rapid growth in early childhood is associated with both serum glucose and lipids levels at 6 years old. Thus appropriate weight gain should be emphasized to children.