天津市5~6岁儿童空腹血糖现状及影响因素分析

Current status and influencing factors of fasting plasma glucose of children aged 5-6 years in Tianjin

目的 调查天津市5~6岁儿童的空腹血糖(FPG)水平现状,分析儿童空腹血糖水平及空腹血糖受损(IFG)的影响因素,为预防成人慢性病提供参考。方法 采用整群抽样法于2018年3—6月对天津市除滨海新区外的15个行政区的49所幼儿园的5~6岁儿童进行了横断面调查。调查包括测量身高、体重,采集空腹指尖血2 ml检测FPG,问卷收集儿童的饮食、运动情况以及生活方式。结果 5 942名5~6岁儿童FPG平均水平为(4.77±0.38)mmol/L,IFG(FPG≥5.6 mmol/L)检出率为0.82%。多因素线性回归结果显示,男童的FPG水平高于女童(β=0.140,P<0.001),居住在市区儿童的FPG水平高于郊区儿童(β=0.126,P<0.001),超重和肥胖儿童FPG水平均高于体重正常儿童(β=0.059、0.072,P<0.001),白天运动时间<0.5 h/d儿童FPG水平高于白天运动时间≥2 h/d儿童(β=0.031,P<0.05)。多因素Logistic回归结果显示男童(OR=2.245,95%CI:1.204~4.186)、居住地为市区(OR=2.112,95%CI:1.169~3.817)和含糖饮料摄入频次≥3次/周(OR=7.724,95%CI:1.725~34.579)是儿童IFG发生的危险因素(P<0.05)。结论 开展学龄前儿童空腹血糖早期筛查和健康生活方式干预,对于成人慢性病的早期预防具有重要公共卫生学意义。

Objective To investigate the current status of fasting plasma glucose(FPG) in children aged 5 to 6 years in Tianjin, and to understand the influencing factors of FPG levels and impaired fasting glucose(IFG) in children for early prevention of adult chronic diseases. Methods A cross-sectional survey was conducted, children aged 5 to 6 in 49 kindergartens from 15 administrative districts of Tianjin were selected using the cluster sampling method from March to June 2018. Children′s height and weight were measured, fasting fingertip blood was collected to test FPG, and questionnaires were collected on children′s diet, exercise and lifestyle. Results The average FPG level of 5 942 children aged 5 to 6 years was(4.77±0.38)mmol/L, and the detection rate of IFG(FPG≥5.6 mmol/L) was 0.82%. Multivariate linear regression results showed that boys had higher FPG levels than girls(β=0.140, P<0.001), children living in urban areas had higher FPG levels than suburban children(β=0.126, P<0.001), overweight and obese children had higher FPG levels than normal-weight children(β=0.059, 0.072, P<0.001), and the FPG level of children with daytime exercise time <0.5 h/d was higher than that of children with exercise time≥2 h/d(β=0.031, P<0.05). The results of multivariate Logistic regression showed that boys(OR=2.245, 95%CI:1.204-4.186), living in urban area(OR=2.112, 95%CI:1.169-3.817) and frequency of intake of sugary drinks ≥3 times/week(OR=7.724, 95%CI:1.725-34.579) were risk factors for IFG in children(P<0.05). Conclusion Early screening of FPG and healthy lifestyle intervention for preschool children are of important public health significance for the early prevention of adult chronic diseases.