骨密度与婴幼儿生长发育速度关系的队列研究

A Cohort Study on the Relationship Between Bone Mineral Density and Infant Growth and Development Rate

目的探讨骨密度与婴幼儿生长发育速度关系。方法随机选取2020年5月1日—2022年4月30日茂名市妇幼保健院儿童保健科进行体格检查的健康婴幼儿作为研究对象,共计200名。入组时收集身高、体质量等体格检查结果,相应的骨密度检查结果。根据骨密度相对变化分为骨密度增加组和骨密度降低组。比较两组患者生长速度,同时分析营养素类药物的使用情况、喂养情况、父母人口社会学特征、遗传因素、日照情况等单因素差异,并分析独立危险因素。结果有143名观察对象的骨密度相对增加,纳入骨密度增加组,3名观察对象的骨密度Z值无变化,余54名观察对象的骨密度相对降低,纳入骨密度降低组。两组观察对象比较,骨密度增加组中增长速度较快的婴幼儿比例高于骨密度降低组,差异有统计学意义(P<0.05)。两组婴幼儿在年龄、维生素D药物使用情况、父母最高学历、父母常住地、日照时间方面的差异有统计学意义(P<0.05),年龄<2岁、无维生素D药物使用、日照时间<2 h/d是骨密度降低的独立影响因素。结论骨密度水平与婴幼儿的生长发育速度有关,茂名市婴幼儿群体中骨密度降低者的比重不容忽视。对于年龄2岁以下、无维生素D药物使用、日照时间<2 h/d的婴幼儿,应加强干预和重点防护。此文的研究结果为骨密度下降后期诊治标准制定提供了借鉴内容。

Objective To explore the relationship between bone mineral density and infant growth and development.Methods A total of 200 healthy infants who came to the department of child health branch of Maoming Maternal and Child Health Hospital for physical examination from May 1,2020 to April 30,2022 were randomly selected as the study subjects.Physical examination results such as height(cm)and weight,and corresponding bone mineral density examination results were collected at the time of enrollment.According to the relative changes of bone mineral density,they were divided into two groups:increased bone mineral density group and decreased bone mineral density group.The growth rate of the two groups of patients was compared.At the same time,the use of nutrient drugs,feeding,sociological characteristics of parents,genetic factors,sunshine and other single factor differences were analyzed,and independent risk factors were analyzed.Results The bone mineral density of 143 subjects increased relatively and were included in the bone mineral density increasing group.The bone mineral density Z value of 3 subjects did not change.The bone mineral density of 54 subjects decreased relatively and were included in the bone mineral density decreasing group.Compared with the observation objects of the two groups,the proportion of infants with faster growth rate in the bone mineral density increase group was higher than that in the bone mineral density decrease group,with a statistically significant difference(P<0.05).There were significant differences between the two groups in terms of age,vitamin D drug use,parents'highest education,parents'permanent residence,and sunshine time(P<0.05).Age<2 years old,no vitamin D drug use,sunshine time<2 h/d were independent risk factors for bone mineral density reduction.Conclusion The level of bone mineral density is related to the growth and development speed of infants.The proportion of infants with decreased bone mineral density in Maoming can not be ignored.For infants under 2 years old,without vitamin D drug use,and with sunshine duration<2 h/d,intervention and key protection should be strengthened.The results of this study provide reference for the formulation of diagnostic and therapeutic standards in the later stage of bone mineral density decline.