22 609例西南地区2~18岁儿童青少年营养状况分析

Analysis of nutritional status in 22609 children and adolescents aged 2-18 years in Southwest China

目的调查西南地区2~18岁儿童青少年营养状况、危险因素和其对生化指标的影响。方法纳入2017年4月至2021年3月在重庆医科大学附属儿童医院进行常规体检的儿童。BMI确定营养状况,根据性别、地区、年龄进行统计分析,采用多因素Logistic回归分析不同营养状况的危险因素。结果共纳入22 609例,其中消瘦、超重和肥胖的总体发生率分别为5.87%、9.81%和10.50%。男孩肥胖和消瘦患病率高于女孩(χ^(2)=24.79、12.39,均P<0.05),而超重患病率低于女孩(χ^(2)=4.32,P<0.05);城市地区男孩超重患病率高于农村地区(χ^(2)=4.68,P<0.05);男孩与女孩在三个年龄组中分别进行对比,12~18岁年龄组中男孩肥胖患病率最高(χ^(2)=12.49,P<0.01),女孩消瘦患病率最低(χ^(2)=6.18,P<0.05)。与男孩相比,女孩发生肥胖(OR=0.80,95%CI:0.73~0.87)和消瘦(OR=0.80,95%CI:0.71~0.90)的风险降低。与12~18岁青少年组相比,2~<6岁组儿童发生肥胖的风险降低(OR=0.55,95%CI:0.46~0.67),~<12岁组儿童发生消瘦的风险增加(OR=1.70,95%CI:1.25~2.33)。肥胖儿童在ALT、AST、ALP、UA、UN、CRE、TG、TC、HDL-C和LDL-C水平上差异均具有统计学意义(均P<0.05)。结论西南地区儿童青少年营养状况与全国整体水平相当。肥胖和消瘦的流行与性别和年龄有关。肥胖儿童更易出现生化指标异常。

Objective To investigate the epidemiology,risk factors and biochemical indexes of nutritional status in children and adolescents aged 2~18 years in Southwest China.Methods Children attending routine health checkups at the Children′s Hospital of Chongqing Medical University between April 2017 and March 2021 were enrolled in this study.Nutritional status was defined based on BMI cut-off values,and statistically analyzed based on gender,region and age.Its risk factors were analyzed by multivariate Logistic regression.Results A total of 22609 cases were recruited and the overall prevalence of wasting,overweight and obesity was 5.87%,9.81%and 10.50%,respectively.The prevalence of obesity and wasting in boys was higher than that in girls(χ^(2)=24.79,12.39,all P<0.05),and the prevalence of overweight in boys was lower than that in girls(χ^(2)=4.32,P<0.05).The prevalence of overweight among boys in urban regions was higher than that in rural regions(χ^(2)=4.68,P<0.05).Compared in three age groups,boys aged 12~18 years had the highest prevalence of obesity(χ^(2)=12.49,P<0.01),while girls had the lowest prevalence of wasting(χ^(2)=6.18,P<0.05).Compared with boys,girls had a lower risk of obesity and wasting(OR=0.80,95%CI:0.73~0.87),(OR=0.80,95%CI:0.71~0.90).Compared to children aged 12~18 years,children aged 2~<6 years had a lower risk of obesity(OR=0.55,95%CI:0.46~0.67),while children aged 6~<12 years had a higher risk of wasting(OR=1.70,95%CI:1.25~2.33).Significant differences were reported in ALT,AST,ALP,UA,UN,CRE,TG,TC,HDL-C and LDL-C levels in obese children(all P<0.05).Conclusion The nutritional status of children and adolescents in Southwest China is comparable to that at the national level.The prevalence of obesity and wasting is associated with gender and age.Obese children are more likely to have biochemical abnormalities.