天津幼儿发育与健康队列研究

A cohort study of infant development and health in Tianjin

目的 了解学龄前儿童肥胖及相关代谢异常的发生现状,为今后开展干预提供理论支持。方法 采用整群抽样法,选取2017年9月—2018年10月入学就读幼儿园小班的3 952名天津本地出生儿童进行基线调查及随访(问卷调查、体格检测和实验室检测),同时依托天津市妇幼卫生信息系统,回顾母亲孕产期检查、分娩和儿童出生后至学龄前期的定期体检信息,形成双向队列研究。结果 分别有3 935,3 654和2 739名儿童完成幼儿园小、中、大班阶段的随访。幼儿园儿童的身高和体重随年龄递增,而体脂百分比随年龄递减(β线性趋势=-0.74,P<0.01)。3年中男童的身高、体重和体质量指数(BMI)均高于女童(P值均<0.05),而体脂百分比低于女童(小班17.5%,18.5%;中班16.4%,17.2%;大班16.1%,17.1%,P值均<0.05)。儿童超重肥胖检出率和肥胖检出率均随年龄递增(趋势χ^(2)值分别为15.51,38.72,P值均<0.05),其中肥胖的总检出率从基线水平的5.4%增长到9.6%。实验室检测结果显示,小班男童的空腹血糖异常检出率高于女童(7.7%,4.8%),血脂异常检出率低于女童(23.8%,27.7%)(χ^(2)值分别为12.01,6.63,P值均<0.05)。结论 研究建立了一个起始于胚胎初期的大型生长队列,将从多维度探索促进儿童健康、防治儿童肥胖和慢性病的策略。

Objective To investigate the current situation of obesity and related metabolic abnormalities among preschool children,so as to provide theoretical support for future intervention.Methods A cohort of 3952 children,born in Tianjin and enrolled in the kindergarten from September 2017 to October 2018,were selected to conduct a baseline survey and a three-year follow-up(questionnaire survey,physical examination and laboratory testing).At the same time,a two-way cohort study was conducted to retrospectively collect maternal prenatal examination,delivery and regular physical examination information of children from birth to preschool age from Tianjin Maternal and Child Health Information System.Results A total of 3935,3654 and 2739 children completed the follow-up in the primary,middle and senior classes of kindergarten respectively.The height and weight of pre-school children increased with age,while the percentage of body fat decreased with age(βtrend=-0.74,P<0.01).During three-year follow up,height,weight and body mass index of boys were higher than girls(P<0.05),while the percentage of body fat was lower than girls(primary class:17.5%,18.5%;middle class:16.4%,17.2%;senior class:16.1%,17.1%,P<0.05).The detection rate of overweight(including obesity)and obesity increased with age(χ^(2) trend were 15.51,38.72,P<0.05).The total detection rate of obesity increased from 5.4%at the baseline level to 9.6%.Laboratory test results showed that the detection rates of fasting blood glucose of boys were higher than that of girls in primary class,but blood lipid abnormalities were in the opposite(glucose:7.7%,4.8%;lipid:23.8%,27.7%)(χ^(2)=12.01,6.63,P<0.05).Conclusion The study has established a large growth cohort starting from the early embryonic stage,which will help to establish the strategies to promote children's health and prevent obesity and chronic diseases from multidimensional perspectives.