异基因造血干细胞移植患儿营养状况变化及其相关因素分析

[目的]了解异基因造血干细胞移植(allogeneic hematopoietic stem cell transplantation,allo-HSCT)患儿营养状况的变化趋势及其相关因素。[方法]分别于移植前、移植后7d、30d、60d、100d对89例allo-HSCT患儿进行身高、体重、体重指数Z值(z score of body mass index,BMIz)、三头肌皮褶厚度(TSF)、腹围(WC)、体脂百分比(percent of body fat,BF%)等营养指标测量,评价alloHSCT患儿营养状况的改变,并通过记录移植时间、患儿性别、疾病诊断、移植物来源、人类白细胞表面抗原(human leucocyte antigen,HLA)相合度等,分析影响患儿营养状况的相关因素。[结果]在移植后100d内患儿BMIz、TSF均呈现先降后升趋势,在移植后第30天降至最低点,然后逐渐上升(P<0.01);腹围及BF%在移植后逐渐上升,并于移植后第60天达到峰值(P<0.01)。BMIz值变化受移植前10d的BMIz值影响(P<0.01);TSF变化受疾病诊断、供体亲缘性、HLA相合度、移植前10d的BMIz值的影响(P<0.01);腹围变化受性别、疾病诊断、供体亲缘性、HLA相合度、移植前10d的BMIz值的影响(P<0.01);BF%变化受性别、疾病诊断、HLA相合度、移植前10d的BMIz值的影响(P<0.05)。[结论]allo-HSCT患儿在移植后100d内营养状况随时间改变而改变。移植患儿的营养状况变化受性别、疾病诊断、供体亲缘性、HLA相合度、移植前10d的BMIz值多种因素的影响,尤其是移植前患儿的BMIz值直接影响移植过程中患儿的营养状况;女孩更容易引起中心型肥胖。

Correlates of subjectively and objectively measured physical activity in young adolescents

Background： Many studies examining individual-level correlates in youth utilize self-report rather than objective measures of physical activity （PA）. This utilization of self-report may result in associations that are not present when examining objectively measured PA. The present study investigates the relationship between hypothesized correlates of PA with objectively and subjectively measured PA. Methods： Participating children （n 232, 101 males, mean age - 12.3 years） provided a minimum of four monitored days of PA （via accelerometer） and completed a survey assessing moderate-to-vigorous physical activity （MVPA）, sport competence, appearance, enjoyment, and self-efficacy. Height and weight were measured and body mass index （BMI） was calculated. Results： Hierarchical regression models controlling for sex, race, and BMI Z-score showed that only sex and BMI Z-score were significant correlates of objective MVPA while only sex was a significant correlate of objective total PA. However, in a separate model examining the relationship with subjective MVPA, enjoyment of PA and self-efficacy for PA were the only significant correlates of self-reported PA. Conclusion： Measuring MVPA via self-report versus accelerometry produces considerably different results in a sample of young adolescents. Future studies should use caution when selecting outcome measures if the intent is to identify modifiable correlates of MVPA in youth.

Effects of pre-pregnancy body mass index and gestational weight gain on neonatal birth weight

To evaluate the effects of maternal pre-pregnancy body mass index （pre-BMI） and gestational weight gain （GWG） on neonatal birth weight （NBW） in the population of Chinese healthy pregnant women, attempting to guide weight control in pregnancy. A retrospective cohort study of 3772 Chinese women was conducted. The population was stratified by maternal pre-BMI categories as underweight （〈18.5 kg/m2）, normal weight （18.5-23.9 kg/m2）, overweight （24.0-27.9 kg/m2）, and obesity （〉28.0 kg/m2）. The NBW differences were tested among the four groups, and then deeper associations among maternal pre-BMI, GWG, and NBW were investigated by multivariate analysis. NBW increased significantly with the increase of maternal pre-BMI level （P〈0.05）, except overweight to obesity （P〉0.05）. The multivariate analysis showed that both pre-BMI and GWG were positively correlated with NBW （P〈0.05）. Compared with normal pre-BMI, underweight predicted an increased odds ratio of small-for-gestational-age （SGA） and decreased odds ratio for macrosomia and large-for-gestational-age （LGA）, and the results were opposite for overweight. With the increase of GWG, the risk of SGA decreased and the risks of macrosomia and LGA increased. In addition, in different pre-BMI categories, the effects of weight gain in the first trimester on NBW were different （P〈0.05）. NBW is positively affected by both maternal pre-BMI and GWG, extreme pre-BMI and GWG are both associated with increased risks of abnormal birth weight, and maternal pre-BMI may modify the effect of weight gain in each trimester on NBW. A valid GWG guideline for Chinese women is an urgent requirement, whereas existing recommendations seem to be not very suitable for the Chinese.

Effect of acupuncture on serum PYY and nesfatin-1 in obese patients with insulin resistance

Objective To observe the effect of acupuncture on serum peptide YY(PYY)and nesfatin-1 in obese patients with insulin resistance.Methods Ninety-eight obese patients with insulin resistance were divided into a control group and an observation group by the random number table method,with 49 cases in each group.The control group received exercise and dietary interventions,and the observation group received additional acupuncture treatment to the exercise and dietary interventions.The body mass index(BMI),body fat percentage,fasting insulin(FINS),fasting plasma glucose(FPG),homeostasis model assessment for insulin resistance(HOMA-IR),triglyceride(TG),total cholesterol(TC),and serum PYY and nesfatin-1 levels were compared before and after treatment.The efficacy was evaluated after treatment.Results The total effective rate was significantly higher in the observation group than in the control group(P<0.05).After treatment,the BMI,body fat percentage,and serum TG and TC levels decreased significantly in both groups(P<0.05),and were significantly lower in the observation group than those in the control group(P<0.05).The FINS,FPG,HOMA-IR,and serum PYY and nesfatin-1 levels of the control group were not significantly changed after treatment(P>0.05).The FINS,FPG and HOMA-IR of the observation group decreased significantly after treatment(P<0.05),and were lower than those in the control group(P<0.05).The serum PYY and nesfatin-1 levels of the observation group increased significantly after treatment(P<0.05),and were higher than those in the control group(P<0.05).Conclusion Based on exercise and dietary interventions,acupuncture is effective for obese patients with insulin resistance.It can reduce the BMI,body fat percentage,blood lipids,blood glucose,and serum insulin levels and improve insulin resistance.The action may be associated with the up-regulation of serum PYY and nesfatin-1.