Abnormal Adipokines Associated with Various Types of Obesity in Chinese Children and Adolescents

Objective To explore the role of adipokines including insulin, resistin, leptin, adiponectin, acylation stimulating protein （ASP） and complement C3 （C3） in various types of obesity （peripheral obesity, abdominal obesity and mixed obesity） in Chinese children and adolescents, and their relationships with body size and pubertal development. Methods Children and adolescents （n=3 508） aged 6 to 18 years, with 1 788 boys and 1 720 girls were assessed for body mass index, waist circumference, pubertal development, blood insulin, resistin, leptin, adiponectin, ASP and C3 levels. Three types of obesity [peripheral obesity （n=43）, abdominal obesity （n=473）, mixed obesity （n=1 187）] and non‐obese control （n=1 805） were defined with combined use of Chinese body mass index and waist circumference criteria. Results Serum resistin, leptin and adiponectin levels were higher in girls than those in boys （all P0.01）. Insulin and leptin increased and adiponectin decreased across five Tanner stages in both girls and boys （all P0.001）, while ASP changed only in girls （P0.001） and C3 only in boys （P0.001）. Insulin, leptin and ASP were higher, but adiponectin was lower in all three types of obesity vs. the non‐obese control （all P0.05）. The greatest abnormalities of all six adipokines were found in the mixed obesity group. With inclusion of body mass index and waist circumference in simultaneous regression analyses, both body size indices were independently and significantly correlated with insulin, leptin and adiponectin after age and gender adjustment. Compared with waist circumference, the body mass index was stronger in interpreting insulin, leptin, adiponectin and ASP levels, whereas it was weaker in explaining variance of plasma C3. Conclusions Obese children have a worse metabolic profile with high insulin, resistin, leptin, ASP and C3, and low adiponectin levels. The adipokine profile in mixed obesity is worse than that in peripheral or abdominal obesity. Identification of obese subjects with a malignant adipokine profile using a combination of body mass index and waist circumference is important for the prevention of obesity‐related disease.

Ethnic Differences in Body Mass Index and Prevalence of Obesity in School Children of Urumqi City, Xinjiang, China

Objective To investigate the prevalence of obesity and distribution of body mass index （BMI） in school children of four ethnic groups in Urumqi, Xinjiang, China. Methods A total of 55 508 school children of Han, Hui, Uygur and Kazak nationalities aged 8-18 years were selected by a cluster sampling from a districts of Urumqi City for anthropometrie measurement and demographic survey. Prevalence of obesity and overweight and distribution of body mass index （BMI） by gender, age, and nationality were analyzed and compared. Cutoff points of BMI for defining obesity and overweight were based on the proposal set by the Working Group on Obesity in China （WGOC） to assess age-, gender- and nationality-specific prevalence of obesity and overweight. Results Prevalence of obesity was 5.34%, 6.78%, 3.39 %, and 1.22% for boys and 2.61%, 1.83%, 1.78%, and 1.40% for girls of Han, Hui, Uygur and Kazak nationalities, respectively. Prevalence of obesity tended to decrease with age overall, whereas that of overweight increased with age in Han children. Conclusions Prevalence of obesity in school children in Urumqi varies with their nationalities and is lower than that of an average national level and a level of western countries. Obesity is more prevalent in boys than in girls of Urmuqi overall, which is just the opposite in Kazak children. Han boys and Hui girls have the highest prevalence of obesity and Kazak boys and girls have the lowest ones. Prevalence of obesity decreases with age, but that of overweight shows a different trend.

Risk Factors for Overweight and Obesity among Children Ages 0 to 3.5 Living in the Miramichi Public Health Region of New-Brunswick, Canada

Obesity, a major risk factor in numerous pathologies, poses a public health problem. The objective of this study was to assess the prevalence of the risk of overweight, overweight and obesity, as well as to identify and analyze the risk factors for weight gain among children in Miramichi in New Brunswick’s Horizon Health Network (HHN). This descriptive cross-sectional study was done between 2009 and 2014. The study population was composed of 335 children (185 boys and 150 girls) ages 0 to 42 months and their parents. Overweight and obesity were determined according to World Health Organisation (WHO) criteria adapted for Canada. A logistic regression analysis was performed to determine the risk factors associated with overweight and obesity. The prevalence of risk for overweight is 21% at birth as opposed to 55% at 42 months (both sexes together), and the prevalence of risk for overweight including obesity affects 11.8% of children, that is, 12.7% of boys as opposed to 10.94% of girls (p < 0.0001). The prevalence among boys is 1.2 times that among girls. This study also reveals that at 42 months, the average prevalence of obesity is 6.5% (8% for boys and 5% for girls). The mothers of overweight children have a higher post-pregnancy BMI (32.78 ± 4.16 kg/m2) than do the mothers of children who are a healthy weight (26.17 ± 7.90 kg/m2) (p < 0.0001). Moreover, 29.7% of children are overweight when both parents are overweight compared to 14.97% when both parents are a healthy weight (p < 0.05). This means that children are twice as likely to be overweight when both parents are overweight compared to children whose parents are a healthy weight. Otherwise, only 17% of the 335 children assessed in this study were breastfed and started on solid foods in accordance with the WHO recommendations. This study clearly shows that overweight is associated with sex, birth weight, parental obesity, maternal breastfeeding and the age of introduction of solid foods. The prevalence and identification of risk factors for overweight and infant obesity used to screen at-risk children will have the advantage of allowing adapted prevention strategies to be established.

Report on Childhood Obesity in China (2) Verification of BMI Classification Reference for Overweight and Obesity in Chinese Children and Adolescents

Objective To verify Working Group for Obesity in China （WGOC） recommended body mass index （BMI） classification reference for overweight and obesity in Chinese children and adolescents using the data of 2002 China Nationwide Nutrition and Health Survey. Methods PediaWic metabolic syndrome （MetS） and abnormality of each risk factor for MetS were defined using the criteria for US adolescents. Definition of hyper-TC, LDL, and dyslipidemia in adults was applied as well. The average level and abnormality rate of the metabolic indicators were described by BMI percentiles and compared with general linear model analysis. Receiver operating characteristic analysis was used to summarize the potential of BMI to discriminate between the presence and absence of the abnormality of these indicators. Results There was neither significantly increasing nor significantly decreasing trend of biochemical parameter levels in low BMI percentile range （〈65th）. Slight increasing trend from the 75th and a significant increase were found when BMI≥85th percentile. In general, the prevalence of the examined risk factors varied slightly when BMI percentile〈75th, and substantial increases were consistently seen when BMI percentile≥75th. As an indicator of hyper-TG, hypertension and MetS, the sensitivity and specificity were equal at the point of BMI〈75th percentile, and the Youden＇s index of risk factors also reached peak point before 75th percentile except for MetS. When the BMI percentile was used as the screening indicator of MetS, Youden＇s index reached peak point at 85th percentile, just the point in the ROC graph that was nearest to the upper left comer. Conclusion The BMI classification reference for overweight and obesity recommended by WGOC is rational to predict and prevent health risks in Chinese children and adolescents. Lower screening cut-off points, such as 83th percentile or 80th percentile, should not be excluded when they are considered as overweight criteria in future intervention or prevention studies.

Epidemics of overweight and obesity among growing childhood in China between 1997 and 2009： Impact of Family Income, Dietary Intake, and Physical Activity Dynamics

Background： Obesity has become a major health problem among children and adolescents worldwide. This study aimed to examine the trends of overweight and obesity among childhood in China and assess their associations with family income, dietary intake, and physical activity （PA） between 1997 and 2009. Methods： Two waves of cross-sectional data of Chinese children and adolescents aged 7-17 years from the China Health and Nutrition Survey were used. Weight and height were measured following standardized procedures. Dietary intake was assessed by 3 consecutive 24-h recalls. Childhood overweight and obesity were defined using the International Obesity Task Force-recommended body mass index cut-offs. Multivariate linear regression analysis was used to examine the associations of family income with diet intakes and PA. Multivariate logistic regression analysis was conducted to assess the associations of overweight and obesity with family income, dietary intake, and PA. Results： The prevalence of childhood overweight and obesity increased from 12.6% in 1997 to 22.1% in 2009, particularly in the medium- and high-family income groups, which increased by 102.7% and 90.3%, respectively. Higher fat intake （% energy）, and moderate and vigorous PA were significantly associated with overweight and obesity in final model （odds ratio [OR] = 1.01, 95% confidence interval [CI]： 1.00-1.02, P = 0.004; and OR = 0.99, 95% CI： 0.98-1.00, P = 0.036, respectively）. Conclusions： The prevalence of overweight and obesity among Chinese children and adolescents has increased between 1997 and 2009. Reducing fat intake and increasing PA may help obesity prevention.

Association between fetal macrosomia and risk of obesity in children under 3 years in Western China: a cohort study

Background Fetal macrosomia,defined as birth weight equal or over 4000 g,is a major concern for both neonatal and maternal health.A rapid increasing trend in fetal macrosomia is observed in different regions of China.We aimed to examine the association between fetal macrosomia and risk of childhood obesity in Western China.Methods All macrosomic live singletons (≥ 4000 g),and a random sample of singletons with normal birth weight (2500-3999 g) born in four districts of Chengdu,Western China,in 2011 were included in the cohort study.Maternal demographics,obstetric factors,labor and delivery summary at baseline were extracted from the Chengdu Maternal and Child Health Management System.Anthropometric measurements before 3 years and infant feeding information at around 6 months were also collected.Childhood obesity under 3 years was primarily defined as a weight-for-length/height z score ≥ 1.645 using the WHO growth reference.Secondary definitions were based on weight-for-age and body mass index (BMI)-for-age over the same cut-offs.Results A total of 1767 infants were included in the analyses,of whom 714 were macrosomic.After controlling for maternal age,parity,gestational age and anemia at the first antenatal visit,pre-pregnancy BMI,gestational weight gain,gestational age at birth,baby age and sex,and breastfeeding practices at 6 months,the risk of childhood obesity defined according to weight-for-length/height among macrosomic babies was 1.90 (95% confidence interval 1.04-3.49) times that of babies with normal birth weight.The risk of childhood obesity for macrosomic babies was 3.74 (1.96-7.14) and 1.64 (0.89-3.00) times higher based on weight-for-age and BMI-for-age,respectively.Conclusion Fetal macrosomia is associated with increased risk of obesity in children under 3 years in Western China.

Efficacy observation of auricular point sticking in combination with a healthy diet for simple obesity in children

Objective To observe the clinical efficacy of combining auricular point sticking and a healthy diet to treat simple obesity in children aged 6–9 years old.Methods A total of 190 eligible obese kids were divided into an observation group and a control group using the random number table method,with 95 cases in each group.The observation group was intervened by auricular point sticking plus guide on a healthy diet,while the control group was only provided with the guide on a healthy diet.The therapeutic efficacy was observed after intervention for three consecutive months,as well as the changes in body mass(BM),body mass index(BMI),waist circumference(WC),hip circumference(HC),and subcutaneous fat thickness.Results After the 3-month intervention,the total effective rate was 91.6%in the observation group,versus 74.7%in the control group,and the between-group difference was statistically significant(P<0.01);in both groups,the BM,BMI,WC,HC,and subcutaneous fat thickness all decreased significantly(P<0.05),and were lower in the observation group than in the control group,showing statistical significance(P<0.05).Conclusion Auricular point sticking plus a healthy diet is safe and effective in treating simple obesity in children,producing more significant efficacy than healthy diet intervention alone.

Homocysteine and Cardiovascular Risk Factors in Overweight or Obese Children and Adolescents

Introduction: Among the extrinsic factors, homocysteine (Hy) stands out, which is an intermediate amino acid of the intracellular metabolism of methionine involved in the process of cellular oxidation, which promotes the installation of atheromatous plaques and, therefore, is considered as an emerging cardiovascular risk factor. Objective: To evaluate the plasma homocysteine levels (Hy) in overweight or obese children and adolescents and their relation with cardiovascular risk factors. Methods: A cross-sectional study was conducted from July 2011 to May 2012 with overweight or obesity children and adolescents aged 2 to 18 years followed at the Center for Childhood Obesity (IOC), Campina Grande-PB. A structured form was used to record demographic, socioeconomic and clinics variables and the patients underwent laboratory tests to define their lipid and glucose profiles and measurement of plasma Hy levels. Results: The study evaluated a total of 165 children and adolescents with mean age of 12.5 (±2.5) years;the majority were female (57.0%). Regarding the lipid profile, there was more individuals with low HDL cholesterol (88.5%). Plasma Hy levels were high in 24.2% of the sample. The mean Hy levels ranged from 4.3 to 18.9 μmol/L, being higher in males, obese adolescents and also in patients with high insulin levels and resistance. Conclusions: The results shown in this study emphasize the importance of detecting and controlling the plasma Hy levels as an independent cardiovascular risk factor, and the need for further studies to evaluate the clinical and biological factors related to alterations in its metabolism.

Prevalence of pre-school children for overweight/obesity in Turkey

Background Most of the studies and interventions are targeted to address undernutrition, but childhood obesity has become a silent killer among children. Developing countries, including Turkey, could recognize the importance of the issue now and have begun to discuss the necessity of studies on this subject. Therefore, this study aims to examine the prevalence of obesity among pre-school children in Turkey. Methods The data source of this study is the Turkey Demographic and Health Survey (TDHS)-2013. The TDHS-2013 was a sample study to gather information about the fertility levels and changes in them, infant and child mortality, family plan-ning, and maternal and infant health at the national level. Results Overweight/obesity for height was 8.6% and 6.6% for age. Overweight/obesity problems are mostly observed in the West and are higher in urban areas. Overweight/obesity decreases with increasing age. There is a positive correlation between overweight/obesity and maternal educational level. As the household welfare level increases, overweight/obesity increases in pre-school children. Female children are at higher risk of overweight/obesity than males. As birth order increases, overweight/obesity decreases. Children living in other regions have overweight/obesity problems more than the pre-school children living in the East. Conclusions This study speculates that obesity appears to be a major problem among pre-school children in Turkey. Based on the findings, the current situation of overweight/obesity among pre-school children is so close to many developing and developed countries, whose obesity levels are a greater concern. This finding demonstrates that effective interventions of obesity should begin as early as infancy in Turkey, as it is a developing country.

Noninvasive Parameters and hepatic fibrosis scores in children with nonalcoholic fatty liver disease

AIM:To evaluate the noninvasive parameters and hepatic fibrosis scores in obese children with nonalcoholic fatty liver disease(NAFLD).METHODS:A total of 77 children diagnosed with NAFLD via liver biopsy were included and divided into 2 subgroups according to the histopathologic staging of hepatic fibrosis:mild(stage 0-1)vs significant fibrosis(stage 2-4).Clinical and laboratory parameters were evaluated in each patient.The aspartate aminotransferase(AST)/alanine aminotransferase(ALT)ratio,AST/platelet ratio index(APRI),PGA index,Forns index,FIB-4,NAFLD fibrosis score,and pediatric NAFLD fibrosis index(PNFI)were calculated.RESULTS:No clinical or biochemical parameter exhibited a significant difference between patients with mild and significant fibrosis.Among noninvasive hepatic fibrosis scores,only APRI and FIB4 revealed a significant difference between patients with mild and significant fibrosis(APRI:0.67±0.54 vs 0.78±0.38,P=0.032 and FIB4:0.24±0.12 vs 0.31±0.21,P=0.010).The area under the receiving operating characteristic curve of FIB4 was 0.81,followed by Forns index(0.73),APRI(0.70),NAFLD fibrosis score(0.58),AST/ALT ratio(0.53),PGA score(0.45),and PNFI(0.41).CONCLUSION:APRI and FIB4 might be useful noninvasive hepatic fibrosis scores for predicting hepatic fibrosis in children with NAFLD.

Convulsive Seizures Revealing a Meningioma in Children: A Case Report from the Hospital Center of Soavinandriana

Meningiomas in children are rare. They represent only 1% to 3% of all intracranial tumors. It was a case report of a childhood girl meningioma, which is from the rare tumor and presenting by seizures, evolving in an apyretic context. She had no notion of irradiation or particular personal history apart from wearing glasses since the age of 5 years. She weighed 70 kg (BMI = 31). Biological examinations were normal. The brain scan showed a left frontal extra-axial tumor process measuring 76 × 60 × 55 mm. Tumor resection was performed. Macroscopically, the surgical specimen was found to be 8 firm, lobulated, yellowish-white fragments measuring 14 × 11 × 2 cm and weighing 150 g in total. The histological examination showed a proliferation of meningothelial cells, with a tendency to stratify and to roll up on each other in an onion bulb shape, without excess of mitoses and without cortical infiltration, evoking a meningioma. Meningioma in children remains a rare tumor. In our case, seizures were the only revealing signs of this disease. Cerebral computed tomography oriented the diagnosis. Anatomopathological examination was essential for confirmation.

Efect of early feeding practices and eating behaviors on body composition in primary school children

Background Understanding children’s feeding practices and eating behaviors is important to determine etiology of childhood obesity.This study aimed to explore the relationship between early feeding practices,eating behavior and body composition among primary school children.Methods The data were collected from 403 primary school children.They were administered structured questionnaire,including sociodemographic characteristics,early feeding practices and Child’s Eating Behavior Questionnaire.Anthropometric and blood pressure(BP)measurements were performed.Results Children with obesity and overweight showed higher food approach subscales and lower food avoidance subscales compared to a healthy and underweight child.Children who were exclusively or predominantly breast fed during the frst 6 months had the lowest scores for the food approach subscales,food responsiveness(FR)and emotional overeating(EOE)and had the highest scores for the food avoidance subscales,satiety responsiveness(SR)and emotional under eating(EUE).Children who were introduced solid food after 6 months showed lower scores for FR,enjoyment of food and EOE but scored highest for SR,slowness in eating(SE)and EUE.All anthropometric measurements were positively correlated with all food approach subscales and negatively with SE,SR and food fussiness.All food approach subscales were positively correlated with BP percentiles.All food avoidance subscales were negatively correlated with both BP percentiles,except for EUE,which was negatively correlated with diastolic BP percentile only.Age,SR,SE and FR were predictors for child body mass index.Conclusion Early feeding practices and eating behavior are considered as prevention approaches for obesity.

针刺治疗儿童单纯性肥胖的临床疗效观察

目的观察针刺治疗儿童单纯性肥胖(胃热湿阻型)的临床疗效。方法通过网络随机方法将120例单纯性肥胖儿童(胃热湿阻型)分为对照组和观察组各60例。对照组采取饮食+运动管理方案,观察组在此基础上加用针刺疗法。治疗12周后对比两组临床疗效与干预前后肥胖指标[体质量、体脂率与体质量指数(BMI)]、中医证候积分、瘦素与血清胰岛素情况。结果(1)观察组治疗总有效率为86.7%(52/60),明显高于对照组40.0%(24/60),差异有统计学意义(P<0.05)。(2)两组治疗方案对单纯性肥胖患儿的体质量、BMI、体脂率、中医证候积分、胰岛素和瘦素水平改善的差异有统计学意义(P<0.05),说明针刺联合饮食管理加运动方案优于单纯饮食管理加运动方案。结论针刺疗法是治疗儿童单纯性肥胖的有效手段,可显著改善患儿体质量、BMI、体脂率及中医证候,其机制可能与改善糖代谢、瘦素抵抗,抑制食欲等有关。

健康生命轨迹计划缘起与发展:社区-家庭-母婴多层面儿童超重与肥胖干预研究队列

健康生命轨迹计划(HeLTI)是由世界卫生组织(WHO)牵头,中国、加拿大、南非、印度等多个国家参与的前瞻性出生队列干预研究。本项目旨在利用HeLTI在个性化健康教育和权威专业健康指导方面的优势,探索建立涵盖备孕期、孕产期、婴幼儿期、学龄前期等多个阶段的社区-家庭-母亲-儿童(CFMC)干预措施,实施连续性多层面的干预,构建国际合作研究平台,实现从生命源头预防肥胖等发育源性疾病的目标。由中国、加拿大共同实施的中加健康生命轨迹计划(SCHeLTI)也称生命树项目,受中国国家自然科学基金委和加拿大卫生研究院共同资助,由国际和平妇幼保健院牵头,与上海交通大学医学院附属新华医院、复旦大学妇产科医院及加拿大舍布鲁克大学等知名大学和机构共同组成研究团队。项目纳入的研究对象主要来自上海市徐汇区、长宁区、闵行区、奉贤区、松江区的妇幼保健院及其管辖的42个社区卫生服务中心。本项目所采用的生命早期多层面综合干预方案将在上海地区乃至全国进行推广,研究结果期待为WHO制定儿童肥胖早期干预指南提供科学依据。

中国2014—2020年7~12岁儿童生长趋势及超重肥胖状况分析

背景自改革开放以来,中国的社会经济快速发展,儿童的身高、体质量等基础指标快速上升。既往研究显示中国儿童的身高增长放缓,体质量的增长加速,导致了超重和肥胖的高患病率,调查当前中国儿童的生长发育与营养状况对于预防及应对生长趋势的消极影响十分重要。目的分析2014—2020年中国7~12岁儿童生长趋势和超重肥胖趋势,为制定儿童体质促进和肥胖预防措施提供科学依据。方法本研究于2022年5月选取中国家庭追踪调查(CFPS)2014年、2016年、2018年和2020年4次调查中10817名7~12岁儿童的身高、体质量和BMI数据,以性别和城乡分层,比较2014—2020年不同性别和城乡间身高、体质量、超重患病率、肥胖患病率和超重肥胖患病率的流行趋势,并采用Logistic回归分析探讨中国2014—2020年7~12岁儿童超重肥胖影响因素。结果2020年7~12岁城市女性儿童、乡村男性儿童、乡村女性儿童的身高相较于2014年增高了3.8 cm(95%CI=1.3~6.2 cm)、6.5 cm(95%CI=4.3~8.5 cm)、6.6 cm(95%CI=4.3~8.8 cm);2020年7~12岁城市男性儿童、城市女性儿童、乡村男性儿童、乡村女性儿童的体质量相较于2014年增高了2.3 kg(95%CI=0.8~3.9 kg)、2.1 kg(95%CI=0.6~3.7 kg)、3.0 kg(95%CI=1.7~4.2 kg)、3.0 kg(95%CI=1.8~4.2 kg),差异有统计学意义(P<0.05)。2014—2020年间,男性儿童的超重肥胖率从26.5%上升至29.5%,女性儿童的肥胖率和超重肥胖率分别从12.1%和21.1%下降至7.9%和17.3%,城市儿童的超重率和超重肥胖率分别从11.7%和21.6%上升至14.9%和26.4%,乡村儿童的肥胖率和超重肥胖率分别从14.3%和25.8%下降至11.2%和21.6%,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄和性别是儿童超重的影响因素(P<0.05);城乡、年龄和性别是儿童肥胖和超重肥胖的影响因素(P<0.05);年龄是男性儿童肥胖的影响因素(P<0.05);年龄和年份是男性儿童超重肥胖的影响因素(P<0.05);年龄是女性儿童超重的影响因素(P<0.05);城乡、年龄和年份是女性儿童肥胖和超重肥胖的影响因素(P<0.05)。结论2014—2020年间,中国7~12岁儿童身体形态快速增长,乡村增量大于城市,城乡差距缩小,同时男性和城市儿童超重肥胖患病率继续增加,女性和乡村儿童下降。城乡、年龄和性别是儿童超重肥胖患病率的影响因素。

2018—2023年上海市普陀区7~18岁儿童青少年中心性肥胖变化趋势分析

背景随着居民经济水平的提高及生活方式的改变,儿童青少年肥胖问题日益严峻,威胁着儿童青少年的健康成长,目前多数研究主要以BMI作为儿童青少年肥胖的评价指标,可能低估了儿童青少年中心性肥胖水平。因此,亟需评价儿童青少年中心性肥胖水平及变化趋势,为有针对性提出干预措施提供科学依据。目的分析2018—2023年上海市普陀区7~18岁儿童青少年腰围水平及中心性肥胖率变化趋势。方法利用2018年、2020—2023年上海市普陀区中小学生健康体检数据,分析普陀区7~18岁儿童青少年腰围水平、中心性肥胖率及变化趋势。以不同性别儿童青少年年龄别第90百分位数(P_(90))作为儿童青少年高腰围界值点,将腰围超过同年龄同性别组的P_(90)值定义为中心性肥胖。应用SPSS 22.0、SAS 13.1软件进行统计学分析、Excel 2021进行图形绘制。结果2018—2023年参加上海市普陀区中小学生健康体检学生共280648人次,其中男生146334人次(52.1%),女生134314人次(47.9%),中位年龄为10.5(8.7,12.6)岁。2018—2023年男女生腰围整体水平呈波动下降趋势,差异有统计学意义(H_男=209.785、H_女=373.076,P<0.001),男生由2018年的65.2(58.0,74.0)cm下降至2023年的64.8(56.9,74.0)cm,女生由60.5(55.0,67.0)cm下降至59.8(53.8,66.2)cm。2018—2023年男女生组各年份中心性肥胖率比较,差异均有统计学意义(χ_(男)^(2)=264.123、χ_(女)^(2)=448.289,P<0.001);Cochran-Armitage趋势检验结果显示,2018—2023年男女生组中心性肥胖率整体呈下降趋势(Z_(趋势男)=-10.974,Z_(趋势女)=-15.218,P_(趋势)<0.001);男生中心性肥胖率由2018年的28.8%(6714/23286)下降至2023年的24.6%(7935/32227),女生中心性肥胖率由21.9%(4604/21062)下降至15.5%(4604/29695)。男生整体腰围水平及中心性肥胖率均高于女生(U=7128257114.500、χ^(2)=2928.075,P<0.001)。男女生中心性肥胖率随年龄增长呈上升趋势(Z_(趋势男)=35.167,Z_(趋势女)=6.533,P_(趋势)<0.001)。结论本研究提示普陀区7~18岁儿童青少年腰围水平、中心性肥胖率呈波动下降趋势;男生腰围水平和中心性肥胖率较同年龄女生高;中心性肥胖率随年龄增长呈上升趋势,本研究结果为后续有针对性开展儿童青少年中心性肥胖干预工作提供了理论支持。

有氧运动对超重肥胖儿童执行功能影响的Meta分析

背景研究证实,超重肥胖儿童执行功能与肥胖密切相关,并可能存在双向关联。有氧运动作为一种有效的干预手段,可有效促进其大脑发展和认知功能,尤其是执行功能,但改善效果的量化关系仍需要进一步探讨。目的系统评价有氧运动对超重肥胖儿童执行功能相关指标干预效果。方法检索中国知网(CNKI)、万方数据知识服务平台(Wanfang Data)、中国生物医学文献数据库(CBM)、Cochrane Library、PubMed、Embase、Web of Science数据库中有氧运动干预超重肥胖儿童执行功能的随机对照试验,检索时限从各数据库建库至2023年7月。依据Cochrane风险偏倚评估工具对纳入的文献进行质量评估,采用RevMan 5.4和Stata 15.0软件对结局指标进行Meta分析。结果最终纳入9项随机对照试验,其中包括940例超重肥胖儿童。Meta分析结果显示,单次有氧运动干预能够有效提高超重肥胖儿童的执行功能(WMD=-6.98,95%CI=-11.89~-2.07,P=0.005);亚组分析结果显示,单次干预时长<30 min的有氧运动对超重肥胖儿童执行功能子成分的改善均无显著性差异(WMD=-0.84,95%CI=-9.37~7.68,P=0.85);单次干预时长>30 min的有氧运动可改善超重肥胖儿童的抑制功能(WMD=-10.50,95%CI=-19.15~-1.85,P=0.02)。进行长期运动干预(干预周期为8周)时,与对照组相比,有氧运动可改善超重肥胖儿童干扰控制(WMD=-0.16,95%CI=-0.18~-0.14,P<0.00001),对计划(WMD=4.20,95%CI=-8.34~16.73,P=0.51)、注意(WMD=0.41,95%CI=-12.08~12.91,P=0.95)、同步(WMD=3.93,95%CI=-8.22~16.08,P=0.53)、连续(WMD=2.48,95%CI=-9.18~14.14,P=0.68)的改善效果不明显。结论单次长时间的有氧运动对超重肥胖儿童执行功能子成分有选择性积极影响,长周期固定频次、时间的有氧运动可以改善超重肥胖儿童干扰控制能力,但计划、注意、同步、连续方面未产生改善效果。

以腹痛、淀粉酶升高为主要表现的糖尿病酮症酸中毒肥胖患儿误诊为急性胰腺炎临床分析

目的 探讨以腹痛、淀粉酶升高为主要表现的糖尿病酮症酸中毒(DKA)肥胖患儿误诊为急性胰腺炎的原因及防范措施。方法 回顾性分析2022年4月—2023年5月收治的曾误诊为急性胰腺炎的DKA肥胖患儿6例的临床资料。结果 6例均因持续性剧烈腹痛就诊,中上腹压痛,血尿淀粉酶升高,腹部B超检查示胰腺均稍增大,初步诊断为急性胰腺炎,予相应治疗腹痛无缓解。误诊时间7~20 h。后根据病史、实验室及腹部CT检查确诊为DKA。予补液、小剂量胰岛素、纠正酸碱失衡及水电解质紊乱等治疗1~3 d,病情缓解。结论 对以原因不明腹痛、淀粉酶升高就诊者,应详细询问是否有糖尿病病史或家族史,开拓诊断思维,认真查体和鉴别诊断,及早行相关检查,以提高DKA确诊率。

中医在儿童青少年肥胖管理中应用的研究进展

中医学认为,阴阳平衡的失调是儿童青少年肥胖的根本原因。中医从内分泌调节着手,针对肝、脾、肾、心脏、肺以及三焦等脏腑进行有针对性的调整,通过调和气血津液的相互作用,以达到身体内部的整体协调,从而达到减肥的目标,在应对肥胖症方面展现了显著疗效。本文对中医在肥胖治疗方面的认识以及研究进展进行了综述,旨在为未来青少年儿童肥胖研究提供方向和理论基础。

中国7~12岁儿童生长迟缓与肥胖并存的共病调查与影响因素分析

目的分析2010—2020年中国7~12岁儿童生长迟缓型肥胖的变化趋势及影响因素,为制定儿童体质健康干预措施提供依据。方法选取中国家庭追踪调查(China Family Panel Studies,CFPS)2010—2020年调查中16289名7~12岁儿童的身高及体重指数数据,分析2010—2020年不同性别和城乡间生长迟缓率、肥胖率和生长迟缓型肥胖率的流行趋势,以及儿童生长迟缓型肥胖的影响因素。结果2010—2020年中国7~12岁儿童生长迟缓率、生长迟缓型肥胖率总体水平呈下降趋势(P<0.05);按性别、城乡分组,2010—2020年除乡村男女儿童组、乡村儿童组、女性儿童组外,其余各组肥胖率总体水平呈上升趋势(P<0.05);男性及乡村儿童的生长迟缓率、肥胖率、生长迟缓型肥胖率总体水平分别高于女性及城市儿童,差异均有统计学意义(P<0.05);城乡、年龄、性别、年份是7~12岁儿童生长迟缓、生长迟缓型肥胖的影响因素(P<0.05)。结论中国7~12岁儿童的生长迟缓率、肥胖率及生长迟缓型肥胖率存在性别、城乡差异,应重点关注和预防男性及乡村儿童的生长迟缓型肥胖。