儿童早期不同阶段生长速度对6岁时糖脂代谢的影响

目的 评估婴幼儿期快速生长对其6岁时血糖血脂代谢的影响,为有效预防儿童期和成年后发生代谢性疾病提供理论依据。方法 选取2017年3月1日—2018年6月30日天津市50所市级管理的幼儿园的大班儿童9 719例为研究对象进行横断面调查。检测儿童身高、体重、空腹血糖、总胆固醇和甘油三酯,并回顾性收集其出生及2岁时的身长与体重等数据。定义两次测量的年龄别体重Z评分差值＞0.67为快速生长,分析0~2岁和2~5岁两阶段的快速生长与6岁时血糖和血脂代谢的关系。结果 0~2岁和2~5岁两阶段均为快速生长者在6岁时空腹血糖 (4.78±0.45)mmol/L与(4.66±0.51)mmol/L] 和甘油三酯 (0.96±0.44)mmol/L与(0.83±0.34)mmol/L] 均高于两阶段均为非快速生长者(P＜0.05)。Logistic回归分析结果显示,0~2岁快速生长 OR(95%CI):1.343(1.040~1.733)]、2~5岁快速生长 OR(95%CI):2.697(2.038~3.570)] 均为6岁时甘油三酯升高的危险因素(P＜0.05)。结论 儿童早期快速生长可能与儿童6岁时空腹血糖和甘油三酯升高有关。应重视儿童早期的适宜体重生长。

Effects of growth rate during infancy and childhood on glucose and lipid metabolism at 6 years old

Objective To assess the impact of rapid growth during infancy or childhood on serum levels of glucose and lipids at the age of 6 years old,to provide theoretical basis for the effective prevention of metabolic disease in childhood and adulthood. Methods From March 1st, 2017 to June 30th, 2018, a total of 9 719 children aged six years in senior class of 50 municipal kindergartens in Tianjin were selected by a cross-sectional survey. Body weight, height, serum levels of glucose, total cholesterol and triglycerides were measured. The anthropometry data at birth and at 1 year old was retrospectively collected. Rapid growth was defined as standard deviation higher than 0.67 of weight gain from two measurements. Then the correlations of rapid growth at 0- to 2-year-old, 2-to 5-year-old with blood glucose and lipids levels were analyzed. Results Compared with children with non-rapid growth, children with rapid growth during infancy (from birth up to 2 years old) and childhood (2 to 5 years old) had higher serum levels of glucose (4.78±0.45)mmol/L vs. (4.66±0.51)mmol/L] and triglycerides (0.96±0.44)mmol/L vs. (0.83±0.34)mmol/L] at 6 years old (P<0.05). Logistics regression analysis indicated that children with rapid growth during infancy(OR=1.343, 95%CI: 1.040—1.733) and childhood(OR=2.697, 95%CI: 2.038—3.570) increased the risk for higher level of triglycerides(P<0.05). Conclusions Rapid growth in early childhood is associated with both serum glucose and lipids levels at 6 years old. Thus appropriate weight gain should be emphasized to children.