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智利学童的生长发育迟缓

Growth deficits in Chilean school children.

作者信息

Amigo H, Bustos P, Leone C, Radrigán M E

机构信息

Department of Nutrition, School of Medicine, University of Chile, Santiago, Chile, USA.

出版信息

J Nutr. 2001 Feb;131(2):251-4. doi: 10.1093/jn/131.2.251.

Abstract

Stunting is highly prevalent in Latin American countries regardless of socioeconomic performance. The purpose of this study was to identify risk factors of growth deficit among children starting primary education whose parents were of short stature compared with those whose parents were not of short stature, in the poorest districts of Santiago, Chile. A case-control study was carried out with two types of cases. Case 1 included children whose height was between -1.0 and -3.0 (SD) of the height/age of the National Center for Health Statistics/World Health Organization standard and whose parent's height was below -2.0 SD (n = 115). Case 2 included stunted children (as defined previously) whose parent's height was above -2 SD (n = 76). Controls were children whose stature was +/-0.5 SD and whose parent's height was also above -2 SD (n = 115). Logistic regression models were carried out for case 1 and 2 children compared with the controls. Similar risk factors were found in both models, without any significant interaction: these included history of malnutrition, drunkenness in the family, lack of health care, unhygienic housing conditions, small length at birth and short period of exclusive breastfeeding. The most important risk factors for case 1 children were a history of malnutrition [with an odds ratio (OR) of 5.26 and confidence interval (CI) of 2.68-10.34] and short length at birth (OR = 4.87, CI 2.18-10.92). For case 2 children, the most important risk factors were a history of malnutrition (OR = 4.58, CI 2.20-9.53) and unhygienic housing conditions (OR = 4.29, CI 1.76-10.48). In conclusion, similar factors explained growth deficits in children starting primary school independent of the parent's height, suggesting that genetics would have a limited impact at this age and at this socioeconomic level. To reduce stunting in countries with an epidemiological profile such as that of Chile, it is still important to reduce adverse environmental conditions.

摘要

无论社会经济状况如何,发育迟缓在拉丁美洲国家都极为普遍。本研究的目的是,在智利圣地亚哥最贫困的地区,确定父母身材矮小的小学入学儿童与父母身材正常的儿童相比,生长发育不足的风险因素。开展了一项病例对照研究,包含两种类型的病例。病例1包括身高处于美国国家卫生统计中心/世界卫生组织标准身高/年龄的-1.0至-3.0(标准差)之间且父母身高低于-2.0标准差的儿童(n = 115)。病例2包括父母身高高于-2标准差的发育迟缓儿童(如前所述定义)(n = 76)。对照为身高处于±0.5标准差且父母身高也高于-2标准差的儿童(n = 115)。对病例1和病例2儿童与对照进行了逻辑回归模型分析。在两个模型中发现了相似的风险因素,且无任何显著交互作用:这些因素包括营养不良史、家庭中有酗酒情况、缺乏医疗保健、住房条件不卫生、出生时身长较短以及纯母乳喂养时间短。病例1儿童最重要的风险因素是营养不良史[优势比(OR)为5.26,置信区间(CI)为2.68 - 10.34]和出生时身长较短(OR = 4.87,CI 2.18 - 10.92)。对于病例2儿童,最重要的风险因素是营养不良史(OR = 4.58,CI 2.20 - 9.53)和住房条件不卫生(OR = 4.29,CI 1.76 - 10.48)。总之,相似的因素可解释小学入学儿童的生长发育不足,与父母身高无关,这表明在这个年龄和这种社会经济水平下,遗传因素的影响有限。对于像智利这种具有此类流行病学特征的国家,要减少发育迟缓,减少不良环境条件仍然很重要。

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