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6 月龄和 15 月龄柬埔寨儿童生长迟缓、消瘦与体成分的相关性及其与母乳喂养的关系。

Stunting, wasting and breast-feeding as correlates of body composition in Cambodian children at 6 and 15 months of age.

机构信息

Department of Nutrition, Exercise and Sports, University of Copenhagen, Rolighedsvej 26, 1958 Frederiksberg C, Denmark.

Department of Fisheries Post-harvest Technologies and Quality Control, Fisheries Administration, PO Box 582, 186 Preah Norodom Blvd., Phnom Penh 12301, Cambodia.

出版信息

Br J Nutr. 2019 Mar;121(6):688-698. doi: 10.1017/S0007114518003884. Epub 2019 Jan 23.

Abstract

The study aimed at assessing stunting, wasting and breast-feeding as correlates of body composition in Cambodian children. As part of a nutrition trial (ISRCTN19918531), fat mass (FM) and fat-free mass (FFM) were measured using 2H dilution at 6 and 15 months of age. Of 419 infants enrolled, 98 % were breastfed, 15 % stunted and 4 % wasted at 6 months. At 15 months, 78 % were breastfed, 24 % stunted and 11 % wasted. Those not breastfed had lower FMI at 6 months but not at 15 months. Stunted children had lower FM at 6 months and lower FFM at 6 and 15 months compared with children with length-for-age z ≥0. Stunting was not associated with height-adjusted indexes fat mass index (FMI) or fat-free mass index (FFMI). Wasted children had lower FM, FFM, FMI and FFMI at 6 and 15 months compared with children with weight-for-length z (WLZ) ≥0. Generally, FFM and FFMI deficits increased with age, whereas FM and FMI deficits decreased, reflecting interactions between age and WLZ. For example, the FFM deficits were -0·99 (95 % CI -1·26, -0·72) kg at 6 months and -1·44 (95 % CI -1·69; -1·19) kg at 15 months (interaction, P<0·05), while the FMI deficits were -2·12 (95 % CI -2·53, -1·72) kg/m2 at 6 months and -1·32 (95 % CI -1·77, -0·87) kg/m2 at 15 months (interaction, P<0·05). This indicates that undernourished children preserve body fat at the detriment of fat-free tissue, which may have long-term consequences for health and working capacity.

摘要

本研究旨在评估柬埔寨儿童的发育迟缓、消瘦和母乳喂养与身体成分的相关性。作为一项营养试验(ISRCTN82552400)的一部分,在 6 个月和 15 个月时使用 2H 稀释法测量脂肪量 (FM) 和去脂体重 (FFM)。在 419 名入组婴儿中,98%接受母乳喂养,15%发育迟缓,4%消瘦。在 15 个月时,78%接受母乳喂养,24%发育迟缓,11%消瘦。未接受母乳喂养的婴儿在 6 个月时的 FMI 较低,但在 15 个月时则没有。与身长别年龄 Z 值≥0 的儿童相比,发育迟缓的儿童在 6 个月时的 FM 较低,在 6 个月和 15 个月时的 FFM 较低。发育迟缓与身高调整后的脂肪量指数 (FMI) 或去脂体重指数 (FFMI) 无关。消瘦的儿童在 6 个月和 15 个月时的 FM、FFM、FMI 和 FFMI 均低于体重别身长 Z 值 (WLZ)≥0 的儿童。一般来说,FFM 和 FFMI 不足随着年龄的增长而增加,而 FM 和 FMI 不足则随着年龄的增长而减少,这反映了年龄与 WLZ 之间的相互作用。例如,6 个月时的 FFM 不足为-0.99(95%CI-1.26,-0.72)kg,15 个月时为-1.44(95%CI-1.69;-1.19)kg(交互作用,P<0.05),而 FMI 不足分别为 6 个月时-2.12(95%CI-2.53,-1.72)kg/m2 和 15 个月时-1.32(95%CI-1.77,-0.87)kg/m2(交互作用,P<0.05)。这表明,营养不良的儿童保留体脂肪,而损害去脂组织,这可能对健康和工作能力产生长期影响。

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