Ma Jia, Zhang Zhixin, Niu Wenquan, Chen Jie, Guo Sihui, Liu Shufang, Dong Yanhui, Yang Zhaogeng, Wang Wenlai, Song Ci, Ma Jun, Pei Tao
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.
Front Pediatr. 2019 Oct 30;7:425. doi: 10.3389/fped.2019.00425. eCollection 2019.
The north-south height distinctions in Chinese children suggest that some geographical-climatic factors could determine height variation of short stature. In a national health survey, we aimed to explore the spatial distribution of short stature on city scales, and detect its socio-economic and geographical-climatic factors. Data on the prevalence of short stature were obtained from a 2014 cross-sectional survey of China (CNSSCH). In total, 213,795 Han Chinese students aged 7-18 years, from 106 cities across 30 provinces, were included. Both China and World Health Organization (WHO) growth references were adopted to define short stature. A spatial clustering was apparent in the distribution of short stature. After multivariable adjustment, altitude and humidity significantly increased the risk of high prevalence in short stature, according to the WHO (odds ratio [OR] = 1.61 and 1.26, 95% confidence interval [CI]: 1.20-2.17 and 1.03-1.54) and China (OR = 1.54 and 1.26; 95% CI: 1.15-2.05 and 1.02-1.55) growth references. Additionally, education significantly decreased the risk of high prevalence in short stature according to the WHO (OR = 0.40; 95% CI: 0.22-0.74) and China (OR = 0.42; 95% CI: 0.22-0.77) growth references. Combining both altitude >400 m and education <9 years, as well as education <9 years and humidity >70%, received the largest effect-size estimate, and significance retained after multivariable adjustment. Our findings indicate that high altitude and humidity increased the risk of high prevalence in short stature, high education was associated with low prevalence. Additionally, we observed possible interactions between education and altitude/humidity. They may interactively explain spatial discrepancy and predict short stature in Chinese school children. Further validations are necessary.
中国儿童的南北身高差异表明，一些地理气候因素可能决定矮小身材的身高变化。在一项全国性健康调查中，我们旨在探讨城市尺度上矮小身材的空间分布，并检测其社会经济和地理气候因素。矮小身材患病率的数据来自2014年中国横断面调查（CNSSCH）。总共纳入了来自30个省份106个城市的213795名7至18岁的汉族学生。中国和世界卫生组织（WHO）的生长标准均被用于定义矮小身材。矮小身材的分布存在明显的空间聚集。多变量调整后，根据WHO（优势比[OR]=1.61和1.26，95%置信区间[CI]：1.20-2.17和1.03-1.54）和中国（OR=1.54和1.26；95%CI：1.15-2.05和1.02-1.55）的生长标准，海拔和湿度显著增加了矮小身材高患病率的风险。此外，根据WHO（OR=0.40；9%CI：0.22-0.74）和中国（OR=0.42；95%CI：0.22-0.77）的生长标准，教育程度显著降低了矮小身材高患病率的风险。海拔>400米且教育年限<9年，以及教育年限<9年且湿度>70%的组合，效应量估计最大，多变量调整后仍具有显著性。我们的研究结果表明，高海拔和高湿度增加了矮小身材高患病率的风险，高教育程度与低患病率相关。此外，我们观察到教育与海拔/湿度之间可能存在相互作用。它们可能相互作用解释空间差异并预测中国学龄儿童的矮小身材。需要进一步验证。
