Master of Public Health, Epidemiology, University of Toronto, Toronto, Canada.
The Hospital for Sick Children Research Institute, Child Health and Evaluative Sciences, SickKids Research Institute, Toronto, ON, Canada.
Int J Behav Nutr Phys Act. 2020 Apr 29;17(1):41. doi: 10.1186/s12966-020-00943-6.
While studies exist on the association between screen time and cardiometabolic risk among adolescents, research examining the effect of screen time on cardiometabolic risk in young children is lacking. The primary objective of this study was to examine the association between daily screen time and cardiometabolic risk (CMR) [sum of age- and sex-standardized z-scores of systolic blood pressure (SBP), glucose, log-triglycerides, waist circumference (WC), and negative high-density lipoprotein (HDL) cholesterol divided by the square root of five] in young children. Secondary objectives included examining individual CMR risk factors, including waist-to-height ratio and non high-density lipoprotein (non-HDL) cholesterol, as well as the individual cut-offs of these risk factors. Additional analyses include examining the association between screen time and CMR by handheld/non-handheld devices.
A study was conducted among young children 3 to 6 years from the TARGet Kids! practice-based research network in Toronto and Montreal, Canada. Children with one or more measures of screen time and CMR were included in this study. Generalized estimating equation (GEE) multivariable linear regressions and multivariable logistic regressions, using published cut-offs, were conducted to evaluate these associations.
Data from 1317 children [mean age 52 months (SD = 13.36), 44.34% female] were included for analyses. There was no evidence of associations between screen time and total CMR score or individual risk factors (p > 0.05) after adjusting for confounders. A statistically significant, but small association between daily screen time and non-HDL cholesterol was found (B = 0.046; CI = [0.017 to 0.075]; p = 0.002.
Though no relationship was reported between daily screen time and the majority of CMR factors in early childhood, there was an association between daily screen time and non-HDL cholesterol. As the relationship between daily screen time and CMR factors may not be apparent in early childhood, studies to evaluate longer-term cardiometabolic effects of screen time are needed. Although there is an evidence-based rationale to reduce screen time in early childhood, prevention of cardiometabolic risk may not be the primary driver.
虽然已有研究探讨了青少年的屏幕时间与心血管代谢风险之间的关联，但缺乏研究屏幕时间对幼儿心血管代谢风险影响的研究。本研究的主要目的是检验儿童每日屏幕时间与心血管代谢风险（CMR）[收缩压（SBP）、血糖、对数甘油三酯、腰围（WC）和负高密度脂蛋白（HDL）胆固醇的年龄和性别标准化 z 分数之和除以五的平方根]之间的关联。次要目标包括检查个别 CMR 风险因素，包括腰高比和非高密度脂蛋白（非-HDL）胆固醇，以及这些风险因素的个别临界值。其他分析包括检查手持/非手持设备的屏幕时间与 CMR 之间的关联。
本研究在加拿大多伦多和蒙特利尔的 TARGet Kids! 实践研究网络中的 3 至 6 岁幼儿中进行。本研究纳入了有一项或多项屏幕时间和 CMR 测量值的儿童。使用已发表的临界值，通过广义估计方程（GEE）多变量线性回归和多变量逻辑回归来评估这些关联。
共纳入 1317 名儿童的数据[平均年龄为 52 个月（标准差=13.36），44.34%为女性]进行分析。在调整了混杂因素后，屏幕时间与总 CMR 评分或个别风险因素之间没有关联（p>0.05）。每天的屏幕时间与非-HDL 胆固醇之间存在统计学上显著但较小的关联（B=0.046；CI=[0.017 至 0.075]；p=0.002）。
尽管在幼儿期，没有报告每日屏幕时间与大多数 CMR 因素之间存在关系，但每日屏幕时间与非-HDL 胆固醇之间存在关系。由于每日屏幕时间与 CMR 因素之间的关系在幼儿期可能不明显，因此需要研究评估屏幕时间对心血管代谢的长期影响。虽然有减少幼儿期屏幕时间的循证依据，但预防心血管代谢风险可能不是主要驱动因素。
