Wang Jun-Yi, Hu Pei-Jin, Luo Dong-Mei, Dong Bin, Ma Yinghua, Dai Jie, Song Yi, Ma Jun, Lau Patrick W C
Institute of Child and Adolescent Health, Peking University School of Public Health, National Health Commission Key Laboratory of Reproductive Health, Beijing, China.
Department of Sport and Physical Education, Hong Kong Baptist University, Kowloon Tong, China.
Front Pediatr. 2020 May 12;8:193. doi: 10.3389/fped.2020.00193. eCollection 2020.
The aim of this study was to assess the geographic disparity in anemia and whether stunting was associated with anemia in different geographic groups among school-aged children in China. 71,129 Han children aged 7, 9, 12, and 14 years old were extracted from the 2014 cycle of Chinese National Surveys on Children Constitution and Health. Anemia, anemia severity, and stunting were defined according to WHO definitions. Binary logistic regression models were used to estimate the association between anemia and stunting in different geographic groups. The prevalence of anemia was significantly higher in girls (10.8%) than boys (7.0%). The highest anemia prevalence was in Group VII (lower class/rural, 12.0%). A moderate/severe prevalence of anemia was concentrated in Group VII and Group VIII (western/lower class/rural) for both sexes. The prevalence of anemia was higher in stunting boys than non-stunting boys in Group IV (lower class/city, χ = 12.78, = 0.002) and Group VII (χ = 6.21, = 0.018), while for girls, it was higher in stunting girls than their non-stunting peers only in Group II (upper class/large city, χ = 4.57, = 0.046). Logistic regression showed that the stunting children have 30% higher risk of anemia than non-stunting children after adjustment for age, sex and school (OR = 1.30, 95% CI: 1.05-1.60). A significant geographic disparity and an association between anemia and stunting among specific groups of school-aged children in China was demonstrated. Consequently, eliminating the geographic disparity and ameliorating stunting might contribute to the improvement of Chinese children's anemia. Specific guidelines and interventions are needed, especially for adolescent girls and the groups with serious anemia burden.
本研究旨在评估中国学龄儿童贫血的地域差异，以及不同地域组中发育迟缓与贫血是否相关。从2014年中国儿童体质与健康全国调查中提取了71129名7、9、12和14岁的汉族儿童。贫血、贫血严重程度和发育迟缓根据世界卫生组织的定义进行界定。采用二元逻辑回归模型估计不同地域组中贫血与发育迟缓之间的关联。女孩的贫血患病率（10.8%）显著高于男孩（7.0%）。贫血患病率最高的是第七组（下层/农村，12.0%）。男女中重度贫血患病率均集中在第七组和第八组（西部/下层/农村）。在第四组（下层/城市，χ = 12.78，P = 0.002）和第七组（χ = 6.21，P = 0.018）中，发育迟缓男孩的贫血患病率高于非发育迟缓男孩，而对于女孩，仅在第二组（上层/大城市，χ = 4.57，P = 0.046）中，发育迟缓女孩的贫血患病率高于非发育迟缓同伴。逻辑回归显示，在对年龄、性别和学校进行调整后，发育迟缓儿童患贫血的风险比非发育迟缓儿童高30%（OR = 1.30，95%CI：1.05 - 1.60）。研究表明中国学龄儿童特定群体中存在显著的地域差异以及贫血与发育迟缓之间的关联。因此，消除地域差异和改善发育迟缓可能有助于改善中国儿童的贫血状况。需要制定具体的指导方针和干预措施，特别是针对青春期女孩和贫血负担较重的群体。
