Yang Min, Deng Xiangling, Wang Shunan, Zhou Bo, Niu Wenquan, Zhang Zhixin
Graduate School, Beijing University of Chinese Medicine, Beijing, China.
Department of Pediatrics, China-Japan Friendship Hospital, Beijing, China.
Endocr Connect. 2021 Jun 14;10(6):607-619. doi: 10.1530/EC-21-0147.
We aimed to identify and characterize potential factors, both individually and jointly as a nomogram, associated with short stature and pre-shortness in Chinese preschool-aged children.
Total of 9501 children aged 3-6 years were recruited from 30 kindergartens in Beijing and Tangshan from September to December 2020 using a stratified random sampling method. Effect-size estimates are expressed as odds ratio (OR) and 95% CI.
The prevalence of short stature and pre-shortness in preschool-aged children was 3.9% (n = 375) and 13.1% (n = 1616), respectively. Factors simultaneously associated with the significant risk for short stature, pre-shortness and both included BMI, paternal height, maternal height, birth weight, birth height, latter birth order (≥2) and less parental patience to children. Besides, breastfeeding duration (≥12 months) was exclusively associated with pre-shortness (OR, 95% CI, P: 1.16, 1.01 to 1.33, 0.037), and childhood obesity with both short stature (3.45, 2.62 to 4.54, <0.001) and short stature/pre-shortness (1.37, 1.15 to 1.64, <0.001). Modeling of significant factors in nomograms had descent prediction accuracies, with the C-index being 77.0, 70.1 and 71.2% for short stature, pre-shortness and both, respectively (all P < 0.001).
Our findings indicate the joint contribution of inherited characteristics, nutrition status from the uterus to childhood, and family psychological environment to short stature and pre-shortness in Chinese preschool-aged children. Further validation in other independent groups is warranted.
我们旨在识别并描述与中国学龄前儿童身材矮小和矮小倾向相关的潜在因素，包括单个因素以及作为列线图的联合因素。
2020年9月至12月，采用分层随机抽样方法，从北京和唐山的30所幼儿园招募了9501名3至6岁的儿童。效应量估计值以比值比（OR）和95%置信区间表示。
学龄前儿童身材矮小和矮小倾向的患病率分别为3.9%（n = 375）和13.1%（n = 1616）。与身材矮小、矮小倾向以及两者的显著风险同时相关的因素包括体重指数、父亲身高、母亲身高、出生体重、出生身高、出生顺序靠后（≥2）以及父母对孩子的耐心较少。此外，母乳喂养持续时间（≥12个月）仅与矮小倾向相关（OR，95%置信区间，P：1.16，1.01至1.33，0.037），而儿童肥胖与身材矮小（3.45，2.62至4.54，<0.001）以及身材矮小/矮小倾向（1.37，1.15至1.64，<0.001）均相关。列线图中显著因素的模型具有良好的预测准确性，身材矮小、矮小倾向以及两者的C指数分别为77.0%、70.1%和71.2%（均P < 0.001）。
我们的研究结果表明，遗传特征、从子宫内到儿童期的营养状况以及家庭心理环境共同影响中国学龄前儿童的身材矮小和矮小倾向。有必要在其他独立群体中进行进一步验证。
