Chen Manman, Li Yanhui, Chen Li, Gao Di, Yang Zhaogeng, Ma Ying, Ma Tao, Dong Bin, Dong Yanhui, Ma Jun, Hu Jie
National Health Commission Key Laboratory of Reproductive Health, School of Public Health, Institute of Child and Adolescent Health, Peking University, Beijing, China.
Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
Front Pediatr. 2021 May 20;9:661164. doi: 10.3389/fped.2021.661164. eCollection 2021.
To evaluate the associations between single-child status and metabolic syndrome (MS) and to identify the highest risk group of MS among single children. Differences in participants' characteristics by sex were examined by Student's -test for continuous variables and Pearson's chi-squared test for categorical variables. Multivariate logistic regression analysis was performed to estimate the odds ratios () and 95% confidence intervals () for MS and its components according to the single-child status. Radar maps were used to compare the composition of different components in MS. In total, 11,784 (5,880 boys) children and adolescents were included in this study, with a mean age of (11.3 ± 3.1) years. MS was observed in 7.1% of participants, with a higher prevalence in boys (8.2%) than girls (5.9%) ( < 0.05). The prevalence of MS, elevated blood pressure and abdominal obesity in single children were higher than that in children with siblings, particularly in boys ( < 0.001). Elevated risk of abdominal obesity was observed in single children [boys (1.56, 95% CI: 1.31, 1.85), girls (1.40, 95% CI: 1.19, 1.63)], however, increased ORs of elevated blood pressure and metabolic syndrome were observed in single-child boys only (1.19, 95% CI: 1.01, 1.40 and 1.76, 95% CI: 1.34, 2.31, respectively). Results showed that a statistically significant association between single child status and MS was mainly observed in urban boys (2.04, 95% CI: 1.33, 3.12) and rural boys (1.50, 95% CI: 1.05, 2.15), but not in girls. Among all the combinations of MS, two combinations were significantly associated with the single-child status, including the combination of elevated blood pressure, abdominal and low HDL-C (1.45, 1.04, 2.04) and the combination of elevated blood pressure, abdominal obesity, low HDL-C and hypertriglyceridemia (2.04, 1.40, 3.06) ( < 0.05). The present study found that single children and adolescents had a higher risk of MS, elevated blood pressure and abdominal obesity. The associations were stronger in urban boys. Further attention should be directed to the prevention and control strategies targeting the high-risk population of MS.
评估独生子女状况与代谢综合征（MS）之间的关联，并确定独生子女中MS的最高风险组。通过学生t检验分析连续变量参与者特征的性别差异，通过Pearson卡方检验分析分类变量参与者特征的性别差异。进行多因素逻辑回归分析，以估计根据独生子女状况得出的MS及其各组分的比值比（OR）和95%置信区间（CI）。使用雷达图比较MS中不同组分的构成。本研究共纳入11784名儿童和青少年（5880名男孩），平均年龄为（11.3±3.1）岁。7.1%的参与者患有MS，男孩患病率（8.2%）高于女孩（5.9%）（P<0.05）。独生子女中MS、血压升高和腹型肥胖的患病率高于有兄弟姐妹的儿童，尤其是男孩（P<0.001）。独生子女腹型肥胖风险升高[男孩（1.56，95%CI：1.31，1.85），女孩（1.40，95%CI：1.19，1.63）]，然而，仅独生子女男孩的血压升高和代谢综合征的OR升高（分别为1.19，95%CI：1.01，1.40和1.76，95%CI：1.34，2.31）。结果表明，独生子女状况与MS之间的统计学显著关联主要见于城市男孩（2.04，95%CI：1.33，3.12）和农村男孩（1.50，95%CI：1.05，2.15），而女孩未见此关联。在MS的所有组合中，两种组合与独生子女状况显著相关，包括血压升高、腹型肥胖和低HDL-C的组合（1.45，1.04，2.04）以及血压升高、腹型肥胖、低HDL-C和高甘油三酯血症的组合（2.04，1.40，3.06）（P<0.05）。本研究发现，儿童和青少年独生子女患MS、血压升高和腹型肥胖的风险更高。城市男孩中的关联更强。应进一步关注针对MS高危人群的防控策略。
