Djalalinia Shirin, Kelishadi Roya, Qorbani Mostafa, Sheidaei Ali, Emamian Mohammad Hassan, Motlagh Mohammad Esmaeil, Ardalan Gelayol, Asayesh Hamid, Mahdavi Gorabi Armita, Heshmat Ramin
Ministry of Health and Medical Education, Tehran, Iran.
Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
J Diabetes Metab Disord. 2021 Feb 20;20(1):467-476. doi: 10.1007/s40200-021-00767-6. eCollection 2021 Jun.
The current study aims to evaluate socioeconomic inequality in growth disorders and its determinants in Iranian children and adolescents.
In this nationwide cross-sectional survey, 14,880 students aged 6-18 years were selected through multistage cluster sampling method from urban and rural areas of 30 provinces of Iran in 2011. Socioeconomic status (SES) was calculated using principle component analysis. Socioeconomic inequality in growth disorders (including; underweight, excess weight, overweight, general obesity, abdominal obesity, and short stature) was assessed using concentration index (C) and slope index of inequality (SII). The Oaxaca Blinder decomposition method was used to determine determinants of this inequality.
Totally, 13,486 students participated in this study (participation rate: 90.6%), comprising 50.8% boys and 75.6% urban inhabitants. Their mean age was 12.47 ± 3.36 years with no significant gender difference. The prevalence of excess weight, overweight, and general and abdominal obesity increased linearly as SES increased, and the prevalence of underweight and short stature decreased linearly as SES increased. The C index for underweight and short stature was negative, which suggests that inequality was in favor of high SES groups, and regarding overweight, excess weight, general and abdominal obesity, the index was positive, indicating that inequality was in favor of in low SES groups.
Our findings show a considerable inequality in prevalence of growth disorders in Iranian children and adolescents. These findings provide practical information for health policies and programs.
本研究旨在评估伊朗儿童和青少年生长发育障碍方面的社会经济不平等现象及其决定因素。
在这项全国性横断面调查中，2011年通过多阶段整群抽样方法从伊朗30个省的城乡地区选取了14880名6至18岁的学生。采用主成分分析法计算社会经济地位（SES）。使用集中指数（C）和不平等斜率指数（SII）评估生长发育障碍（包括体重过轻、超重、肥胖、全身肥胖、腹型肥胖和身材矮小）方面的社会经济不平等。采用Oaxaca Blinder分解法确定这种不平等的决定因素。
共有13486名学生参与了本研究（参与率：90.6%），其中男生占50.8%，城市居民占75.6%。他们的平均年龄为12.47±3.36岁，性别差异不显著。随着SES的升高，超重、肥胖、全身肥胖和腹型肥胖的患病率呈线性上升，而体重过轻和身材矮小的患病率则呈线性下降。体重过轻和身材矮小的C指数为负，这表明不平等有利于高SES群体；而对于超重、肥胖、全身肥胖和腹型肥胖，该指数为正，表明不平等有利于低SES群体。
我们的研究结果表明，伊朗儿童和青少年生长发育障碍患病率存在相当大的不平等。这些发现为卫生政策和项目提供了实用信息。
