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青少年营养不良双重负担的模式与决定因素:中国农村一个出生队列的14年随访

Patterns and Determinants of the Double Burden of Malnutrition Among Adolescents: A 14-Year Follow-Up of a Birth Cohort in Rural China.

作者信息

Elhoumed Mohamed, Andegiorgish Amanuel Kidane, Qi Qi, Gebremedhin Mitslal Abrha, Wang Liang, Uwimana Gérard, Cheng Yue, Zhu Zhonghai, Zeng Lingxia

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, P. R. China; National Institute of Public Health Research (INRSP), Nouakchott, Mauritania.

Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, P. R. China; Department of Epidemiology and Biostatistics, Asmara College of Health Sciences, School of Public Health, Asmara, Eritrea.

出版信息

J Pediatr. 2022 Mar;242:48-56.e3. doi: 10.1016/j.jpeds.2021.10.062. Epub 2021 Nov 6.

DOI:10.1016/j.jpeds.2021.10.062
PMID:34748738
Abstract

OBJECTIVE

To examine the prevalence of the double burden of malnutrition and its associated factors among adolescents in rural China.

STUDY DESIGN

A birth cohort of adolescents born to women in northwestern China who participated in a double-blind, randomized, controlled trial of micronutrient supplementation during pregnancy from August 2002 to January 2006 was enrolled. Follow-up was conducted from June to December 2016.

RESULTS

A total of 2115 participants were analyzed (median age 12 years; IQR ± 1), the majority of whom were male (59.7%). The nutritional status distribution was 17.72% underweight, 8.62% overweight, 0.96% obese, and 2.58% stunted. Girls were less likely to be overweight/obese (relative risk ratio [RRR] 0.67, 95% CI 0.48-0.92) but more likely to be underweight (RRR 1.65, 95% CI 1.25-2.17) or stunted (RRR 2.26, 95% CI 1.21-4.22). Children of underweight mothers (RRR 1.63, 95% CI 1.19-2.25) with a history of small for gestational age (RRR 1.64, 95% CI 1.14-2.36) or described as being a "picky eater" (RRR 1.53, 95% CI 1.18-1.99) had a greater risk of being underweight. Children whose fathers' education was primary or below (RRR 2.25, 95% CI 1.11-4.59), with maternal height <150.1 cm (RRR 2.46, 95% CI 1.12-5.39), or who had mothers with underweight (RRR 2.80, 95% CI 1.37-5.72) had a greater likelihood of stunting. Overweight/obesity was associated with high and middle household wealth (RRR 1.62, 95% CI 1.14-2.32), mothers with overweight (RRR 1.86, 95% CI 1.25-2.78), and picky eating (RRR 0.62, 95% CI 0.46-0.84).

CONCLUSIONS

Malnutrition (undernutrition and overweight/obesity) is common in rural Chinese adolescents and is associated with perinatal, genetic, and economic conditions.

摘要

目的

调查中国农村青少年营养不良双重负担的患病率及其相关因素。

研究设计

纳入了2002年8月至2006年1月在中国西北部地区参与孕期微量营养素补充双盲、随机、对照试验的妇女所生育的青少年出生队列。随访时间为2016年6月至12月。

结果

共分析了2115名参与者(中位年龄12岁;四分位间距±1),其中大多数为男性(59.7%)。营养状况分布为:体重不足17.72%,超重8.62%,肥胖0.96%,发育迟缓2.58%。女孩超重/肥胖的可能性较小(相对风险比[RRR]0.67,95%可信区间0.48 - 0.92),但体重不足(RRR 1.65,95%可信区间1.25 - 2.17)或发育迟缓(RRR 2.26,95%可信区间1.21 - 4.22)的可能性较大。母亲体重不足(RRR 1.63,95%可信区间1.19 - 2.25)、有小于胎龄儿病史(RRR 1.64,95%可信区间1.14 - 2.36)或被描述为“挑食者”(RRR 1.53,95%可信区间1.18 - 1.99)的儿童体重不足风险更大。父亲受教育程度为小学及以下(RRR 2.25,95%可信区间1.11 - 4.59)、母亲身高<150.1厘米(RRR 2.46,95%可信区间1.12 - 5.39)或母亲体重不足(RRR 2.80,95%可信区间1.37 - 5.72)的儿童发育迟缓的可能性更大。超重/肥胖与中高家庭财富(RRR 1.62,95%可信区间1.14 - 2.32)、母亲超重(RRR 1.86,95%可信区间1.25 - 2.78)和挑食(RRR 0.62,95%可信区间0.46 - 0.84)有关。

结论

营养不良(营养不足和超重/肥胖)在中国农村青少年中很常见,并且与围产期、遗传和经济状况有关。

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