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广州市6~12岁儿童糖代谢异常流行状况及其影响因素

普迎琦 桂曌环 黄闪 张羽珊 陈亚军

普迎琦, 桂曌环, 黄闪, 张羽珊, 陈亚军. 广州市6~12岁儿童糖代谢异常流行状况及其影响因素[J]. 中华疾病控制杂志, 2024, 28(2): 183-190. doi: 10.16462/j.cnki.zhjbkz.2024.02.009
引用本文: 普迎琦, 桂曌环, 黄闪, 张羽珊, 陈亚军. 广州市6~12岁儿童糖代谢异常流行状况及其影响因素[J]. 中华疾病控制杂志, 2024, 28(2): 183-190. doi: 10.16462/j.cnki.zhjbkz.2024.02.009
PU Yingqi, GUI Zhaohuan, HUANG Shan, ZHANG Yushan, CHEN Yajun. The prevalence of abnormal glucose metabolism and its associated factors in children aged 6-12 years in Guangzhou[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 183-190. doi: 10.16462/j.cnki.zhjbkz.2024.02.009
Citation: PU Yingqi, GUI Zhaohuan, HUANG Shan, ZHANG Yushan, CHEN Yajun. The prevalence of abnormal glucose metabolism and its associated factors in children aged 6-12 years in Guangzhou[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2024, 28(2): 183-190. doi: 10.16462/j.cnki.zhjbkz.2024.02.009

广州市6~12岁儿童糖代谢异常流行状况及其影响因素

doi: 10.16462/j.cnki.zhjbkz.2024.02.009
基金项目: 

国家自然科学基金 81673193

详细信息
    通讯作者:

    陈亚军,E-mail: chenyj68@mail.sysu.edu.cn

  • 中图分类号: R587.1;R179

The prevalence of abnormal glucose metabolism and its associated factors in children aged 6-12 years in Guangzhou

Funds: 

National Natural Science Foundation of China 81673193

More Information
  • 摘要:   目的  了解广州市6~12岁儿童空腹血糖(fasting plasma glucose,FPG)水平和糖代谢异常现状及其影响因素。  方法  采用分层整群随机抽样方法,在广州市抽取5所小学共4 690名6~12岁儿童进行问卷调查、体格检查和FPG检测。根据FPG值对儿童糖尿病(diabetes mellitus, DM)(FPG≥7.0 mmol/L)、空腹血糖受损(impaired fasting glucose, IFG)(6.1 mmol/L≤FPG<7.0 mmol/L)和糖代谢异常(FPG≥6.1 mmol/L)进行筛查。采用多因素线性回归分析模型和多因素logistic回归分析模型分析儿童FPG和糖代谢异常的影响因素。  结果  广州市6~12岁儿童FPG平均水平为(5.16±0.34) mmol/L,糖代谢异常率、IFG和DM检出率分别为0.79%、0.64%和0.15%。多因素线性回归分析模型结果显示男童(β=0.161, 95% CI:0.089~0.135, P<0.001)、9~12岁儿童(9~<11岁: β=0.071, 95% CI:0.025~0.075, P<0.001; 11~12岁: β=0.090, 95% CI:0.056~0.126, P<0.001)、腹型肥胖儿童(β=0.042, 95%CI: 0.009~0.078, P=0.013)FPG水平较高。多因素logistic回归分析模型分析结果腹型肥胖(β=1.576, OR=4.838, 95% CI:2.200~10.638, P<0.001)、未每天吃早餐的儿童(β=1.158, OR=3.184, 95% CI:1.069~9.484, P=0.038)糖代谢异常风险较高。  结论  广州市6~12岁儿童糖代谢异常率偏低,腹型肥胖、未每天吃早餐是儿童糖代谢异常的危险因素。
  • 表  1  广州市6~12岁儿童基本情况

    Table  1.   Basic information of children aged 6-12 years in Guangzhou

    特征  Characteristic 合计
    Total
    男童   Boy 女童   Girl t2
    value
    P
    value
    人数 Number of participants 4 690(100.00) 2 490(53.09) 2 200(46.91)
    年龄/岁  Age /years 9.12±1.75 9.11±1.75 9.13±1.75 -0.390 0.697
    DM家族史 Family history of DM 0.121 0.728
        无  No 2 555(70.62) 1 367(70.87) 1 188(70.34)
        有  Yes 1 063(29.38) 562(29.13) 501(29.66)
    BMI/(kg·m-2) 17.29±3.26 17.6±3.46 16.93±2.99 6.904 <0.001
    超重肥胖  Overweight and obesity 76.661 <0.001
        否  No 3 419(76.47) 1 713(71.32) 1 706(82.46)
        是  Yes 1 052(23.53) 689(28.68) 363(17.54)
    腹型肥胖  Abdominal obesity 60.372 <0.001
        否 No 3 965(86.16) 1 995(82.40) 1 970(90.33)
        是 Yes 637(13.84) 426(17.60) 211(9.67)
        血脂异常  Dyslipidemia 3.602 0.058
        否 No 3 274(69.81) 1 768(71.00) 1 506(68.45)
        是  Yes 1 416(30.19) 722(29.00) 694(31.55)
    注:BMI,体质指数;DM,糖尿病。
    ①以(x±s)或人数(占比/%)表示。
    Note: BMI, body mass index; DM, diabetes mellitus.
    ① (x±s) or number of people (proportion/%)。
    下载: 导出CSV

    表  2  广州市6~12岁儿童糖代谢流行状况

    Table  2.   Prevalence of glucose metabolism in children aged 6-12 years in Guangzhou

    特征
    Characteristic
    参与者人数(占比/%)
    Number of participants (proportion/%)
    FPG水平
    level (mmol/L, x±s)
    糖代谢异常儿童人数(占比/%)
    Number of children with abnormal glucose metabolism (proportion/%)
    IFG儿童人数(占比/%)
    Number of children with IFG (proportion/%)
    DM儿童人数(占比/%)
    Number of children with DM (proportion/%)
    合计  Total 4 690(100.00) 5.16±0.34 37(0.79) 30(0.64) 7(0.15)
    性别 Gender
        男 Boy 2 490(53.09) 5.21±0.34 22(0.88) 19(0.76) 3(0.12)
        女  Girl 2 200(46.91) 5.10±0.34 15(0.68) 11(0.50) 4(0.18)
        t2值  value 11.547 0.607 1.268 0.026
        P值  value <0.001 0.436 0.260 0.872
    年龄组/岁  Age group/years
        6~<9 1 832(39.06) 5.11±0.36 17(0.93) 13(0.71) 4(0.22)
        9~<11 1 611(34.35) 5.17±0.34 13(0.81) 11(0.68) 2(0.12)
        11~12 1 247(26.59) 5.22±0.32 7(0.56) 6(0.48) 1(0.08)
        F2值  value 39.772 1.284 0.685 0.907
        P值  value <0.001 0.526 0.710 0.714
    DM家族史  Family history of DM
        无 No 2 555(70.62) 5.15±0.34 19(0.74) 15(0.59) 4(0.16)
        有 Yes 1 063(29.38) 5.14±0.35 10(0.94) 8(0.75) 2(0.19)
        t2值  value 0.676 0.367 0.326 0.000
        P值 value 0.499 0.545 0.568 1.000
    超重肥胖  Overweight and obesity
        否  No 3 419(76.47) 5.15±0.34 21(0.61) 17(0.50) 4(0.12)
        是  Yes 1 052(23.53) 5.22±0.35 15(1.43) 12(1.14) 3(0.29)
        t2值  value -5.635 6.635 5.191 0.592
        P值  value <0.001 0.010 0.023 0.442
    腹型肥胖  Abdominal obesity
        否  No 3 965(86.16) 5.15±0.34 24(0.61) 20(0.50) 4(0.10)
        是  Yes 637(13.84) 5.22±0.37 13(2.04) 10(1.57) 3(0.47)
        t2值 value -5.102 14.181 8.107 2.868
        P值  value <0.001 <0.001 0.004 0.090
    血脂异常  Dyslipidemia
        否  No 3 274(69.81) 5.16±0.34 26(0.79) 22(0.67) 4(0.12)
        是  Yes 1 416(30.19) 5.15±0.35 11(0.78) 8(0.56) 3(0.21)
        t2值  value 1.281 0.004 0.176 0.101
        P值  value 0.200 0.951 0.675 0.751
    MVPA/(h·d-1)
        ≥1 1 265(35.41) 5.15±0.33 6(0.47) 6(0.47) 0(0.00)
        <1 2 307(64.59) 5.14±0.35 23(1.00) 17(0.74) 6(0.26)
        t2值  value 0.571 2.771 0.891 1.934
        P值  value 0.568 0.096 0.345 0.164
    SSB摄入/(杯·周-1)  SSB intake/(Cups·week-1)
        <2 2 324(64.92) 5.13±0.35 19(0.82) 13(0.56) 6(0.26)
        ≥2 1 256(35.08) 5.17±0.33 10(0.80) 10(0.80) 0(0.00)
        t2值  value -3.473 0.005 0.706 1.882
        P值  value 0.001 0.946 0.401 0.170
    油炸食品摄入  Fried food intake
        否  No 1 724(47.65) 5.14±0.34 14(0.81) 10(0.58) 4(0.23)
        是  Yes 1 894(52.35) 5.15±0.35 15(0.79) 13(0.69) 2(0.11)
        t2值  value -1.283 0.005 0.159 0.274
        P值  value 0.200 0.946 0.690 0.601
    每天吃早餐  Eat breakfast every day
        是  Yes 3 428(94.80) 5.14±0.34 25(0.73) 20(0.58) 5(0.15)
        否  No 188(5.20) 5.19±0.41 4(2.13) 3(1.60) 1(0.53)
        t2值  value -1.573 2.799 1.526 0.125
        P值  value 0.116 0.094 0.217 0.724
    注:DM, 糖尿病;IFG, 空腹血糖受损;FPG, 空腹血糖;MVPA, 中高强度体力活动;SSB, 含糖饮料。
    1.不同年龄段儿童FPG水平两两比较采用LSD法。
    ①采用连续性校正χ2检验;②采用Fisher确切概率法检验。
    Note: DM, diabetes mellitus; IFG, impaired fasting glucose; FPG, fasting plasma glucose; MVPA, moderate to vigorous physical activity; SSB, sugar-sweetened beverages.
    1.The LSD method was performed to compare the FPG levels in children of different age groups.
    ①Continuity correction χ2 test was adopted; ②The Fisher exact probability test was performed.
    下载: 导出CSV

    表  3  广州市6~12岁儿童FPG水平多因素线性回归分析模型分析

    Table  3.   Multiple linear regression analysis of fasting plasma glucose levels in children aged 6-12 years in Guangzhou

    因素 Factor 参与者人数(占比/%)
    Number of participants (proportion /%)
    FPG水平  level /(mmol·L-1), (x±s) 标准化β值(95% CI)
    Normalized β value (95% CI)
    t
    value
    P
    value
    性别  Gender
        男 Boy 2 490(53.09) 5.21±0.34 0.161(0.089~0.135)
        女  Girl 2 200(46.91) 5.10±0.34 1.000 -9.571 <0.001
    年龄组/岁  Age group/years
        6~<9 1 832(39.06) 5.11±0.36 1.000
        9~<11 1 611(34.35) 5.17±0.34 0.071(0.025~0.075) 3.966 <0.001
        11~12 1 247(26.59) 5.22±0.32 0.090(0.056~0.126) 5.069 <0.001
    DM家族史  Family history of DM
        无  No 2 555(70.62) 5.15±0.34 1.000
        有  Yes 1 063(29.38) 5.14±0.35 -0.018(-0.039~0.011) -1.108 0.268
    腹型肥胖  Abdominal obesity
        否  No 3 965(86.16) 5.15±0.34 1.000
        是 Yes 637(13.84) 5.22±0.37 0.042(0.009~0.078) 2.483 0.013
    血脂异常  Dyslipidemia
        否  No 3 274(69.81) 5.16±0.34 1.000
        是 Yes 1 416(30.19) 5.15±0.35 -0.018(-0.038~0.011) -1.057 0.291
    MVPA/(h·d-1)
        ≥1 1 265(35.41) 5.15±0.33 1.000
        <1 2 307(64.59) 5.14±0.35 0.008(-0.018~0.030) 0.483 0.629
    SSB摄入/(杯·周-1)  SSB intake/(Cups·week-1)
        <2 2 324(64.92) 5.13±0.35 1.000
        ≥2 1 256(35.08) 5.17±0.33 0.031(-0.002~0.047) 1.800 0.072
    油炸食品摄入  Fried food intake
        否  No 1 724(47.65) 5.14±0.34 1.000
        是  Yes 1 894(52.35) 5.15±0.35 -0.005(-0.027~0.020) -0.276 0.783
    每天吃早餐  Eat breakfast every day
        是  Yes 3 428(94.80) 5.14±0.34 1.000
        否  No 188(5.20) 5.19±0.41 0.024(-0.014~0.089) 1.412 0.158
    注:DM,糖尿病;MVPA, 中高强度体力活动;SSB, 含糖饮料;FPG, 空腹血糖。
    Note: DM, diabetes mellitus; MVPA, moderate to vigorous physical activity; SSB, sugar-sweetened beverages; FPG, fasting plasma glucose.
    下载: 导出CSV

    表  4  广州市6~12岁儿童糖代谢异常多因素logistic回归分析模型分析

    Table  4.   Multiple logistic regression analysis of abnormal glucose metabolism in children aged 6-12 years in Guangzhou

    因素  Factor β值  value sx Wald χ2值  value OR值  value (95% CI) P值 value
    性别  Gender
        男  Boy 1.000
        女 Girl 0.204 0.383 0.284 1.226 (0.579~2.597) 0.594
    年龄组/岁  Age group/years
        6~<9 1.000
        9~<11 -0.214 0.421 0.259 0.807 (0.354~1.841) 0.611
        11~12 0.128 0.537 0.056 1.136 (0.397~3.254) 0.812
    DM家族史  Family history of DM
        无  No 1.000
        有 Yes 0.084 0.398 0.045 1.088 (0.499~2.372) 0.833
    腹型肥胖  Abdominal obesity
        否  No 1.000
        是  Yes 1.576 0.402 15.375 4.838 (2.200~10.638) <0.001
    血脂异常  Dyslipidemia
        否  No 1.000
        是  Yes -0.493 0.440 1.256 0.611 (0.258~1.447) 0.262
    MVPA/(h·d-1)
        ≥1 1.000
        <1 0.768 0.463 2.753 2.156 (0.870~5.344) 0.097
    SSB摄入/(杯·周-1)  SSB intake/ (Cups·week-1)
        <2 1.000
        ≥2 -0.122 0.416 0.087 0.885 (0.392~1.998) 0.769
    油炸食品摄入  Fried food intake
        否  No 1.000
        是  Yes -0.046 0.390 0.014 0.955 (0.445~2.051) 0.906
    每天吃早餐  Eat breakfast every day
        是 Yes 1.000
        否  No 1.158 0.557 4.325 3.184 (1.069~9.484) 0.038
    注:DM,糖尿病;MVPA, 中高强度体力活动;SSB, 含糖饮料。
    Note: DM, diabetes mellitus; MVPA, moderate to vigorous physical activity; SSB, sugar-sweetened beverages.
    下载: 导出CSV
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出版历程
  • 收稿日期:  2023-03-31
  • 修回日期:  2023-08-23
  • 网络出版日期:  2024-03-30
  • 刊出日期:  2024-02-10

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