陈敏, 康淑蓉, 李云. 基于广义估计方程分析婴幼儿超重肥胖的影响因素[J]. 上海预防医学, 2020, 32(12): 1029-1034. DOI: 10.19428/j.cnki.sjpm.2020.20219
引用本文: 陈敏, 康淑蓉, 李云. 基于广义估计方程分析婴幼儿超重肥胖的影响因素[J]. 上海预防医学, 2020, 32(12): 1029-1034. DOI: 10.19428/j.cnki.sjpm.2020.20219
CHEN Min, KANG Shu-rong, LI Yun. Analysis on determinants of infants overweight and obesity based on generalized estimation equation[J]. Shanghai Journal of Preventive Medicine, 2020, 32(12): 1029-1034. DOI: 10.19428/j.cnki.sjpm.2020.20219
Citation: CHEN Min, KANG Shu-rong, LI Yun. Analysis on determinants of infants overweight and obesity based on generalized estimation equation[J]. Shanghai Journal of Preventive Medicine, 2020, 32(12): 1029-1034. DOI: 10.19428/j.cnki.sjpm.2020.20219

基于广义估计方程分析婴幼儿超重肥胖的影响因素

Analysis on determinants of infants overweight and obesity based on generalized estimation equation

  • 摘要:
    目的采用广义估计方程探讨婴幼儿超重、肥胖的影响因素。
    方法提取2017年1月至2019年12月在上海市闵行区完成儿童保健规范体检的26 624例2周岁幼儿的相关信息,计算6、12、18、24月龄的身高别体重以评价营养状况。以营养不良、正常、超重、肥胖为应变量,构建有序多分类应变量的广义估计方程,分析婴幼儿超重、肥胖的影响因素。
    结果随着月龄的增长,6~24月龄婴幼儿超重、肥胖的检出率均呈下降趋势,正常的比例呈上升趋势,差异有统计学意义(P < 0.001)。广义估计方程显示男性(OR=1.182)、母亲文化程度低(小学:OR=1.399;初中:OR=1.124;高中:OR=1.083)、父亲体重大(OR=1.003)、母亲孕前体重大(OR=1.003)、孕周长(OR=1.058)、6月龄时日睡眠时间长(OR=1.032)、低月龄(6月龄:OR=2.911;12月龄:OR=1.952;18月龄:OR=1.232)的婴幼儿超重、肥胖可能性大(P < 0.05)。低出生体重(< 2 500 g:OR=0.205;2 500~3 999 g:OR=0.410)、6月龄纯母乳喂养(OR=0.946)的婴幼儿超重、肥胖可能性小(P < 0.05)。
    结论应采取综合性干预措施,提倡准父母在孕前保持正常体重,加强科学育儿及喂养知识宣教,尽量延长纯母乳喂养时间,以控制婴幼儿超重、肥胖的发生。

     

    Abstract:
    ObjectiveTo explore the determinants of infants overweight and obesity using generalized estimation equation (GEE).
    MethodsData were extracted from 26 624 2-year old infants who completed required health examination from January 2017 to December 2019 in Minhang District of Shanghai.The weight for height at 6, 12, 18 and 24 months of age was calculated to evaluate nutrition status of infants.Ordinal multinomial GEE was fitted with malnutrition, normality, overweight and obesity as responding variables to explore the determinants of infants overweight and obesity.
    ResultsIncidence rate of overweight and obesity in infants of 6 to 24 months of age had a tendency of decline, and proportion of normality showed as increasing tendency along with the increase of months of age(P < 0.001).GEE showed that the following factors were more likely involved in infant overweight and obesity: male(OR=1.182), lower education level of mother (OR=1.399 for primary school, OR=1.124 for junior high school, and OR=1.083 for senior high school, respectively), higher body weight of father(OR=1.003), higher pre-pregnant body weight of mother(OR=1.003), longer gestational age(OR=1.058), longer sleeping time at 6 month of age(OR=1.032), lower month of age (OR=2.911 for 6 months, OR=1.952 for 12 months, and OR=1.232 for 18 months, respectively).Those with low birth weight (OR=0.205 for < 2 500 g, and OR=0.410 for 2 500~3 999 g, respectively)and exclusive breastfeeding at 6 months of age(OR=0.946)had low likelihood of overweight and obesity.
    ConclusionComprehensive measures should be taken to control infants overweight and obesity, including encouraging expectant parents to maintain normal body weight before pregnancy, strengthening the education of scientific feeding knowledge, and extending exclusive breastfeeding.

     

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