| Objective:1.To describe the distribution and trend of FPG,Hyperglycemia and DM among Chinese children and adolescents of aged 6-17 years in 2002,2012 and 2016.2.To obtain the Dietary Patterns of Chinese children and adolescents,in 2012 and 2016,with Factor Analysis.3.To explore the relevant factors of FPG,Hyperglycemia and DM in Chinese children and adolescents,the purpose is to provide scientific basis for the prevention and therapy of DM in Chinese children and adolescents.Methods:1 SubjectsThe subjects were from Chinese Nutrition and Health Survey in 2002 and Chinese Nutrition and Health Surveillance in 2012 and 2016.They were the children and adolescents of aged 6-17 who have result of FPG.The children and adolescents who had the data of basic information,physical health and activity,medical physical examination,FFQ and laboratory tests of FPG and lipid were used for a multivariate analysis.2 MethodAccording to the data of basic information,physical health and activity,medical physical examination,FFQ and laboratory tests of FPG and lipid,to describe distribution and the trend of FPG,Hyperglycemia and DM in Chinese children and adolescents.The multi-level model was used to analyze the association of FPG,Hyperglycemia and DM with Dietary Pattern,overweight,obesity and so on.Results:1 General characteristic in subjectsThere were 36195 children and adolescents with FPQ test results.The proportion of men and women were 51.79%and 48.21%in 2002.There were 27 271 subjects with FPQ test results,the proportion of men and women were 50.77%and 49.22%in 2012,of which 20 919 were include in multivariate analysis.There were 51 902 subjects in 2016,The proportion of men and women were 49.99%and 50.01%,and 49 784 subjects were include in multivariate analysis.2 Distribution and trend of FPG and prevalence of Hyperglycemia and DMIn 2002,the mean of FPG among Chinese children and adolescents were(4.61 ±0.56)mmol/L.In 2012,the mean of FPG among children and adolescents were(4.91 ±0.68)mmol/L.In 2016,the mean of FPG among children and adolescents were(4.99 ±0.54)mmol/L.The results of three surveillance/survey showed that the mean of FPG among children and adolescents increased gradually from 2002 to 2016,and the increased from 2002 to 2012 with statistical significance,and there was no significant statistical difference from 2012 to 2016.The mean of FPG in urban was higher than the rural,and boys was higher than girls,the age group of 11-14 years old were the highest,the age group of 11-14 years old were the lowest.In 2002,the prevalence of DM and Hyperglycemia among children and adolescents were 0.33%(0.14,0.52)and 0.76%(0.48,1.04).In 2012 the prevalence of DM and Hyperglycemia were 0.51%(0.36,0.66)and 2.38%(1.78,2.99).In 2016 the prevalence of DM and Hyperglycemia were 0.26%(0.20,0.32)and 2.40%(1.97,2.83).The results of three surveillance/survey showed that the prevalence of DM was not found increased trend,but the prevalence of Hyperglycemia increased gradually,it was consistent with the increase of FPG level.We found the distribution prevalence of DM and Hyperglycemia among children and adolescents in different surveillance/survey,were not consistent.In 2002,the prevalence of DM and Hyperglycemia among children and adolescents in urban areas were higher than rural areas,that in girls was higher than in boys.In 2012,the prevalence of DM and Hyperglycemia in rural areas were higher than urban areas,that in boys was higher than in girls.In 2016,the prevalence of DM and Hyperglycemia in urban areas were higher than rural areas,that in boys was higher than in girls.However the age distribution of DM and Hyperglycemia among children and adolescents was the highest in 11-14 years old.3 The group of Dietary PatternAccording to the FFQ,to obtain three Dietary Patterns of Chinese children and adolescents in 2012 by Factor Analysis,which were puffed food and beverage snacks Dietary Pattern,animal food Dietary Pattern and cereal-potato Dietary Pattern.There were four Dietary Patterns in 2016,include biscuit and dried fruit snacks Dietary Pattern,animal food Dietary Pattern,puffed food and beverage snacks Dietary Pattern and cereal-potato Dietary Pattern.According to the quartile interval of factor scores,the Dietary Patterns were divided into three categories:T1,T2 and T3.The higher the score of this Dietary Pattern,the subjects more inclined to this Dietary Pattern.4 Relevant factors of FPG,Hyperglycemia in children and adolescents4.1 FPGThe distribution result of FPG among children and adolescents in 2012,there were statistical significant difference in animal food Dietary Pattern,cereals and potatoes Dietary Pattern,Overweight and Obesity,Hypertension,gender and age.multi-level linear model of FPG showed that Overweight and Obesity was associated with the increase of FPG,Hypertension was also relevant to the increase of FPG,the level of FPG in aged 11-14 group was the highest.In 2016,the distribution of FPG among children and adolescents showed that there were significant statistical difference in biscuit and dried fruit snacks Dietary Pattern,animal food Dietary Pattern,cereal-potato Dietary Pattern,sleep time,family income level,Overweight and Obesity,Hypertension,gender and age.The results of Multi-level linear model showed that there were significant differences in animal food Dietary Pattern and puffed food and beverage snacks Dietary Pattern.They were associated with the increase of FPG in children and adolescents and cereal-potatoes Dietary Pattern had a two-way effect on the FPG.The results show that high or low scores of cereal-potato Dietary Pattern have a positive effect on the increased of FPG.In 2016,the association of FPG with Overweight and Obesity,Hypertension and age were consistent with the results in 2012.The FPG level of children and adolescents in 2016 was higher than that in 2012 after adjusting for factors such as overweight,obesity,region,age and gender.4.2 HyperglycemiaIn 2012,the prevalence of Hyperglycemia among children and adolescents were significantly statistical difference in the factors of three Dietary Patterns,family income level,urban and rural areas,overweight and obesity,Hypertension.Two-level logistic regression model showed that the prevalence of Hyperglycemia in children and adolescents from high-income families was 2.3 times higher than low-income families;the prevalence of Hyperglycemia in overweight and obesity was higher than non-overweight and obesity,the overweight was 1.2 and the obesity was 1.8 times and the prevalence of Hyperglycemia in hypertension was 1.6 times than non-hypertension.In 2016,the prevalence of Hyperglycemia among children and adolescents were significant statistical difference in the factors of animal Dietary Patterns,overweight and obesity,sleep time,hypertension,dyslipidemia,urban and rural areas,age and gender.Two-level logistic regression model showed that the prevalence of Hyperglycemia in urban children and adolescents was about 1.5 times that in rural areas,boys was 1.7 times than girls,overweight and obesity was 1.2 times and 1.4 times than non-overweight and obesity groups,hypertension was 1.5 times than non-hypertension,dyslipidemia was 1.2 times than non-hypertension.The Hyperglycemia of children and adolescents aged 11-14 years was the highest,which was consistent with the results of FPG multi-level model.Two-level logistic regression model showed that Hyperglycemia among children and adolescents was related to overweight and obesity,hypertension,gender and age.However,2016 results showed that Hyperglycemia also may be related to dyslipidemia and animal food Dietary Patterns.Conclusion:Three Surveillance/Survey results showed that the mean of FPG among Chinese children and adolescents had an increased trend from 2002 to 2016.On the whole,every percentile of FPG was increased.The mean of FPG among children and adolescents in urban was higher than rural areas,while the FPG level of rural children and adolescents changed greatly;boys was higher than girls,the 11-14 years old group children and adolescents is the highest,the distribution of FPG in age group may be relevant to pubertal development.In addition,animal Dietary Pattern,puffed food and beverage snacks Dietary Pattern,overweight and obesity and hypertension may be associated with the increase of FPG among children and adolescents.Excessive or insufficient intake of grain and tubers may be relevant to the increase of FPG among children and adolescents.The FPG level among Overweight and obesity and hypertension children and adolescents is higher than normal group.The FPG for Chinese children and adolescents increased from 2002 to 2016,with a significant increase from 2002 to 2012.The prevalence of DM among Chinese children and adolescents is still at a low level,and the increased trend of DM prevalence had not been found,but the increased trend of Hyperglycemia rate was obvious,from 0.76%in 2002 to 2.40%in 2016.The Hyperglycemia rate among urban areas children and adolescents was higher than rural areas,boys were higher than girls,the highest Hyperglycemia rate was in 11-14 years old children and adolescents.Animal food Dietary Pattern may be associated with Hyperglycemia.Overweight and obesity,hypertension and Dyslipidemia were occur simultaneously in children and adolescents.The results of this study showed that reducing animal food intake and moderate intake of grain and tubers may be beneficial to maintain blood glucose level in children and adolescents.Controlling Overweight and Obesity,Hypertension and Dyslipidemia in children and adolescents may be beneficial to the prevention and control of DM in children and adolescents. |
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