| ObjectiveOur present study aimed to examine the trends of the prevalence of overweight and obesity among Tianjin preschool children from 2006 to 2014, discuss the risk factors of obesity during the childhood from the perspectives of individuals, families and lifestyles, and further to explore the relationship among childhood obesity, blood lipids, blood glucose, blood uric acid, for the purpose of providing scientific basis for prevention and intervention measures for obesity among preschool children. Methods1.A total of 145,078 children aged 3~6 years completed the annual health examination from 46 kindergartens in Tianjin, China during 2006 to 2014. The health examination information were obtained, including height, weight and other information. Z-scores for weight-for-age, height-for-age, and BMI-for-age were calculated based on the child growth criterion of the World Health Organization(WHO).2.In 2015, 1~2 representative kindergartens were selected using method of cluster sampling. According to child care manual coding, retrospective study in 2013 and 2014 physical examination handbook of 1286 children from 33 kindergartens were selected to analyze the trend of height, weight, body mass index(BMI) with the age and the differences between different age and sex by using Chi-square tests,the Logistic regression,analysis of variance and T test.3. Preschool children in kindergartens were selected to perform the growth and health questionnaire survey, physical examination and to perform the longitudinal cohort analysis by using the Logistic regression and analysis of variance.4. Involved in the investigation of childcare facilities of 3305 cases of 5~6-years-old children fasting total cholesterol, triglyceride, blood glucose, blood uric acid test by using T tests,analysis of variance and the Logistic regression. Results1.From 2006 to 2014, height-for-age Z-scores significantly increased from 0.34 to 0.54, weight-for-age Z-scores kept constant, and mean values of BMI-for-age Z-scores significantly decreased from 0.40 to 0.23. The prevalence of overweight decreased from 23.4% to 20.7%, and prevalence of obesity increased from 7.0% in 2006 to 7.9% in 2010, and then kept stable from 2010 to 2014. Boys had higher prevalence of overweight(26.6% vs. 18.4%) and obesity(10.1% vs. 4.8%) than girls. The prevalence of obesity increased with age, from 4.9% among children 3 years old to 11.6% among children 6 years old.2.The height, weight and BMI were higher in the boys than in the girls during 2013 to 2015(P < 0.05, the height and weight among the children aged 6 years old was higher than 5 years old children(P < 0.05) in 2014 and 2015, but there was no statistically significant difference in BMI. In 2013, height, weight and BMI in children aged 6 years old were higher than the 5 years old children. The trend analysis of weight in different age and height from the three years presented that there was statistically significance in the changes of weight between 5 years old children and 6 years old children(P < 0.05). There was no statistical significance in the change of BMI(P < 0.05). In 2013 six-year-old children height(P < 0.05), body weight(P < 0.05) and BMI(P < 0.05) higher than the children at the age of five. Three years of different gender, height, weight, BMI change trend analysis, according to the results of the boy’s weight and the difference between girls was statistically significant(P < 0.05). In 2013, 2014 and 2015 children of different age obese and overweight constitute no statistically significant difference(P>0.05). Different gender of obesity and overweight in 2013 was no statistically significant difference(P > 0.05).In 2014 and 2015, the constitution of obese and overweight in boys is higher than in girls.3. Select 2013 years into the queue weight 1072 normal children, to carry out the longitudinal cohort analysis on 1072 children, the incidence of obesity was 4.6%(49/1072) in 2015, the incidence of overweight was 7.2%(77/1072), the incidence of overweight or obesity combined was 11.8%. The studies suggest that the age, gender, childbirth way, tires, times are not associated with the incidence of obesity. Boy, high age group, the exclusive breastfeeding, and watching screen(including TV, mobile phone, computer) for a long time, eating rapidly are risk factors for 5~6 years old children’s obesity.4. Among children with different gender, the difference of total cholesterol was statistically significant(P<0.05), which of the boys was lower than that of the girls. The abnormal rate of serum lipids and total cholesterol in children aged 3 years was significantly higher than other age groups, and the difference was statistically significant(P<0.05). There was no significant difference in the rate of abnormal blood lipid and total cholesterol in different body type(P>0.05). However, the abnormal rate of glycerol in obese children was much higher than that in normal children(P<0.05). There were significant differences in total cholesterol and triglyceride levels among children with different sex(P<0.05), and girls were higher than boys. Children of different ages, their total cholesterol levels were statistically significant(P<0.05). Different size of the children, the difference of triglyceride levels has statistical significance(P<0.05). Dyslipidemia rate and abnormal rate of total cholesterol in different body types has no statistical significance(P>0.05). But obese children triglycerides abnormal rate is much higher than non-obese children, 6.5% and 0.9%, respectively. In different gender, age, and size of 3~6 years old children, abnormal blood sugar rate were no statistical difference(P>0.05). Blood sugar levels of children aged 3~6 with different gender were statistical differences(P<0.05), boys average blood glucose level higher than girls. Children of different ages, the blood sugar level were statistical differences(P<0.05), along with the growth of the age, the average blood glucose levels increased gradually. Children in different body types, the blood sugar levels were statistically difference(P<0.05). Obese children, the average blood glucose levels higher than normal size of children. Abnormal rate of blood uric acid in different age and sex were no statistical difference(P>0.05), but abnormal rate of blood uric acid in different size children were statistical difference(P<0.05), the level of obese children were higher than normal size children. In addition, although age, blood uric acid levels were on the rise, but no statistical differences between different age groups(P>0.05). And different gender, shape children blood uric acid levels existed differences(P<0.05). Boy blood uric acid levels were higher than the girls, obese children blood uric acid levels higher than normal size. Total cholesterol, triglycerides, blood uric acid associated with being overweight or obese, blood sugar and overweight or obese is linked with no statistical significance(P>0.05). ConclusionsThe prevalence of overweight decreased from 2006 to 2014 among Chinese children aged 3~6 years old, whereas the prevalence of obesity increased from 2006 to 2010, and then kept stable until 2014. The prevalence of obesity in the boys was higher than the girls, with the rapid increase during the 3~6 years old. Thus, the prevention and intervention for obesity should focus on preschool children. Boy, non-exclusive breastfeeding, and watch screen(including TV, mobile phone, computer) for a long time, eating fast are the risk factors for obesity among children aged 5~6 years old. The education of parents, the average time of sleep and whether eating the main food after going back home from the childcare facilities were not associated with the prevalence of obesity. The obesity was closely related with the blood glucose, lipid profile and metabolism of serum uric acid. The children with obesity had the higher level of lipid profile, blood glucose and serum uric acid, presenting the increase trend with the increased age. The early prevention for the metabolic disease and cardiovascular disease should be performed from the children, and the children with obesity should be considered as the main intervention objective to perform the health education and monitor. |
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