Association Between Physical Growth And Respiratory Tract Infection In Children Aged 1-6 Years

Objective(s):To obtain physical growth indicators(height,weight,paramedian fat thickness)and thumb adductor pollicis muscle thickness(APMT)of children aged 1-6 years with respiratory tract infections(RTI);to obtain malnutrition rates of children aged1-6 years with recurrent respiratory tract infections(RRTI);to analyze the correlation between common physical indicators(height,weight)and APMT;and to analyze the correlation between common physical indicators(height,weight)and APMT of children aged 1-6 years with respiratory tract infections(RTI).We also analyzed the correlation between common physical indicators(height and weight)and APMT;analyzed the correlation between physical nutritional status,APMT and RRTI and RTI scores in children aged 1～6 years with hospitalized respiratory tract infections;initially explored the correlation between various physical indicators,physical deviation and APMT in children aged 1～6 years.The correlation between physical indicators,physical deviation and APMT in children aged 1～6 years;analysis of the factors influencing physical deviation and RRTI in hospitalized children aged 1～6years.Methods:Children aged 1-6 years diagnosed with respiratory tract infection in the pediatric inpatient unit of the Second Affiliated Hospital of Kunming Medical University from December 2021 to November 2022 were selected,and height,weight,paramedian fat thickness,and thumb adductor muscle thickness were measured in all cases,and information on children and their families,maternal and infant births,nutritional feeding and health care,and respiratory tract infections in the past year were Questionnaire survey.Children with respiratory infections were divided into malnourished and non-malnourished groups,growth retarded and non-growth retarded groups,underweight and non-underweight groups,and wasting and non-wasting groups according to Z scores.According to the diagnostic criteria of recurrent respiratory tract infection,the enrolled children with respiratory tract infection were divided into recurrent respiratory tract infection group and non-recurrent respiratory tract infection group.SPSS25.0 statistical software was used for statistical analysis,normal distribution of measurement data was expressed as mean ± standard deviation with one-way ANOVA,non-normal distribution of measurement data was expressed as median P50(P25,P75)with non-parametric rank sum test,and count data were expressed as percentages by chi-square test or Fisher’s exact probability method;Pearson analysis was used for correlation of normally distributed quantitative data,and Spearman analysis was used for correlation analysis of hierarchical variable data and non-normally distributed quantitative data;the area under the ROC curve was used to determine the diagnostic value of thumb adductor muscle,respiratory infection score,recurrent respiratory infection,and malnutrition risk factors were analyzed by logistic regression,and the difference was considered statistically significant at P<0.05.Results:1.A total of 173 children were enrolled in the study,including 81(46.8%)males and 92(53.2%)females;72(41.6%)were discharged with a diagnosis of upper respiratory tract infection,38(22.0%)with acute bronchitis,45(26.0%)with mild pneumonia,and 18(10.4%)with severe pneumonia.2.The incidence rate of RRTI in the enrolled children was 39.3%,and there were differences in the RRTI rate and RTI scores among different age groups,among which the incidence rate of RRTI was the highest and the RTI scores were the highest in the two age groups of 3～ and 4～ years,which were the high risk age for respiratory tract infection.3.18.3% of the enrolled children were underweight;11.6% were growth retarded;1.7% were wasted;and 17.3% were total malnutrition.4.The height and weight of the enrolled children were positively correlated with the APMT of the dominant hand and non-dominant hand,with the highest correlation between weight and the APMT of the dominant hand(r=0.371,P<0.001),and the linear regression equation was y=8.37+0.4x.5.APMT and paraventral fat thickness of both hands were lower in the malnourished,underweight,and wasted groups than in the non-malnourished,non-underweight,and non-wasted groups,respectively(P < 0.05).The APMT of habitual hand and non-habitual hand were positively correlated with the levels of WAZ and WHZ,r was 0.332,0.269,0.305 and 0.213,respectively.the levels of APMT of both hands and paramedian fat thickness could be used as predictors of malnutrition,and the APMT of habitual hand in children aged 5-6 years had the highest predictive value of malnutrition(AUC=0.980,P<0.05).6.The RTI score in the last 1 year of the enrolled children could be used as a predictor of RRTI(AUC=0.876,P<0.05),and the RTI score of 9.3 was selected as the cut-off value according to the maximum of the Jorden index,and ≥9.3 was classified as the high-risk group of respiratory tract infection and <9.3 as the low-risk group of respiratory tract infection.7.RTI score was negatively correlated with the habitual hand and non-habitual hand APMT,r was-0.286 and-0.229,respectively,and the correlation between habitual hand APMT and RTI score was better.8.logistic regression analysis showed that RRTI in children with hospitalized RTI was a risk factor for the development of malnutrition(OR=2.628,95% CL1.135-6.082,P<0.05);malnutrition(OR=2.972,95% CL 1.226-7.203,P<0.05),passive smoking(OR=0.419,95% CL 0.212-0.829,P < 0.05),and age(OR=1.442,95% CL 1.1-1.891,P < 0.05)were risk factors for the development of RRTI.Conclusion(s):1.39.3% incidence of RRTI in children aged 1-6 years with hospitalized respiratory sensitization,with children aged 3-5 years as the high prevalence group with high respiratory infection scores requiring focused attention,and an RTI score of9.3 as the best cut-off value for predicting RRTI;2.17.3% prevalence of malnutrition in children aged 1-6 years hospitalized with respiratory infections,including 18.3% underweight,11.6% growth retardation and1.7% wasting.Children’s usual hand APMT can be used to estimate body weight and can be used as a physical indicator to predict malnutrition in children aged 5-6 years;3.RRTI and malnutrition in hospitalized children with respiratory illness are mutual risk factors;the smaller the APMT value the higher the RTI score;prevention and treatment of RRTI in hospitalized children with respiratory illness should pay attention to the correction of malnutrition and avoid passive smoking at the same time.