| Objective:To investigate preschool physical differences between simple obese and normal weight children, discuss the hazard of obesity to the health of children aged3-6; To understand the risk factors leading to childhood obesity and observe blood levels of leptin and adiponectin among simple obesity children in order to explore their relationship with childhood obesity; To provide the theoretical basis for integrated intervention strategies to childhood obesity; To establish a long-term and effective scientific model of health promotion and health education for obese children in the future and promote the health development of children.Methods:The investigation was performed in36kindergartens of Jingzhou city and Wuchang, Hankou, Jiangxia, Caidian, Dongxihu districts of Wuhan city, Hubei province from August to October2011based on a cluster sampling survey. The cases enrolled were three to six years old simple obese children according to the Children Growth Standards made by WHO in2006(weight-for-height≥+2SD deemed to be obese), and the controls were health normal weight children matched by community, gender, age (±3months), height (±3centimeters). The cases and controls were interviewed with the same self-made questionnaires by professionally trained investigator.3ml of blood samples were collected from children. Serum leptin and adiponectin concentrations were detected by ELISA. The statistical analyses were conducted by chi-square test, t test,1:1pair conditional logistic regression, and covariance analysis.Results:A total of467pairs of cases and controls were investigated.1. Analysis of the measurement index of the child:the chest circumferences of the obese group and the control group were58.68±5.10cm and49.93±3.50cm, the waist measurements of the obese group and the control group were60.61±6.85cm and50.78±3.12cm, the hiplines were66.06±5.12cm and55.60±3.50cm, the systolic and dilate pressure of the two groups were95.39±9.22mmHg and87.76±6.72mmHg,62.06±6.25mmHg and58.49±6.13mmHg; the Skinfold Thickness of the obese group and the control group were8.64±3.06mm and6.19±1.26mm (bicipital muscle),13.27±3.76mm and8.14±1.89mm (abdomen),19.41±3.46mm and11.12±2.95mm (thigh),10.03±2.85mm and6.66±1.45mm (subscapular),12.11±3.58mm and7.58±2.28mm (waist). The measurement differences between the two groups were statistically significant (P<0.001). The hemoglobin values, adiponectin levels, and leptin levels of the obese group and the control group were126.07±9.21g/L and123.12±8.89g/L,8.93±5.11mg/L and13.60±5.81mg/L,11.65±4.98μg/L and3.89±2.33μg/L. The measurement differences between the two groups were statistically significant (P<0.05).2. The family characteristics:the childbearing age of the mothers in the obese group and the control group were27.02±3.85years and26.41±3.80years, the difference had statistical significance (t=2.453, P<0.05). The childbearing age of the fathers in the obese group and the control group were28.92±4.88years and29.34±4.47years, the difference had no statistical significance (P>0.05). The education level of the mothers in the obese group and the control group were mainly undergraduates which accounted for39.5%and50.1%respectively. The education level of the fathers in the obese group and the control group were mainly undergraduates which accounted for54.6%and55.2%respectively. The mothers in the obese group and the control group were mainly business or service personnel, which accounted for35.8%and34.0%respectively. The fathers in the obese group and the control group were mainly technical personnel, which accounted for35.8%and33.4%respectively. These differences showed no statistical significance. The family incomes of the obese group and the control group were concentrated distributed at2000-<2500Yuan and2500-<3000Yuan, and the difference was statistically significant (P<0.05).3. Children’s personality traits and living habits:Analysis of character, eating behavior (breakfast, food preferences, bedtime snacks, times of meal a day, frequency of having fast food, snacks intake and eating speed, etc.), physical activity (sedentary static behavior, activity time, etc.) and sleep time in obese and control groups. There were significant differences of partiality for sweets (P=0.048) and meat (P=0.000), times of meal a day (P=0.000), eating speed (P=0.000), time of watching TV (P=0.000) and activity time (P=0.001) in both groups.4. Pregnancy:We analyzed the parents’ BMI, smoking/drinking, abnormal gestation and birth, first trimester vaginal bleeding or injury, mothers’ living habits (categories of food intake, emotional state, activity, sleeping time and etc), change of weight and diseases during pregnancy in both groups. Mothers’ BMI of the obese group and the control group were22.29±2.89and21.23±2.53(t=5.908, P<0.001), fathers’BMI were24.29±3.17and23.20±2.79(t=5.386, P<0.001), weight gain during pregnancy were17.26±6.34Kg and14.93±5.98Kg(t=5.658, P<0.001). The difference of intake of bean products (P<0.001) and sweets (P<0.05), sleeping time (P<0.05) and emotional state (P<0.05) in both groups were statistically significant.5. The children’s birth history:we analyzed the weight, length, mode of delivery and gestational age. We found that birth weight of the babies in the obese group were heavier than the control group (3514.52±524.01g vs.3263.90±446.77g). The proportion of macrosomia in the obese group was obviously higher than that in control group (15.0%vs.8.8%). We also found analogous results about their height in both group (50.84±1.81cm vs.50.24±1.45cm). The proportion of cesarean section in obesity group was significantly higher than the control group (72.8%vs.64.2%). There was no significant difference with gestational age between the two groups (P>0.05).6. Feeding history of children:In the obese group, there were282children had breastfeeding history (60.4%),107children had mixed feeding (22.9%) and78children had formula feeding (16.7%). In the control group, there were315children had breastfeeding history (67.5%),97children had mixed feeding (20.8%),55children had artificial feeding (11.8%). The proportion of breastfeeding children was obviously lower than the control group (60.4%vs.67.5%, P<0.05). The proportion of breastfeeding for6or more months in the obese group was significantly lower than control group (43.7%vs.51.9%, P<0.05). There were differences of the first time to have supplementary food (P=0.046) and solid complementary (P=0.010) in these two groups. 7. Parents’ awareness of children obesity related knowledge:Whether parents know the body mass index (BMI)(P=0.040) and attitudes of childhood obesity (P=0.019) in these two groups had significant differences.8. Analysis of obesity affects factors:According to the multifactor conditional logistic regression analysis, Children partiality for meat (OR=1.713), daily TV time>3h (OR=7.820), mother’s BMI≥24(OR=3.884), the father’s BMI>24(OR=3.905), birth weight≥4000g (OR=2.108), weight gain at13to20kg during pregnancy (OR=1.960), weight gain>20kg during pregnancy (OR=5.147), leptin level>10.45μg/L (OR=2.697) were associated with a higher childhood obesity risk. Average household income per head at2500-<3000Yuan (OR=0.183), and average household income per head≥3000Yuan(OR=0.135), slower eating speed of children (OR=0.471), often ingest beans and its products during pregnancy (OR=0.406), time of breastfeeding≥6months(OR=0.486), first time to have supplementary food in4to6months (OR=0.383), first time to have supplementary food>6months(OR=0.355), leptin level<4.40μg/L(OR=0.516), parents knew more than3reasons that cause childhood obesity(OR=0.222) proved to be protector factors against childhood obesity.9. Duration of breast-feeding and leptin and adiponectin levels of children:The children’s serum leptin level was lower than bottle feeding ones when they breastfed for4-<6months or≥6months. The difference had statistical significance (P<0.05). The difference of adiponectin level showed no statistical significance (P<0.05).Conclusions:Environmental factors and serum leptin level have influence on the simple obesity of children aged3-6.1. The reflection of childhood obesity is not just on the higher and weight, excessive amount of fat accumulates in different parts of the body. Obesity has been shown cardiovascular risks on the children under3-6years old.2. There are many factors influencing the obesity of preschool children, and children’s unhealthy diet and lifestyle are the main causes. What’s more, the childhood obesity is closely related to the weights of their parents, children with parents of overweight are prone to be obese. Mothers’ diet, weight gain during pregnancy, breastfeeding, the time to supply complementary food, knowledge of parents to childhood obesity, family economic situations are the influencing factors of childhood obesity.3. There is lower level of serum adiponectin and higher leptin level (leptin resistance) in obese children, prolonged breastfeeding could reduce serum leptin level in children.4. Emphasis on prevention of obesity in children is needed; parents should receive scientific family feeding knowledge to help children establish healthy dietary habits in order to eliminate obesity eventually. |
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