The relationship between stunting and underweight of infants with altitude in Tibet-based on propensity score matching method

SUOLANG Qu-zhen; LI Ya-jie; LUO Yang-cuo; NIMA Qu-cuo; CIREN Zhuo-ga; YANG Shu-juan

doi:10.16462/j.cnki.zhjbkz.2022.09.010

Volume 26 Issue 9

Sep. 2022

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SUOLANG Qu-zhen, LI Ya-jie, LUO Yang-cuo, NIMA Qu-cuo, CIREN Zhuo-ga, YANG Shu-juan. The relationship between stunting and underweight of infants with altitude in Tibet-based on propensity score matching method[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(9): 1043-1049. doi: 10.16462/j.cnki.zhjbkz.2022.09.010

Citation:

SUOLANG Qu-zhen, LI Ya-jie, LUO Yang-cuo, NIMA Qu-cuo, CIREN Zhuo-ga, YANG Shu-juan. The relationship between stunting and underweight of infants with altitude in Tibet-based on propensity score matching method[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(9): 1043-1049. doi: 10.16462/j.cnki.zhjbkz.2022.09.010

Citation:

SUOLANG Qu-zhen, LI Ya-jie, LUO Yang-cuo, NIMA Qu-cuo, CIREN Zhuo-ga, YANG Shu-juan. The relationship between stunting and underweight of infants with altitude in Tibet-based on propensity score matching method[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(9): 1043-1049. doi: 10.16462/j.cnki.zhjbkz.2022.09.010

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The relationship between stunting and underweight of infants with altitude in Tibet-based on propensity score matching method

doi: 10.16462/j.cnki.zhjbkz.2022.09.010

1.
Department of Epidemiology and Health Statistics, West China School of Public Health, Sichuan University, West China Fourth Hospital, Chengdu 610041, China
2.
Tibet Center for Disease Control and Prevention, Lhasa 850000, China

Funds:

Tibet Natural Science Foundation Project XZ202101ZR0103G

Tibet Natural Science Foundation Project XZ2019ZR G-142

More Information

Corresponding author: YANG Shu-juan, E-mail: rekiny@126.com
Received Date: 2021-12-17
Rev Recd Date: 2022-05-18

Available Online: 2022-09-17

Publish Date: 2022-09-10

Abstract

Abstract

Objective To investigate the incidence of stunting and underweight of infants in Tibet and its relationship with altitude. Methods Multi-stage stratified cluster sampling method was used to select infants aged 0-3 years for on-site physical examination and questionnaire survey of guardians. The propensity score matching method was used to balance the confounding factors between the two comparison groups. Univariate logistic regression was used to analyze the relationship between altitude with stunting and underweight. Results The incidence of stunting and underweight of infants in Tibet were 20.9% and 8.7%. After conducting 1∶1 propensity score matching method, 324 pair, 648 matched samples were obtained. The confounding factors were balanced between the comparison groups. After matching, compared with infants living at relative low altitude (< 4 000 meters), the OR and 95% CI of stunting and underweight of infants living at high altitude (≥4 000 meters) were 2.31(1.74-3.10) and 1.95(1.27-3.09), respectively. High altitude increased the risk of stunting regardless of gender, family income level and birth weight. while increased the risk of underweight in boy, infants with high family income level, normal birthweight and term production (all P < 0.05). Conclusions The growth and development of infants in Tibet is poor. Living at high altitude has a great impact on growth and development of infants.
- Infants and young children,
- Stunting,
- Underweight,
- Altitude,
- Tibet

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References(21)

References

[1]	丁心悦. 2013年中国2岁以下婴幼儿生长发育状况及其与喂养行为关系的研究[D]. 北京: 中国疾病预防控制中心, 2018. Ding XY. The association between feeding behavior and growth and development of infants under 2 years old in China in 2013[D]. Beijing: Chinese Center for Disease Control and Prevention, 2018.
[2]	康轶君, 颜虹, 李强, 等. 2010年拉萨市农村0~35月龄藏族儿童生长发育及营养不良状况[J]. 中华预防医学杂志, 2012, 46(10): 932-936. DOI: 10.3760/cma.j.issn.02530624.2012.10.015. Kang YJ, Yan H, Li Q, et al. Analysis on growth and malnutrition status of Tibetan children aged 0 to 35 months in rural Lhasa in 2010[J]. Chin J Prev Med, 2012, 46(10): 932-936. DOI: 10.3760/cma.j.issn.02530624.2012.10.015.
[3]	王宏运, 刘宁, 胡耀文, 等. 高原低氧环境对人体生长发育和营养状况的影响[J]. 西北国防医学杂志, 2008, 29(4): 289-291. DOI: 10.16021/j.cnki.1007-8622.2008.04.042. Wang HY, Liu N, Hu YW, et al. Growth and development of human body and nutrition status in the environment of plateau and hypoxia[J]. Med J NDFNC, 2008, 29(4): 289-291. DOI: 10.16021/j.cnki.1007-8622.2008.04.042.
[4]	Mohammed SH, Habtewold TD, Abdi DD, et al. The relationship between residential altitude and stunting: evidence from >26 000 children living in highlands and lowlands of Ethiopia[J]. Br J Nutr, 2020, 123(8): 934-941. DOI: 10.1017/S0007114519003453.
[5]	李辉, 朱宗涵, 张德英. 2005年中国九市七岁以下儿童体格发育调查[J]. 中华儿科杂志, 2007, 45(8): 609-614. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHEK200708015.htm Li H, Zhu ZH, Zhang DY. A national survey on growth of children under 7 years of age in nine cities of China, 2005[J]. Chin J Pediatr, 2007, 45(8): 609-614. https://www.cnki.com.cn/Article/CJFDTOTAL-ZHEK200708015.htm
[6]	黄丽红, 陈峰. 倾向性评分方法及其应用[J]. 中华预防医学杂志, 2019, 53(7): 752-756. DOI: 10.3760/cma.j.issn.0253-9624.2019.07.017. Huang LH, Chen F. The propensity score method and its application[J]. Chin J Prev Med, 2019, 53(7): 752-755. DOI: 10.3760/cma.j.issn.0253-9624.2019.07.017.
[7]	Liu J, Sun J, Huang J, et al. Prevalence of Malnutrition and Associated Factors of Stunting among 6-23-Month-Old Infants in Central Rural China in 2019. [J]. Int J Environ Res Public Health, 2021, 18(15): 8165. DOI: 10.3390/ijerph18158165.
[8]	Dang S, Yan H, Yamamoto S. High altitude and early childhood growth retardation: new evidence from Tibet[J]. Eur J Clin Nutr, 2008, 62(3): 342-348. DOI: 10.1038/sj.ejcn.1602711.
[9]	Ma J, Zhang Z, Niu W, et al. Education, altitude, and humidity can interactively explain spatial discrepancy and predict short stature in 213, 795 Chinese school children[J]. Front Pediatr, 2019, 7(7): 425. DOI: 10.3398/fped.2019.00425.
[10]	Martínez JI, Román EM, Alfaro EL, et al. Geographic altitude and prevalence of underweight, stunting and wasting in newborns with the INTERGROWTH-21st standard[J]. J Pediatr (Rio J), 2019, 95(3): 366-373. DOI: 10.1016/j.jped.2018.03.007.
[11]	Weitz CA, Garruto RM, Chin CT, et al. Morphological growth and thorax dimensions among Tibetan compared to Han children, adolescents and young adults born and raised at high altitude[J]. Ann Hum Biol, 2004, 31(3): 292-310. DOI: 10.1080/0301446042000196316.
[12]	Dittmar M. Linear growth in weight, stature, sitting height and leg length, and body proportions of Aymara school-children living in an hypoxic environment at high altitude in Chile[J]. Z Morphol Anthropol, 1997, 81(3): 333-344. doi: 10.1127/zma/81/1997/333
[13]	Leonard WR, Dewalt KM, Stansbury JP, et al. Influence of dietary quality on the growth of highland and coastal Ecuadorian children[J]. Am J Hum Biol, 2000, 12(6): 825-837. DOI:10.1002/1520-6300(200011/12)12:6<825::Aid-ajhb10>3.3.Co;2-5.
[14]	徐小红, 边巴卓玛, 王建东, 等. 西藏高海拔地区孕产期保健现状及母婴预后[J]. 中国实用妇科与产科杂志, 2018, 34(11): 1271-1276. DOI: 10.19538/j.fk2018110120. Xu XH, Bianba ZM, Wang JD, et al. Analysis of maternal health status during pregnancy and after delivery and the maternal and neonatal prognosis in high-altitude areas of Tibet[J]. Chin J Pract Gynecol Obstetr, 2018, 34(11): 1271-1276. DOI: 10.19538/j.fk2018110120.
[15]	Määttä J, Sissala N, Dimova EY, et al. Hypoxia causes reductions in birth weight by altering maternal glucose and lipid metabolism[J]. Scientific Reports, 2010, 10(1): 4260. DOI: 10.1038/s41598-020-61220-x.
[16]	Grant ID, Giussani DA, Aiken CE. Fetal growth and spontaneous preterm birth in high-altitude pregnancy: a systematic review, meta-analysis, and meta-regression[J]. Int J Gynaecol Obstet, 2022, 157(2): 221-229. DOI: 10.1002/ijgo.13779.
[17]	李亚杰, 次仁旺拉, 索朗旺堆, 等. 高原地区0~5岁藏族儿童低出生体重及巨大儿与生长迟缓的关联[J]. 卫生研究, 2022, 51(2): 227-232. DOI: 10.19813/j.cnki.weishengyanjiu.2022.02.009. Li YJ, Ciren WL, Suolang WD, et al. Association of low birth weight and macrosomia with stunting in Tibetan children aged 0-5 years in a plateau area[J]. J Hygiene Res, 2022, 51(2): 227-232. DOI: 10.19813/j.cnki.weishengyanjiu.2022.02.009.
[18]	Frisancho AR, Baker PT. Altitude and growth: a study of the patterns of physical growth of a high altitude Peruvian Quechua population[J]. Am J Phys Anthropol, 1970, 32(2): 279-292. DOI: 10.1002/ajpa.1330320217.
[19]	胡劼, 李华, 牛铭, 等. 高原环境中妊娠期母体缺氧与胎羊先天性心脏病理损伤相关性分析的实验研究[J]. 中国超声医学杂志, 2016, 32(11): 1041-1044. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201611031.htm Hu J, Li H, Niu M, et al. Correlation analysis of sheep fetal cariac pathologicl injury with hypoxia environment induration of pregnance: experimental study[J]. Chin J Ultrasound in Med, 2016, 32(11): 1041-1044. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCY201611031.htm
[20]	de Meer K, Heymans HS, Zijlstra WG. Physical adaptation of children to life at high altitude[J]. Eur J Pediatr, 1995, 154(4): 263-272. doi: 10.1007/BF01957359
[21]	Larson-Nath C, Goday P. Malnutrition in children with chronic disease[J]. Nutr Clin Pract, 2019, 34(3): 349-358. DOI: 10.1002/ncp.10274.