Comparison of anthropometric parameters and laboratory test results before and after the COVID-outbreak among Chinese children aged -years
Bojko Bjelakovic, Mohamed Ahmed Said, Zeinab A Kasemy, Jie Shao, Wen-Hong Dong, Tian-Miao Gu, Bing-Quan Zhu, Ying Shen, Xin-Yu He, Guan-Nan Bai
GN and Shao J ( ) Comparison of anthropometric parameters and laboratory test results before and after the COVID-outbreak among Chinese children aged -years.
Ethics statement The studies involving human participants were reviewed and approved by the Medical Ethics Committee of Children's Hospital, Zhejiang University School of Medicine. Written informed consent for participation was not provided by the participants' legal guardians/next of kin because: Data used in this study was retrieved from electronic records in the hospital. By the time this study was conducted, all participants have finished their health checkup and left the hospital. Considering no additional physical harm were added to the participants due to this study, informed consent was waived by the Medical Ethics Committee of Children's Hospital, Zhejiang University School of Medicine [Review number: 2021-IRB-185].
Author contributions WHD, TMG, GNB, and JS: study concept, design, and drafting of the manuscript. WHD, TMG, BQZ, and YS: acquisition of data. WHD, TMG, BQZ, YS, XYH, GNB, and JS: statistical analysis, interpretation of data, and critical revision of the manuscript for important intellectual content. JS: obtaining funding and study supervision. BQZ and JS: administrative, technical, or material support. All authors contributed to the article and approved the submitted version.
Conflict of interest The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
Publisher's note All claims expressed in this article are solely those of the..
References
Androutsos, Perperidi, Georgiou, Chouliaras, Lifestyle changes and determinants of children's and adolescents' body weight increase during the first COVID-19 lockdown in Greece: the COV-EAT study, Nutrients,
doi:10.3390/nu13030930Fan, Shi, Jia, Wang, Zhao et al., Birth weight, childhood obesity and risk of hypertension: a Mendelian randomization study, J Hypertens,
doi:10.1038/ijo.2017.233Goff, Cowland, Hooper, Frost, Nzesi et al., Low glycaemic index diets and blood lipids: a systematic review and meta-analysis of randomised controlled trials, Nutr Metab Cardiovasc Dis,
doi:10.1016/j.appet.2022.106182Hall, Laddu, Phillips, Lavie, Arena, A tale of two pandemics: how will COVID-19 and global trends in physical inactivity and sedentary behavior affect one another?, Prog Cardiovasc Dis,
doi:10.1016/j.pcad.2020.04.005Hu, Chen, Wang, Li, Yun et al., Vitamin D nutritional status and its related factors for Chinese children and adolescents in 2010-2012, Nutrients,
doi:10.3390/nu9091024Izzo, Santonastaso, Cotticelli, Federico, Pacifico et al., An Italian survey on dietary habits and changes during the COVID-19 lockdown, Nutrients,
doi:10.3390/nu13041197Jia, Liu, Xie, Yuan, Chen et al., Changes in dietary patterns among youths in China during COVID-19 epidemic: the COVID-19 impact on lifestyle change survey (COINLICS), Appetite,
doi:10.1016/j.appet.2020.105015Kang, Jeong, Suh, Ahn, The impact of the Coronavirus Disease-2019 pandemic on childhood obesity and vitamin D status, J Korean Med Sci,
doi:10.3346/jkms.2021.36.e21Li, Huang, Xiao, Zhao, Liu et al., Astherosclerosis subspecialty group of Chinese society of medicine. Prevention and treatment of Dyslipemidemia for children and adolescents: an experts concensus, Obes Res Clin Pract,
doi:10.1016/j.orcp.2020.07.006Ma, Xiong, Zhao, Zheng, Sun et al., COVID-19 home quarantine accelerated the progression of myopia in children aged 7 to 12 years in China, Invest Ophthalmol Vis Sci,
doi:10.1167/iovs.62.10.37Meng, Mi, Cheng, Hou, Zhao et al., Study on the distribution characteristics of waist circumference and waist to height ratio and their appropriate cut-off values in Beijing population aged 3 to 18 years, Chin J Evid Based Pediatr
Meyer, Mcdowell, Lansing, Brower, Smith et al., Changes in physical activity and sedentary behavior in response to COVID-19 and their Frontiers in Public Health frontiersin.org associations with mental health in 3052 US adults, Int J Environ Res Public Health,
doi:10.3390/ijerph17186469Mi, Wang, Meng, Zhu, Han et al., Development of blood pressure reference standards for Chinese children, Chin J Evid Based Pediatr
Pan, Liu, Wang, Guo, Hao et al., Association of public health interventions with the epidemiology of the COVID-19 outbreak in Wuhan, China, JAMA,
doi:10.1001/jama.2020.6130Qiu, He, Qiao, Ding, Ji et al., Sex differences in changes in BMI and blood pressure in Chinese school-aged children during the COVID-19 quarantine, Int J Obes,
doi:10.1038/s41366-021-00871-wRenzo, Gualtieri, Pivari, Soldati, Attina et al., Eating habits and lifestyle changes during COVID-19 lockdown: an Italian survey, J Transl Med,
doi:10.1186/s12967-020-02399-5Shah, Khadilkar, Oza, Karguppikar, Bhor et al., Impact of decreased physical activity due to COVID restrictions on cardio-metabolic risk parameters in Indian children and youth with type 1 diabetes, Diabetes Metab Syndr,
doi:10.3390/nu12061549Sidor, Rzymski, Hala, Jd, Aghabekian et al., Dietary choices and habits during COVID-19 lockdown: experience from Poland,
doi:10.3390/nu12061657Who, Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity
{ 'indexed': {'date-parts': [[2023, 3, 15]], 'date-time': '2023-03-15T04:48:32Z', 'timestamp': 1678855712988},
'reference-count': 33,
'publisher': 'Frontiers Media SA',
'license': [ { 'start': { 'date-parts': [[2023, 3, 14]],
'date-time': '2023-03-14T00:00:00Z',
'timestamp': 1678752000000},
'content-version': 'vor',
'delay-in-days': 0,
'URL': 'https://creativecommons.org/licenses/by/4.0/'}],
'funder': [ { 'DOI': '10.13039/501100012166',
'name': 'National Key Research and Development Program of China',
'doi-asserted-by': 'publisher'},
{ 'DOI': '10.13039/501100001809',
'name': 'National Natural Science Foundation of China',
'doi-asserted-by': 'publisher'}],
'content-domain': {'domain': ['frontiersin.org'], 'crossmark-restriction': True},
'abstract': '<jats:sec><jats:title>Objective</jats:title><jats:p>To compare the physiological health of '
'Chinese children around the COVID-19 '
'lockdown.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We extracted '
"data on children's anthropometric and laboratory parameters from May to November in both 2019 "
"and 2020 from the Health Checkup Center, Children's Hospital, Zhejiang University School of "
'Medicine, Hangzhou, China. Overall, 2162 children aged 3~18 years without comorbidities in '
'2019 and 2646 in 2020 were assessed. Mann Whitney U tests were used to compare differences '
'between the above health indicators before and after COVID-19 outbreak. Quantile regression '
'analyses adjusted for age, sex and body mass index (BMI) were also used in analysis. '
"Chi-square tests and Fisher's exact tests were used for comparing differences of categorical "
'variables.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Compared with '
'children examined in 2019 before the outbreak, children in 2020 had a higher median z score '
'of BMI for age (−0.16 vs. −0.31), total cholesterol (TC, 4.34 vs. 4.16 mmol/L), low density '
'lipoprotein cholesterol (LDL-C, 2.48 vs. 2.15 mmol/L), high density lipoprotein cholesterol '
'(HDL-C, 1.45 vs. 1.43 mmol/L) and serum uric acid (290 vs. 282 μmol/L), and a lower '
'hemoglobin (Hb, 134 vs. 133 g/L), triglycerides (TG, 0.70 vs. 0.78 mmol/L) and 25(OH)D (45.8 '
'vs. 52.2 nmol/L), all <jats:italic>P</jats:italic> &lt; 0.05. No differences were '
'identified for waist height ratio, blood pressure and fasting glucose (both '
'<jats:italic>P</jats:italic> &gt; 0.05). However, in regression models after adjusting, '
'BMI, TC, LDL-C, blood glucose and sUA were positively correlated with year; while Hb, TG and '
'25(OH)D were negatively correlated with year (all <jats:italic>P</jats:italic> &lt; '
'0.05). Accordingly, children in 2020 had a higher prevalence of overweight/obesity (20.6 vs. '
'16.7%, <jats:italic>P</jats:italic> &lt; 0.001), hypercholesterol (16.2%vs. 10.2%, '
'<jats:italic>P</jats:italic> &lt; 0.001), high LDL-C (10 vs. 2.9%, '
'<jats:italic>P</jats:italic> &lt; 0.001), hyperuricemia (18.9 vs.15.1%, '
'<jats:italic>P</jats:italic> = 0.002), vitamin D deficiency (22.6 vs. 8.1%, '
'<jats:italic>P</jats:italic> &lt; 0.001) and a lower prevalence of high TG (4.3 vs. 2.8%, '
'<jats:italic>P</jats:italic> = 0.018) compared with children in '
'2019.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>In this '
'real-world study, we found that long-term lockdown due to COVID-19 outbreak might cause '
"adverse impact on children's metabolic health, which might increase their future risk of "
'cardiovascular diseases. Thus, parents, health professionals, educationists, and caregivers '
"should pay more attention to children's dietary pattern and lifestyle, especially in this new "
'normal against COVID-19.</jats:p></jats:sec>',
'DOI': '10.3389/fpubh.2023.1048087',
'type': 'journal-article',
'created': {'date-parts': [[2023, 3, 14]], 'date-time': '2023-03-14T05:24:43Z', 'timestamp': 1678771483000},
'update-policy': 'http://dx.doi.org/10.3389/crossmark-policy',
'source': 'Crossref',
'is-referenced-by-count': 0,
'title': 'Comparison of anthropometric parameters and laboratory test results before and after the '
'COVID-19 outbreak among Chinese children aged 3–18 years',
'prefix': '10.3389',
'volume': '11',
'author': [ {'given': 'Wen-Hong', 'family': 'Dong', 'sequence': 'first', 'affiliation': []},
{'given': 'Tian-Miao', 'family': 'Gu', 'sequence': 'additional', 'affiliation': []},
{'given': 'Bing-Quan', 'family': 'Zhu', 'sequence': 'additional', 'affiliation': []},
{'given': 'Ying', 'family': 'Shen', 'sequence': 'additional', 'affiliation': []},
{'given': 'Xin-Yu', 'family': 'He', 'sequence': 'additional', 'affiliation': []},
{'given': 'Guan-Nan', 'family': 'Bai', 'sequence': 'additional', 'affiliation': []},
{'given': 'Jie', 'family': 'Shao', 'sequence': 'additional', 'affiliation': []}],
'member': '1965',
'published-online': {'date-parts': [[2023, 3, 14]]},
'reference': [ {'key': 'B1', 'unstructured': 'Coronavirus Disease (COVID-19) Pandemic'},
{'key': 'B2', 'unstructured': 'WHO Coronavirus (COVID-19) Dashboard'},
{ 'key': 'B3',
'doi-asserted-by': 'publisher',
'first-page': '1915',
'DOI': '10.1001/jama.2020.6130',
'article-title': 'Association of public health interventions with the epidemiology of the '
'COVID-19 outbreak in Wuhan, China',
'volume': '19',
'author': 'Pan',
'year': '2020',
'journal-title': 'JAMA.'},
{ 'key': 'B4',
'doi-asserted-by': 'publisher',
'first-page': '229',
'DOI': '10.1186/s12967-020-02399-5',
'article-title': 'Eating habits and lifestyle changes during COVID-19 lockdown: an '
'Italian survey',
'volume': '1',
'author': 'Di Renzo',
'year': '2020',
'journal-title': 'J Transl Med.'},
{ 'key': 'B5',
'doi-asserted-by': 'publisher',
'first-page': '1197',
'DOI': '10.3390/nu13041197',
'article-title': 'An Italian survey on dietary habits and changes during the COVID-19 '
'lockdown',
'volume': '13',
'author': 'Izzo',
'year': '2021',
'journal-title': 'Nutrients.'},
{ 'key': 'B6',
'doi-asserted-by': 'publisher',
'first-page': '6469',
'DOI': '10.3390/ijerph17186469',
'article-title': 'Changes in physical activity and sedentary behavior in response to '
'COVID-19 and their associations with mental health in 3052 US adults',
'volume': '17',
'author': 'Meyer',
'year': '2020',
'journal-title': 'Int J Environ Res Public Health.'},
{ 'key': 'B7',
'doi-asserted-by': 'publisher',
'first-page': '105015',
'DOI': '10.1016/j.appet.2020.105015',
'article-title': 'Changes in dietary patterns among youths in China during COVID-19 '
'epidemic: the COVID-19 impact on lifestyle change survey (COINLICS)',
'volume': '158',
'author': 'Jia',
'year': '2021',
'journal-title': 'Appetite.'},
{ 'key': 'B8',
'doi-asserted-by': 'publisher',
'first-page': '37',
'DOI': '10.1167/iovs.62.10.37',
'article-title': 'COVID-19 home quarantine accelerated the progression of myopia in '
'children aged 7 to 12 years in China',
'volume': '62',
'author': 'Ma',
'year': '2021',
'journal-title': 'Invest Ophthalmol Vis Sci.'},
{ 'key': 'B9',
'doi-asserted-by': 'publisher',
'first-page': '930',
'DOI': '10.3390/nu13030930',
'article-title': "Lifestyle changes and determinants of children's and adolescents' body "
'weight increase during the first COVID-19 lockdown in Greece: the '
'COV-EAT study',
'volume': '13',
'author': 'Androutsos',
'year': '2021',
'journal-title': 'Nutrients.'},
{ 'key': 'B10',
'unstructured': "Ministry of Education of the People's Republic of China. Notice on "
'Postponing the Start of Spring Term in 2020'},
{'key': 'B11', 'unstructured': ''},
{ 'key': 'B12',
'first-page': '245',
'article-title': 'Study on the distribution characteristics of waist circumference and '
'waist to height ratio and their appropriate cut-off values in Beijing '
'population aged 3 to 18 years',
'volume': '4',
'author': 'Meng',
'year': '2007',
'journal-title': 'Chin J Evid Based Pediatr.'},
{ 'key': 'B13',
'first-page': '4',
'article-title': 'Development of blood pressure reference standards for Chinese children',
'volume': '1',
'author': 'Mi',
'year': '2010',
'journal-title': 'Chin J Evid Based Pediatr.'},
{ 'key': 'B14',
'unstructured': 'Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment '
'of Severity'},
{ 'key': 'B15',
'doi-asserted-by': 'publisher',
'first-page': '110646',
'DOI': '10.1016/j.nut.2019.110646',
'article-title': 'Widespread vitamin D deficiency and its sex-specific association with '
'adiposity in Chinese children and adolescents',
'volume': '71',
'author': 'Li',
'year': '2020',
'journal-title': 'Nutrition.'},
{ 'key': 'B16',
'doi-asserted-by': 'publisher',
'first-page': '426',
'DOI': '10.3760/cma.j.issn.0578-1310.2009.06.007',
'article-title': 'Prevention and treatment of Dyslipemidemia for children and '
'adolescents: an experts concensus',
'volume': '47',
'year': '2009',
'journal-title': 'Chin J Pediatrics'},
{ 'key': 'B17',
'doi-asserted-by': 'publisher',
'first-page': '2526',
'DOI': '10.1161/CIRCULATIONAHA.106.657627',
'article-title': 'Serum concentrations of uric acid and the metabolic syndrome among US '
'children and adolescents',
'volume': '115',
'author': 'Ford',
'year': '2007',
'journal-title': 'Circulation.'},
{ 'key': 'B18',
'doi-asserted-by': 'publisher',
'first-page': '383',
'DOI': '10.1016/j.orcp.2020.07.006',
'article-title': 'Weight changes during the COVID-19 home confinement. Effects on '
'psychosocial variables',
'volume': '14',
'author': 'Fernandez-Rio',
'year': '2020',
'journal-title': 'Obes Res Clin Pract.'},
{ 'key': 'B19',
'doi-asserted-by': 'publisher',
'first-page': '1657',
'DOI': '10.3390/nu12061657',
'article-title': 'Dietary choices and habits during COVID-19 lockdown: experience from '
'Poland',
'volume': '12',
'author': 'Sidor',
'year': '2020',
'journal-title': 'Nutrients.'},
{ 'key': 'B20',
'unstructured': 'Impact of COVID-19 lockdown on dietary and lifestyle behaviours among '
'adolescents in Palestine889\n'
' Hala AllabadiJD\n'
' AghabekianV\n'
' KhaderA\n'
' KhammashU\n'
' Dynam Human Health72020'},
{ 'key': 'B21',
'doi-asserted-by': 'publisher',
'first-page': '302',
'DOI': '10.1016/j.jshs.2020.05.006',
'article-title': 'Projecting the impact of the coronavirus disease-2019 pandemic on '
'childhood obesity in the United States: a microsimulation model',
'volume': '9',
'author': 'An',
'year': '2020',
'journal-title': 'J Sport Health Sci.'},
{ 'key': 'B22',
'doi-asserted-by': 'publisher',
'first-page': '2132',
'DOI': '10.1038/s41366-021-00871-w',
'article-title': 'Sex differences in changes in BMI and blood pressure in Chinese '
'school-aged children during the COVID-19 quarantine',
'volume': '45',
'author': 'Qiu',
'year': '2021',
'journal-title': 'Int J Obes.'},
{ 'key': 'B23',
'doi-asserted-by': 'publisher',
'first-page': 'e21',
'DOI': '10.3346/jkms.2021.36.e21',
'article-title': 'The impact of the Coronavirus Disease-2019 pandemic on childhood '
'obesity and vitamin D status',
'volume': '36',
'author': 'Kang',
'year': '2021',
'journal-title': 'J Korean Med Sci.'},
{ 'key': 'B24',
'doi-asserted-by': 'publisher',
'first-page': '102564',
'DOI': '10.1016/j.dsx.2022.102564',
'article-title': 'Impact of decreased physical activity due to COVID restrictions on '
'cardio-metabolic risk parameters in Indian children and youth with type '
'1 diabetes',
'volume': '16',
'author': 'Shah',
'year': '2022',
'journal-title': 'Diabetes Metab Syndr.'},
{ 'key': 'B25',
'doi-asserted-by': 'publisher',
'first-page': '1549',
'DOI': '10.3390/nu12061549',
'article-title': 'Metabolic impacts of confinement during the COVID-19 pandemic due to '
'modified diet and physical activity habits',
'volume': '12',
'author': 'Guía-Galipienso',
'year': '2020',
'journal-title': 'Nutrients'},
{ 'key': 'B26',
'doi-asserted-by': 'publisher',
'first-page': '222',
'DOI': '10.1016/j.pathol.2018.10.013',
'article-title': 'Diet, exercise and weight loss and dyslipidaemia',
'volume': '51',
'author': 'Clifton',
'year': '2019',
'journal-title': 'Pathology.'},
{ 'key': 'B27',
'doi-asserted-by': 'publisher',
'first-page': '1',
'DOI': '10.1016/j.numecd.2012.06.002',
'article-title': 'Low glycaemic index diets and blood lipids: a systematic review and '
'meta-analysis of randomised controlled trials',
'volume': '23',
'author': 'Goff',
'year': '2013',
'journal-title': 'Nutr Metab Cardiovasc Dis.'},
{ 'key': 'B28',
'doi-asserted-by': 'publisher',
'first-page': '106182',
'DOI': '10.1016/j.appet.2022.106182',
'article-title': 'Body weight, dietary intake, and health risk factors pre-COVID and '
'during the COVID-19 pandemic',
'volume': '178',
'author': 'Nzesi',
'year': '2022',
'journal-title': 'Appetite'},
{ 'key': 'B29',
'doi-asserted-by': 'publisher',
'first-page': '1024',
'DOI': '10.3390/nu9091024',
'article-title': 'Vitamin D nutritional status and its related factors for Chinese '
'children and adolescents in 2010-2012',
'volume': '9',
'author': 'Hu',
'year': '2017',
'journal-title': 'Nutrients.'},
{ 'key': 'B30',
'doi-asserted-by': 'publisher',
'first-page': '1876',
'DOI': '10.1097/HJH.0000000000002871',
'article-title': 'Birth weight, childhood obesity and risk of hypertension: a Mendelian '
'randomization study',
'volume': '9',
'author': 'Fan',
'year': '2021',
'journal-title': 'J Hypertens.'},
{ 'key': 'B31',
'doi-asserted-by': 'publisher',
'first-page': '302',
'DOI': '10.1038/ijo.2017.233',
'article-title': 'Long-term metabolic risk for the metabolically healthy overweight/obese '
'phenotype',
'volume': '42',
'author': 'Espinosa De Ycaza',
'year': '2018',
'journal-title': 'Int J Obes.'},
{'key': 'B32', 'unstructured': 'MiksJ\n McIlwaineJ'},
{ 'key': 'B33',
'doi-asserted-by': 'publisher',
'first-page': '108',
'DOI': '10.1016/j.pcad.2020.04.005',
'article-title': 'A tale of two pandemics: how will COVID-19 and global trends in '
'physical inactivity and sedentary behavior affect one another?',
'volume': '64',
'author': 'Hall',
'year': '2021',
'journal-title': 'Prog Cardiovasc Dis.'}],
'container-title': 'Frontiers in Public Health',
'original-title': [],
'link': [ { 'URL': 'https://www.frontiersin.org/articles/10.3389/fpubh.2023.1048087/full',
'content-type': 'unspecified',
'content-version': 'vor',
'intended-application': 'similarity-checking'}],
'deposited': { 'date-parts': [[2023, 3, 14]],
'date-time': '2023-03-14T05:24:51Z',
'timestamp': 1678771491000},
'score': 1,
'resource': {'primary': {'URL': 'https://www.frontiersin.org/articles/10.3389/fpubh.2023.1048087/full'}},
'subtitle': [],
'short-title': [],
'issued': {'date-parts': [[2023, 3, 14]]},
'references-count': 33,
'alternative-id': ['10.3389/fpubh.2023.1048087'],
'URL': 'http://dx.doi.org/10.3389/fpubh.2023.1048087',
'relation': {},
'ISSN': ['2296-2565'],
'subject': ['Public Health, Environmental and Occupational Health'],
'container-title-short': 'Front. Public Health',
'published': {'date-parts': [[2023, 3, 14]]}}
