Aims To identify the gestational weight gain (GWG) patterns in women with gestational diabetes mellitus (GDM) and evaluate their association with offspring weight status from birth to 40 months. Materials and methods This study included 2,723 GDM-mother–child pairs from the Beijing Birth Cohort Study. The association between GWG trajectories identified by the latent class model and offspring weight outcomes from birth to 40 months were evaluated, after adjustment for maternal age, parity, pre-pregnancy body mass index, maternal height, and blood glucose levels. Results Three GWG rate groups, including the non-excessive GWG group (1,994/2,732), excessive GWG group (598 /2,732), and excessive early GWG group (140/2,732), were identified in women with GDM, respectively. Compared to the non-excessive GWG group, the adjusted OR (aOR) and 95% CI were 1.83 (1.35–2.47) and 1.79 (1.06–3.01) for macrosomia, 1.33 (1.07–1.66) and 1.48 (1.01–2.17) for large for gestational age (LGA) in the excessive GWG group and excessive early GWG group. Excessive GWG was also associated with an increased risk of BMI-for-age at 40 months (aOR = 1.66, 95% CI 1.14–2.42). Conclusions Both excessive GWG and excessive early GWG increased the risk of macrosomia and LGA in women with GDM, but only the excessive GWG was associated with childhood overweight/obesity. The results suggest the long-term impact of GWG on offspring weight status in women with GDM and the potential benefits of GWG restriction after GDM diagnosis.

目的 了解北京市两区婴儿睡眠行为和睡眠问题现况并进行影响因素分析,为促进婴儿期睡眠健康提供科学依据.方法 采用整群抽样方法,于2021年6月1日—8月31日期间选取北京市两个区各2个街道/乡镇社区卫生服务中心,并随机抽取894例常住婴儿,对其养护人进行问卷调查,内容包括一般情况和婴儿睡眠状况.结果 婴儿与家人同床睡眠比例为55.0％,41.1％为同屋但不同床睡眠;侧卧和仰卧睡眠比例分别为48.1％和46.9％;奶睡和摇/抱睡分别占50.5％和28.7％.婴儿睡眠问题发生率为65.9％,常见有入睡困难(26.0％)、夜醒≥4次(13.0％)和夜哭(12.8％),昼夜颠倒比例为8.9％.多因素分析显示,昼夜颠倒(OR=2.479,95％CI:1.341～4.584)和夜醒(OR=3.097,95％CI:1.873～5.122)是夜哭的危险因素,而婴儿睡眠困难一般(OR=0.237,95％CI:0.087～0.646)、稍有困难(OR=0.190,95％CI:0.072～0.499)、无困难(OR=0.112,95％CI:0.042～0.294)是夜哭的保护因素.结论 北京地区婴儿以同床睡眠、奶睡/抱睡为主,睡眠问题发生率较高,睡眠节律紊乱会增加夜哭,需要面向家长加强婴儿期睡眠健康宣教和指导工作.

目的 了解北京市3月龄内婴儿发育状况,探讨小月龄婴儿早期发育的影响因素.方法 选取2020年8月至2021年2月在首都医科大学附属北京妇产医院儿童保健门诊进行健康检查的3月龄内婴儿2 980例,采用现况研究设计,通过《年龄与发育进程问卷(第三版)》(Ages and Stages Questionnaires,ASQ-3)获得在沟通、粗大动作、精细动作、解决问题和个人-社会5个能区的发育情况,并分析3月龄内婴儿发育的影响因素.结果 2 980例婴儿在沟通、粗大动作、精细动作、解决问题和个人-社会能区低于界值的比率分别为1.2％、0.03％、1.4％、0.6％和3.2％.多重线性回归分析显示,3月龄内婴儿ASQ-3沟通能区得分与孕周(β=1.286,95％CI:0.862～1.709)和婴儿出生体质量(β=0.002,95％CI:0.000～0.003)呈正相关;粗大动作能区得分与性别(β=-0.671,95％CI:-1.211～-0.132)和产次(β=0.878,95％CI:0.104～1.652)有关;精细动作能区与产次(β=1.524,95％CI:0.663～2.384)呈正相关;解决问题能区与孕周(β=0.780,95％CI:0.386～1.175)、产次(β=1.166,95％CI:0.015～2.316)呈正相关,与母亲年龄(β=-0.179,95％CI:-0.294～-0.064)呈负相关;个人-社会能区得分与孕周(β=0.591,95％CI:0.261～0.921)、产次(β=1.135,95％CI:0.171～2.100)呈正相关,与孕次(β=-0.476,95％CI:-0.943～-0.009)呈负相关.结论 应关注婴儿发育早期影响因素,做好孕期保健减少早产发生,促进婴儿早期心理行为发育.

目的 了解学龄前儿童握力的发育特点,并探讨握力与身高、体重和体成分指标的相关性.方法 2020年9-10月,对北京4所幼儿园的900名学龄前儿童进行问卷调查,并进行身高、体重和握力测量,使用生物电阻抗方法检测体成分,采用偏相关、多元线性回归对握力与体成分指标的相关性进行分析.结果 北京学龄前儿童握力随年龄增长逐渐升高,男童由(5.2±1.7)kg增至(9.3±2.5)kg,女童由(4.3±1.6)kg增至(7.9±2.5)kg(F值分别为57.93,48.77,P值均＜0.01),男童握力高于女童(t=6.42,P＜0.01),肥胖男童握力高于超重和正常体重男童(F=5.35,P＜0.01).调整身高、体重、出生体重、母亲文化程度及过去1周家中进食各类食物频率后,男童握力与瘦体重、上肢肌肉量呈正相关,与体脂肪呈负相关(r值分别为0.11,0.09,-0.18,P值均＜0.05);女童握力与体脂肪呈负相关,与瘦体重呈正相关(r值分别为-0.09,0.09,P值均＜0.05).多元线性回归分析发现,年龄、瘦体重和上肢肌肉量对男童的握力影响有统计学意义(F=66.75,P＜0.01);年龄、瘦体重对女童的握力影响有统计学意义(F=150.81,P＜0.01).结论 学龄前期男童握力可以反映瘦体重和上肢骨骼肌水平的变化,女童可以反映瘦体重的变化.增加瘦体重可以提高学龄前儿童握力水平.

目的 评估北京地区婴儿早期维生素D营养状况,探讨其与体格生长发育的关系.方法 选取2020年4至10月在北京妇产医院门诊进行42天常规体检、年龄在36～48天的1160例健康婴儿作为研究对象,对其进行身长、体重等体格测量和血清25-羟基维生素D[25(OH)D]水平的测定.根据维生素D营养状况将所有婴儿分为缺乏组、不足组和正常组,分析3组婴儿身长、体重和体质量指数(BMI)等的差异.结果 1160例婴儿血清25(OH)D的平均水平为(25.33±6.82)ng/mL,其中男婴为(25.46±6.70)ng/mL,女婴为(25.21±6.94)ng/mL.维生素D缺乏率、不足率和正常率分别为22.24％、55.09％ 和22.67％,维生素D水平和营养状态性别间差异均无统计学意义(P>0.05).缺乏组、不足组和正常组42天体检时的体重、BM I和BMI增量差异均有统计学意义(F值分别为4.397、8.788、4.042,P<0.05);体重增量、身长和身长增量在3组间的差异均无统计学意义(P>0.05).两两比较显示,缺乏组的婴儿42天体检时体重高于正常组,BMI和BMI增量均高于不足组和正常组(P<0.05).分层分析显示,42天体检时男婴中维生素D缺乏组仅BMI高于正常组(P<0.05);女婴中维生素D缺乏组其体重、BMI和BMI增量均高于不足组和正常组(P<0.05).不同BMI的婴儿其25(OH)D水平差异有统计学意义(F=3.979,P<0.05),肥胖婴儿的25(OH)D水平低于BMI正常者(P<0.05),且肥胖婴儿的维生素D缺乏率高于BMI正常者(χ2=8.287,P<0.05).结论 北京地区婴儿早期维生素D缺乏或不足率较高,婴儿早期维生素D缺乏与肥胖有一定相关性.

目的 分析北京市学龄前儿童体质测试数据,为改善儿童体质健康状况提供理论依据.方法 选取2018年北京市妇幼信息系统中26 684名3～6岁儿童体质测试个案数据,按照年龄、性别和地区进行分组,分析不同年龄、性别、地区、营养状况儿童的体质状况差别.结果 北京市学龄前儿童体质水平综合评级为优秀、良好、合格和不合格的分别占39.97％、36.43％、22.83％和0.77％;超重肥胖儿童体质综合评级较非超重肥胖儿童不合格率高,优秀率低.4岁以上郊区儿童的肥胖比例高于城区,且随年龄增长差距逐步扩大.结论 北京市应重视控制学龄前儿童的超重、肥胖率,加强对超重、肥胖儿童的早期管理;开发普及适合儿童在室内、小空间内进行的趣味体育运动项目,以适时弥补户外运动时间的不足;加强园所尤其是郊区园所的健康教育及家园共育管理,帮助家长掌握科学的养育知识,更好地促进学龄前儿童体质和身体素质的全面提升.

目的 分析2011-2019年北京市0～6岁儿童营养不良、肥胖、贫血、龋齿和视力低常的患病情况及变化趋势,掌握0～6岁儿童健康管理中存在的主要问题,以采取相应的措施改善儿童的健康状况.方法 对2011-2019年北京市0～6岁儿童健康状况进行分析,采用SPSS卡方趋势检验分析儿童健康状况随时间变化的趋势.结果 低体重、生长迟缓和消瘦的检出率呈随时间上升的趋势(x2低体重=178.34,P趋势＜ 0.001;x2生长迟缓= 629.49,P趋势 ＜ 0.001;x2消瘦=1 402.78,P趋势＜0.001),由2011 年的0.15％、0.17％和0.18％分别增长到2019年的0.18％、0.26％和0.32％.肥胖检出率呈随时间上升的趋势(x2 = 1 759.50,P趋势＜0.001),由2011年的3.13％增长到2019年的3.49％.贫血检出率整体呈随时间下降的趋势(x2=1 871.17,P趋势＜0.001),由2011年的3.37％下降到2019年的2.60％.3～6岁儿童龋齿检出率和4～6岁儿童视力低常检出率均呈随时间上升的趋势(x2龋齿=7 182.23,P趋势＜0.001;x2视力低常=631.15,P趋势＜0.001),由2011年的37.33％和5.95％增长到2019年的41.33％和7.06％.结论 肥胖、龋齿和视力低常是现阶段北京市儿童保健工作的重点,营养不良和贫血的防控也不容忽视.

目的 探讨北京市早产儿出生情况、影响因素及围生结局.方法 选择2014年1月1日至2019年12月31日,于北京市医疗机构住院分娩,并上报北京市妇幼保健管理信息系统的79173例早产儿为研究对象.其中,出生胎龄<28周的极早早产儿(EEPI)、出生胎龄≥28～32周的早期早产儿(EPI)、出生胎龄≥32～34周的中期早产儿(MPI)、出生胎龄≥35～37周的晚期早产儿(LPI)分别为1021、7858、9102、61192例.收集所有早产儿的家庭人口学信息(户籍所在地、性别及其父母年龄、文化程度、职业),出生胎龄、妊娠胎数,母亲孕期风险情况(风险高、低),以及早产儿围生结局等.采用χ2检验,对早产儿发生率,影响EEPI、EPI、MPI及LPI发生因素的单因素分析及围生儿结局进行分析.采用多因素非条件有序多分类logistic回归分析,对影响EEPI、EPI、MPI及LPI发生的因素进行分析.EEPI、EPI、MPI及LPI出生体重比较,采用单因素方差分析.本研究遵循的程序符合首都医科大学附属北京妇产医院伦理委员会制定的标准,经过该伦理委员会批准(审批文号:IEC-C-03-V04-FJ2).结果 ① 本研究时段北京市早产儿总体发生率为5.68％(79173/1394782);2014—2019年每年分别为4.55％(11355/249429)、4.56％(9549/209455)、6.67％(15983/239692)、5.56％(14674/263991)、6.45％(13790/213819)及6.33％(13822/218396),呈总体增高趋势,并且总体比较差异有统计学意义(χ2=1936.451,P<0.001);每年EEPI、EPI、MPI及LPI发生率,亦均呈上升趋势,差异亦均有统计学意义(χ2=102.991、244.086、242.817、1381.002,P<0.001).②EEPI、EPI、MPI及LPI户籍所在地、母亲年龄、母亲文化程度、母亲孕期风险情况、父亲年龄、父亲文化程度和父亲职业构成比比较,差异均有统计学意义(P<0.05).早产儿母亲孕期风险情况、父亲职业和文化程度,均为影响EEPI、EPI、MPI及LPI发生的独立危险因素,孕期低风险孕妇分娩更晚期的早产儿可能性,是孕期高风险者的1.049倍(OR=1.049,95％CI:1.001～1.100,P=0.047);父亲职业为公务员、军人、国家企事业单位工作人员,以及民营企业、私有企业或个体户工作人员,其获得更晚期的早产儿可能性,分别是父亲职业为无业人员或学生人员的1.351倍(OR=1.351,95％CI:1.290～1.415,P<0.001)与1.293倍(OR=1.293,95％CI:1.239～1.351,P<0.001);父亲文化程度为研究生及以上,其获得更晚期的早产儿可能性,是父亲文化程度为高中及以下者的1.084倍(OR=1.084,95％CI:1.000～1.176,P=0.049).③男性、非北京市户籍、单胎妊娠早产儿的出生体重分别为(2455.5±601.2)g、(2420.1±605.9)g、(2456.8±612.4)g,分别显著高于女性、北京市户籍、多胎妊娠早产儿的出生体重(2347.5±593.3)g、(2400.1±596.6)g、(2223.8±504.2)g,并且差异均有统计学意义(t=5.375、4.715、709.884,P=0.020、0.030、<0.001).本研究时段内各年出生早产儿的出生体重总体比较,差异有统计学意义(F=19.912,P<0.001).④本组79173例早产儿的先天畸形、颅内出血、出生窒息、听力筛查异常、遗传代谢性疾病发生率分别为0.43％(343/79173)、0.21％(167/79173)、6.45％(5105/79173)、2.34％(1809/77236)与0.10％(78/79173).其中,EEPI、EPI、MPI及LPI的先天畸形、颅内出血、出生窒息发生率,以及新生儿听力筛查通过、未通过及未筛查构成比分别比较,差异均有统计学意义(χ2=140.208、25.281、9656.282、197.692,P<0.001).结论 2014—2019年北京市早产儿发生率为5.67％,早产儿围生期结局与早产儿的家庭人口学信息密切相关.因此,针对早产儿家庭人口学信息的医疗干预及管理,可改善早产儿预后.

目的 通过绩效考核结果分析,了解绩效考核效果,发现工作中的问题,不断提高政府部门对妇幼卫生工作重要性认识,促进妇幼卫生体系建设与发展.规范妇幼卫生各项服务,提高服务能力与水平,推动医药卫生体制改革相关政策的落实.方法 通过听取相关部门汇报、查阅资料、问卷调查、现场查看与日常工作相结合等方式,对辖区卫生行政部门、妇幼保健机构,助产机构、基层卫生服务机构、托幼机构等部门的妇幼卫生工作,进行整体评估.结果 6年的北京市妇幼卫生绩效考核发现,大部分区县在政府保障、妇幼保健网络建设、妇幼健康状况、妇幼保健管理与服务均有不同程度提升,实现持续改进.但部分远郊区县发展相对滞后,妇幼工作有待持续改进.结论 通过绩效考核,进一步推动妇幼卫生事业发展,及时发现工作中的问题,明确责任单位,督促积极整改,实现北京市妇幼卫生工作持续改进.

Objective To analyze the trend of children's unintentional injuries from 2011-2016 in kindergartens in Beijing,and to provide the basis for the prevention work of kindergartens children's unintentional injury.Methods Analyze the injury reports of the kindergarten in Beijing from 2011 to 2016.Results The unintentional injuries constituent ratio of kindergartens decreased from 31.13％ to 19.65％ in Beijing from 2011 to 2016.The unintentional injuries incidence rate of children in kindergartens decreased from 5.92‰ to 2.01‰.The unintentional injuries incidence rate of children in kindergartens decreased from 8.10‰ to 2.54‰ in urban area,and decreased from 2.33‰ to 1.28‰ in suburb(x2 =1 275.08,50.64,P＜0.01).The unintentional injuries incidence rate of urban was higher than that of suburb every year,and the differences were of statistical significance(x2 =426.50,275.51,123.34,75.09,45.62,72.91,P＜0.01).The high incidence of injuries included falls(1.55‰-4.40‰v),blunt injuries (0.21‰-0.52‰),and attack by others(0.11‰-0.44‰).Conclusion More attention should be paid to the unintentional injuries of children in kindergartens,and comprehensive measures should be taken to prevent injuries.

[This corrects the article DOI: 10.1371/journal.pone.0177973.].

目的 分析北京市区县妇幼保健机构的服务开展和人力配备情况,评价机构发展现状,为妇幼机构的良好发展与科学规划提供数据支持.方法 采用问卷调查对2013年北京市16所区县妇幼保健机构的人力资源配置、个体服务开展、业务管理与技术指导数据进行描述性统计分析.结果 16所机构的编制缺乏比例、卫生技术人员比例和大学及以上学历人员比例分别为81.3％、81.1％和55.2％.平均年门诊服务人次为21.6万,平均年出院人次为4 067,床位总使用率为81.5％.在个体保健服务和业务管理与技术指导工作中,覆盖率达到100.0％的项目分别占27.4％和72.2％,未开展服务项目的主要原因均为人员不足.平均编制缺乏数高于全国各级水平;卫生技术人员比例低于全国各级水平.2010年至2013年人力资源配置的多项指标均保持逐年增长的趋势;住院医疗服务的多项指标在2012年至2013年出现了下降.结论 北京市区县妇幼保健机构的人员整体素质逐年提高,保健服务稳步推进;同时,妇幼卫生人才队伍亟待加强,妇幼保健机构建设依然落后,接诊服务能力仍有待提高,妇幼保健机构间发展不平衡现象依然明显.

Objective To investigate the incidence and its variation of infectious diseases in kindergartens in Beijing from 2008 to 2015. Methods Annual reports of infectious diseases in kindergartens in Beijing from 2008 to 2015 were longitudinally analyzed .Results The incidence of hand-foot-mouth disease was undulating during these eight years , which was highest in 2008 (2 344.67/100 000) and lowest in 2015 (1 044.55/100 000).The incidence of scarlet fever was increasing and reached peak in 2011 (222.46/100 000) (χ2 =112.893, P<0.05).General downward trends of chickenpox , mumps, dysentery, acute hemorrhagic conjunctivitis and measles were observed (χ2 value was 866.009, 23.821, 123.108, 104.622 and 4.460,respectively, all P<0.05).Hepatitis occurred sometimes.The incidence of infectious diseases of preschool children in urban was higher than that in suburbs (χ2 =40.496,P<0.05), and the outbreak rate of infectious diseases was not significantly different (χ2 =0.001,P>0.05).Hand-foot-mouth disease, chickenpox and mumps/scarlet fever were the top three infectious diseases from 2008 to 2014, and hand-foot-mouth disease , scarlet fever and chickenpox were the top ones in 2015.Conclusion Hand-foot-mouth disease and chickenpox are the focus to be prevented and controlled in kindergartens , including scarlet fever.Supervision should be strengthened in suburbs kindergartens .

OBJECTIVE:To explore the status of two-week illness in primary and secondary students and to provide the basis for rationally distributing heath resources in primary and secondary schools.
 Methods: Stratified cluster sampling method was used to select 6 744 primary and secondary students aged from 9.0-16.9 years, and the name or symptoms of two-week illness, frequencies, medical expenses and days of sick leave were surveyed by using the self-made questionnaires.
 Results: Respiratory system disease (73.6%) and digestive system diseases (13.2%) were the major two-week illness. When they were ill, 58.9% students went to hospital, 39.9% took medicine by themselves, and 1.2% received non-treatment. The two-week morbidity, sick frequencies, average medical expenses per time and days of sick leave were 12.6%, (1.34±0.81) times, 10.0 yuan, and (0.39±0.98) days, respectively. The two-week sick frequencies, average medical expenses per time and days of sick leave among primary or secondary students were (1.37±0.87) or (1.26±0.69) times, 12.0 or 9.0 yuan, and (0.44±1.14) or (0.30±0.55) days, respectively. There was a positive correlation between two week sick frequencies and medical fees per time, or days of sick leave (r=0.301, r=0.275 for primary students, respectively, P<0.01; r=0.334, r=0.290 for secondary students, respectively, P<0.01). The positive correlation between medical fees per time and days of sick leave was also found (r=0.312, r=0.343 for primary students and secondary students, respectively, P<0.01).
 Conclusion: Characteristics of two-week illness among primary and secondary students possess common symptoms, frequent, low medical expenses per time. The frequencies, medical expenses and days of sick leave in primary students were increased compared with that in secondary students.

The patatin like phospholipase containing domain 3 gene (PNPLA3) rs738409 C > G polymorphism, one of the most important gene polymorphisms involved in hepatic steatosis, has been reported to interact with different nutrients and dietary patterns on Non-Alcoholic Fatty Liver Disease (NAFLD), but no studies have focused on its interaction with physical activity or sedentary behavior. Therefore, this study aims at determining whether physical activity or sedentary behavior could modulate the effect of the PNPLA3 variant on childhood NAFLD.

目的 探讨儿童青少年饮食行为模式与超重肥胖的关系,为制定营养教育和干预措施提供依据.方法 对中国7省市28 612名儿童青少年进行体格检查和问卷调查,采用7d饮食行为回顾法收集饮食行为资料.结果 共确定4种饮食行为模式:模式1贡献率为16.58％,与油炸食品、高能量零食、西式快餐、含糖软饮料、在外就餐有关;模式2贡献率为13.02％,与蔬菜、水果、肉或肉制品有关;模式3贡献率为15.58％与早餐、奶有关;模式4贡献率为9.50％,与饭碗大小、吃饭速度有关.多元Logistic回归分析提示,模式1(OR=1.146,95％ CI=1.058～1.242)和模式4(OR=1.848,95％ CI=1.699 ～2.010)是超重肥胖的危险因素,模式3是超重肥胖的保护因素(OR=0.734,95％CI=0.676 ～ 0.798).结论 儿童青少年饮食行为模式与超重肥胖存在一定关联,应加强营养教育,确保儿童青少年健康成长.

ABSTRACTObjectives:Three genome‐wide association studies were previously done for nonalcoholic fatty liver disease (NAFLD) among individuals of Western countries and identified several genetic variants associated with NAFLD. The study aimed to identify whether 7 GWAS‐identified common variants (GCKR rs780094, PDGFA rs343064, FDFT1 rs2645424, COL13A1 rs1227756, EHBP1L1 rs6591182, NCAN rs2228603, and PNPLA3 rs738409) were associated with NAFLD in Chinese children.Methods:This case‐control study recruited 1027 Chinese children of age 7 to 18 years, including 162 children with NAFLD and 865 children without NAFLD. Anthropometric measurements, alanine transaminase (ALT) detection, liver ultrasound examination, and genotyping of 7 variants were performed.Results:The G‐allele of PNPLA3 rs738409 was associated with NAFLD (odds ratio [OR] 1.55, 95% confidence interval 1.13–2.11, P = 0.006) and moderate‐to‐severe steatosis (OR 3.77, 95% confidence interval 1.78–7.98, P = 0.001) adjusted for age, sex, and BMI standard deviation score. In addition, we found each G‐allele of rs738409 increased ALT level by 1.09 IU/L (P = 0.011). Subjects carrying 10 or more risk alleles of 7 variants had an OR of 4.76 (P = 0.025) for NAFLD compared with subjects carrying 3 or fewer risk alleles.Conclusions:The PNPLA3 rs738409 G‐allele was associated with NAFLD and ALT level in Chinese children. It had stronger association with moderate‐to‐severe steatosis. Children carrying 10 or more risk alleles of 7 variants were susceptible for NAFLD.

Objective To investigate the association between rs780094 polymorphism in glucokinase regulatory protein (GCKR) and plasma lipid levels in children and adolescents. Methods 1 026 Chinese children aged 7 to 18 years were recruited,with anthropometric measurements,detection of plasma lipid levels and genotyping of rs780094 performed. Relationships between polymorphism and plasma lipid levels were tested,using multivariate linear regression and logistic regression. Results A-allele of rs780094 in GCKR was associated with increased TC,TG and LDL-C levels(b=0.06 mmol/L,P=0.037;b=0.09 mmol/L,P<0.001;b=0.05 mmol/L,P=0.040) under the additive model adjusted for age,age square and gender. The rs780094 in GCKR was also associated with abnormal levels of TG and LDL-C(OR=1.60,95%CI:1.30-1.97,P<0.001;OR=1.35,95%CI:1.02-1.80,P=0.036). Conclusion The rs780094 in GCKR was associated with plasma lipid levels in children and adolescents while A-allele of rs780094 might serve as genetic factor for the increased plasma lipid levels.

Background. Childhood obesity has become a global public health problem in recent years. This study aimed to explore the association of genetic variants in INSIG-SCAP-SREBP pathway with obesity in Chinese children. Methods. A case-control study was conducted, including 705 obese cases and 1,325 nonobese controls. We genotyped 15 single nucleotide polymorphisms (SNPs) of five genes in INSIG-SCAP-SREBP pathway, including insulin induced gene 1 (INSIG1), insulin induced gene 2 (INSIG2), SREBP cleavage-activating protein gene (SCAP), sterol regulatory element binding protein gene 1 (SREBP1), and sterol regulatory element binding protein gene 2 (SREBP2). We used generalized multifactor dimensionality reduction (GMDR) and logistic regression to investigate gene-gene interactions. Results. Single polymorphism analyses showed that SCAP rs12487736 and rs12490383 were nominally associated with obesity. We identified a 3-locus interaction on obesity in GMDR analyses (P=0.001), involving 3 genetic variants of INSIG2, SCAP, and SREBP2. The individuals in high-risk group of the 3-locus combinations had a 79.9% increased risk of obesity compared with those in low-risk group (OR=1.799, 95% CI: 1.475–2.193, P=6.61×10-9). Conclusion. We identified interaction of three genes in INSIG-SCAP-SREBP pathway on risk of obesity, revealing that these genes affect obesity more likely through a complex interaction pattern than single gene effect.