Freedman D S, Khan L K, Dietz W H, Srinivasan S R, Berenson G S
Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Pediatrics. 2001 Sep;108(3):712-8. doi: 10.1542/peds.108.3.712.
Childhood obesity is related to adult levels of lipids, lipoproteins, blood pressure, and insulin and to morbidity from coronary heart disease (CHD). However, the importance of the age at which obesity develops in these associations remains uncertain.
We assessed the longitudinal relationship of childhood body mass index (BMI, kg/m(2)) to adult levels of lipids, insulin, and blood pressure among 2617 participants. All participants were initially examined at ages 2 to 17 years and were reexamined at ages 18 to 37 years; the mean follow-up was 17 years.
Of the overweight children (BMI >/=95th percentile), 77% remained obese (>/=30 kg/m(2)) as adults. Childhood overweight was related to adverse risk factor levels among adults, but associations were weak (r ~ 0.1-0.3) and were attributable to the strong persistence of weight status between childhood and adulthood. Although obese adults had adverse levels of lipids, insulin, and blood pressure, levels of these risk factors did not vary with childhood weight status or with the age (</=8 years, 12-17 years, or >/=18 years) of obesity onset.
Additional data are needed to assess the independent relationship of childhood weight status to CHD morbidity. Because normal-weight children who become obese adults have adverse risk factor levels and probably will be at increased risk for adult morbidity, our results emphasize the need for both primary and secondary prevention.
儿童肥胖与成人的血脂、脂蛋白、血压和胰岛素水平以及冠心病（CHD）的发病率相关。然而，肥胖发生的年龄在这些关联中的重要性仍不确定。
我们评估了2617名参与者中儿童体重指数（BMI，kg/m²）与成人血脂、胰岛素和血压水平之间的纵向关系。所有参与者最初在2至17岁接受检查，并在18至37岁时再次接受检查；平均随访时间为17年。
超重儿童（BMI≥第95百分位数）中，77%成年后仍肥胖（≥30 kg/m²）。儿童期超重与成人不良风险因素水平相关，但关联较弱（r约为0.1 - 0.3），且归因于儿童期和成年期体重状况的强烈持续性。尽管肥胖成人的血脂、胰岛素和血压水平不良，但这些风险因素的水平并不随儿童体重状况或肥胖开始的年龄（≤8岁、12 - 17岁或≥18岁）而变化。
需要更多数据来评估儿童体重状况与冠心病发病率之间的独立关系。由于体重正常的儿童成年后肥胖会有不良风险因素水平，且可能成年发病风险增加，我们的结果强调了一级和二级预防的必要性。
