Kuh D, Hardy R, Chaturvedi N, Wadsworth M E J
Medical Research Council National Survey of Health and Development, Royal Free and University College, London, UK.
Int J Obes Relat Metab Disord. 2002 Jan;26(1):40-7. doi: 10.1038/sj.ijo.0801861.
To examine the relationship of adult abdominal obesity to birth weight, childhood growth and lifetime socioeconomic circumstances.
A cohort of 3200 men and women with measured waist and hip circumference, height and weight at age 43 who have been followed since their birth in March 1946 in England, Scotland and Wales. Regression models were used to examine mean waist-hip ratio and waist circumference in relation to prospective measures of birth weight, weight relative to height in childhood at ages 4, 7, 11 and 15 and adult body mass index, and to test the independent and interactive nature of the associations and adjust for childhood and adult social class.
There was a small inverse effect of birth weight on waist-hip ratio (P=0.037) but not waist circumference in women, after adjustment for current body size. Relative weight at age 7 was inversely related to waist-hip ratio and waist circumference in men (P<0.001 for both) and waist circumference in women (P=0.007) after adjustment for current body size. These relationships were attenuated in men of large body mass index (P<0.01 for interactions between relative weight at 7 y and body mass index in both cases) but were not modified by birth weight. Relative weights at other ages showed similar patterns to those observed at age 7, the effect being weakest at age 4. These findings were independent of lifetime socioeconomic circumstances.
This study found a small prenatal inverse effect of fetal growth on adult waist-hip ratio due to a reduced hip size. There was also an inverse postnatal effect of childhood growth such that for any given adult body size those who had been lighter in childhood were more at risk of abdominal obesity. These relationships were independent of childhood socioeconomic circumstances and support the idea that insulin resistance may be linked to low weight in childhood.
研究成人腹部肥胖与出生体重、儿童期生长发育及一生社会经济状况之间的关系。
对3200名男性和女性进行队列研究,这些人于1946年3月在英格兰、苏格兰和威尔士出生,在43岁时测量了腰围、臀围、身高和体重。采用回归模型研究平均腰臀比和腰围与出生体重的前瞻性测量值、4岁、7岁、11岁和15岁儿童期体重与身高的相对关系以及成人身体质量指数之间的关系,并检验这些关联的独立性和交互性,同时对儿童期和成人社会阶层进行校正。
在校正当前体型后,出生体重对女性腰臀比有较小的反向影响(P = 0.037),但对腰围无影响。在校正当前体型后,7岁时的相对体重与男性的腰臀比和腰围呈负相关(两者P均<0.001),与女性的腰围呈负相关(P = 0.007)。在体型较大的男性中,这些关系减弱(两种情况下7岁时相对体重与身体质量指数之间的交互作用P<0.01),但不受出生体重的影响。其他年龄的相对体重呈现出与7岁时相似的模式,在4岁时影响最弱。这些发现与一生的社会经济状况无关。
本研究发现,由于臀部尺寸减小,胎儿生长在产前对成人腰臀比有较小的反向影响。儿童期生长也有产后反向影响,即对于任何给定的成人体型,童年时体重较轻的人腹部肥胖风险更高。这些关系与儿童期社会经济状况无关,支持胰岛素抵抗可能与儿童期体重低有关的观点。