Cameron Noël, Pettifor John, De Wet Thea, Norris Shane
Department of Human Sciences, Loughborough University, Loughborough, Leicester, United Kingdom.
Obes Res. 2003 Mar;11(3):457-60. doi: 10.1038/oby.2003.62.
Children with birth weight appropriate for gestational age (AGA) who also demonstrate rapid weight gain in infancy have a greater risk of being overweight or obese during childhood. A concurrent advancement in skeletal maturity would account for their greater size and would, therefore, not necessarily pose a threat of greater risk during adolescence and early adulthood. This study aims to determine whether children with rapid weight gain during infancy have advanced skeletal maturity during childhood.
One hundred and ninety-three African children (boys = 108; girls = 85) of normal birth weight and gestational age were assessed from birth to 9 years. Body composition was assessed at 9 years of age by whole-body DXA, and skeletal maturity was assessed using the Tanner-Whitehouse II technique. Rapid weight gain in infancy was defined as a +0.67 change in weight-for-age Z-score between birth and 2 years.
Rapid weight gain was experienced by over 20% of the sample. Children with rapid weight gain were significantly lighter at birth and significantly taller, heavier, and fatter throughout childhood. Chronological age and Tanner-Whitehouse II technique skeletal ages at 9 years were not significantly different between groups or between sexes within groups.
Because AGA children with rapid weight gain have a greater risk of overweight and obesity but are not advanced in skeletal maturity, later adolescent adjustments toward average weight and fatness values are unlikely. The identification and monitoring of such children is of importance in reducing their risk of morbidity.
出生体重与胎龄相称(AGA)且在婴儿期体重快速增加的儿童,在儿童期超重或肥胖的风险更高。骨骼成熟度的同步提前可以解释他们更大的体型,因此在青春期和成年早期不一定会带来更大的风险威胁。本研究旨在确定婴儿期体重快速增加的儿童在儿童期骨骼成熟度是否提前。
对193名出生体重和胎龄正常的非洲儿童(男孩108名;女孩85名)从出生到9岁进行评估。9岁时通过全身双能X线吸收法评估身体成分,使用坦纳-怀特豪斯II技术评估骨骼成熟度。婴儿期体重快速增加定义为出生至2岁期间年龄别体重Z评分变化+0.67。
超过20%的样本经历了体重快速增加。体重快速增加的儿童出生时明显更轻,在整个儿童期明显更高、更重且更胖。两组之间以及组内不同性别之间9岁时的实际年龄和坦纳-怀特豪斯II技术骨骼年龄无显著差异。
由于体重快速增加的AGA儿童超重和肥胖风险更高,但骨骼成熟度并未提前,青少年后期向平均体重和脂肪值的调整不太可能。识别和监测此类儿童对于降低其发病风险具有重要意义。