Rzehak P, Heinrich J
Institute of Epidemiology, GSF-National Research Center for Environment and Health, Ingolstaedter Landstrasse 1, D-85764, Neuherberg, Germany.
Eur J Epidemiol. 2006;21(9):661-72. doi: 10.1007/s10654-006-9051-8. Epub 2006 Oct 18.
To investigate individual longitudinal change of relative weight, overweight and obesity from age 5 to 25 years by gender.
A cohort was imbedded in four surveys conducted 1992/1993, 1995/1996, 1998/1999 and 2004/2005 in three areas in Germany. Twelve-year-follow-up of 2183 children initially aged 5-13 years at baseline. Main measurements are body mass index (BMI) and international obesity task force (IOTF)-cut point defined overweight and obesity. A special longitudinal random effects model for cohort data was applied, which uses age as meta-meter of follow-up time and takes age at study entry into account.
BMI, overweight and obesity increases with linear and squared age. Girls have a significant higher growth rate than boys in BMI (BMI: 0.89 vs. 0.75 kg/m(2) per 1 year age increment), whereas there is no statistical significant gender difference for overweight [odds ratio (OR) = 1.08 per 1 year] or obesity (OR = 1.11 per 1 year). Longitudinal change rates of BMI vary substantially between individuals [95% reference range (beta +/- 1.96 x SD) for linear change per 1 year is -0.14 to 1.98 in females and -0.29 to 1.83 in males; the 95% range of quadratic change rates are -0.09 to 0.04 in females and -0.08 to 0.05 in males]. Moreover, a steeper increase in BMI over time is observed for children with a higher baseline relative weight.
Increases in BMI and the propensity of overweight and obesity follow a quadratic growth curve with the steepest increase before and during puberty. However, the substantial variability of relative weight gain within individuals indicate, that more research in individual change patterns is needed.
按性别调查5至25岁期间相对体重、超重和肥胖的个体纵向变化。
在1992/1993年、1995/1996年、1998/1999年和2004/2005年于德国三个地区进行的四项调查中纳入了一个队列。对最初在基线时年龄为5至13岁的2183名儿童进行了12年的随访。主要测量指标为体重指数(BMI)以及国际肥胖特别工作组(IOTF)界定的超重和肥胖切点。应用了一种针对队列数据的特殊纵向随机效应模型,该模型将年龄用作随访时间的元指标,并考虑了研究入组时的年龄。
BMI、超重和肥胖随年龄呈线性和二次方增长。女孩在BMI方面的增长率显著高于男孩(BMI:每增加1岁,女孩为0.89 kg/m²,男孩为0.75 kg/m²),而超重(每增加1岁,比值比(OR) = 1.08)或肥胖(每增加1岁,OR = 1.11)方面无统计学显著的性别差异。个体之间BMI的纵向变化率差异很大[女性每年线性变化的95%参考范围(β±1.96×标准差)为 -0.14至1.98,男性为 -0.29至1.83;女性二次方变化率的95%范围为 -0.09至0.04,男性为 -0.08至0.05]。此外,基线相对体重较高的儿童随时间推移BMI的增长更为陡峭。
BMI以及超重和肥胖倾向呈二次方增长曲线,在青春期之前和期间增长最为陡峭。然而,个体相对体重增加的显著变异性表明,需要对个体变化模式进行更多研究。