Blair Nikki J, Thompson John M D, Black Peter N, Becroft David M O, Clark Phillipa M, Han Dug Yeo, Robinson Elizabeth, Waldie Karen E, Wild Chris J, Mitchell Edwin A
Department of Paediatrics, University of Auckland, Auckland, New Zealand.
Arch Dis Child. 2007 Oct;92(10):866-71. doi: 10.1136/adc.2007.116855. Epub 2007 Sep 13.
To identify risk factors associated with obesity in primary school children, with a particular focus on those which can be modified. To identify critical periods and growth patterns in the development of childhood obesity.
871 New Zealand European children were enrolled in a longitudinal study at birth and data were collected at birth, 1, 3.5 and 7 years of age. Data collected at 7 years included weight, height, bioelectrical impedance analysis (BIA), television viewing time and a 24 h body movement record (actigraphy). The outcome measure was percentage body fat (PBF), which was calculated at 3.5 and 7 years using BIA. Univariate and multiple regression analyses were carried out using PBF as a continuous variable.
Multivariable analysis found maternal overweight/obesity, maternal age, female gender, sedentary activity time and hours of television viewing to be independently associated with PBF at 7 years. Growth variables (birth weight, rapid weight gain in infancy, early (1-3.5 years) and middle childhood (3.5-7 years)) were also independently associated with adiposity at 7 years. There was a strong correlation between PBF at 3.5 years and PBF at 7 years.
Many primary school aged children start on the trajectory of obesity in the preschool years, which suggests interventions need to start early. Maternal overweight/obesity, television watching, sedentary activity time and rapid weight gain in infancy, early and middle childhood are risk factors for childhood obesity, and are all potentially modifiable.
确定与小学儿童肥胖相关的风险因素，尤其关注那些可改变的因素。确定儿童肥胖发展过程中的关键时期和生长模式。
871名新西兰欧洲裔儿童在出生时被纳入一项纵向研究，并在出生时、1岁、3.5岁和7岁时收集数据。7岁时收集的数据包括体重、身高、生物电阻抗分析（BIA）、看电视时间和24小时身体活动记录（活动记录仪）。结局指标是体脂百分比（PBF），在3.5岁和7岁时使用BIA计算得出。以PBF作为连续变量进行单变量和多变量回归分析。
多变量分析发现，母亲超重/肥胖、母亲年龄、女性性别、久坐活动时间和看电视时长与7岁时的PBF独立相关。生长变量（出生体重、婴儿期体重快速增加、儿童早期（1 - 3.5岁）和儿童中期（3.5 - 7岁））也与7岁时的肥胖独立相关。3.5岁时的PBF与7岁时的PBF之间存在很强的相关性。
许多小学年龄的儿童在学龄前就开始走上肥胖轨迹，这表明干预措施需要尽早开始。母亲超重/肥胖、看电视、久坐活动时间以及婴儿期、儿童早期和中期体重快速增加是儿童肥胖的风险因素，且均具有潜在可改变性。
