Hui L L, Schooling C Mary, Leung Shirley Sze Lee, Mak Kwok Hang, Ho Lai Ming, Lam Tai Hing, Leung Gabriel M
Department of Community Medicine and School of Public Health, The University of Hong Kong, 5/F William M. W. Mong Block, 21 Sassoon Rd, Pokfulam, Hong Kong, China.
Arch Pediatr Adolesc Med. 2008 Mar;162(3):212-8. doi: 10.1001/archpediatrics.2007.62.
To investigate the association between birth weight, infant growth rate, and childhood adiposity as a proxy for adult metabolic or cardiovascular risk in a Chinese population with a history of recent and rapid economic development.
Prospective study in a population-representative birth cohort.
Hong Kong Chinese population.
Six thousand seventy-five term births (77.5% successful follow-up). Main Exposures Birth weight and growth rate (change in the weight z score) at ages 0 to 3 and 3 to 12 months. Main Outcome Measure Body mass index (BMI) (calculated as the weight in kilograms divided by the height in meters squared) z score at about age 7 years.
Each unit increase in the weight z score at ages 0 to 3 and 3 to 12 months increased the BMI z score by 0.52 and 0.33, respectively. Children in the highest birth weight and growth rate tertiles had the highest BMI z scores. In the lowest birth weight tertile, increases in the weight z score at ages 0 to 3 months had a larger effect on the BMI z score in boys (mean difference, 0.88; 95% confidence interval 0.69-1.07) than in girls (mean difference, 0.52; 95% confidence interval, 0.33-0.71); these differences by birth weight, growth rate at ages 0 to 3 months, and sex were significant (P = .007).
Faster prenatal and postnatal growth were associated with higher childhood BMI in a population with a recent history of rapid economic growth and relatively low birth weight, suggesting that maximal growth may not be optimal for metabolic risk. However, there may be a developmental trade-off between metabolic risk and other outcomes.
在近期经济快速发展的中国人群中，研究出生体重、婴儿生长速率与儿童期肥胖之间的关联，以此作为成人代谢或心血管疾病风险的指标。
对具有人群代表性的出生队列进行前瞻性研究。
中国香港人群。
6075例足月儿出生（随访成功率77.5%）。主要暴露因素为出生体重以及0至3个月和3至12个月时的生长速率（体重Z评分的变化）。主要结局指标为约7岁时的体重指数（BMI）（计算方法为体重千克数除以身高米数的平方）Z评分。
0至3个月和3至12个月时体重Z评分每增加一个单位，BMI Z评分分别增加0.52和0.33。出生体重和生长速率处于最高三分位数的儿童BMI Z评分最高。在出生体重最低的三分位数中，0至3个月时体重Z评分的增加对男孩BMI Z评分的影响（平均差异为0.88；95%置信区间为0.69 - 1.07）大于女孩（平均差异为0.52；95%置信区间为0.33 - 0.71）；出生体重、0至3个月时的生长速率和性别的这些差异具有统计学意义（P = 0.007）。
在近期经济快速增长且出生体重相对较低的人群中，产前和产后生长较快与儿童期较高的BMI相关，这表明最大生长速率可能并非代谢风险的最佳状态。然而，在代谢风险和其他结局之间可能存在发育上的权衡。
