Leibowitz Karen L, Moore Reneé H, Stunkard Albert J, Stallings Virginia A, Berkowitz Robert I, Stettler Nicolas, Chittams Jesse L, Faith Myles S
The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104-4399, USA.
Int J Pediatr Obes. 2009;4(3):150-9. doi: 10.1080/17477160802596130.
The present study tested whether children born at high risk (HR) compared with low risk (LR) for obesity are more likely to have a waist circumference (WC) associated with cardiovascular disease risk factors (CVDRF-WC) and tested whether CVDRF-WC status tracks over time.
This prospective cohort study involved 71 children, three to eight years, who were divided into two groups, LR (n = 37) and HR (n = 34), based upon maternal prepregnancy body mass index (BMI). HR subjects were subdivided into HR normal-weight (HRNW) and HR overweight (HROW) groups, based on BMI > or = 85%. Children were classified as having or not having a CVDRF-WC at each year, using age- and gender-specific WC cut-offs. Anthropometry was assessed annually.
Although HR children had a significantly greater mean WC than LR children at years 5-8 (p < 0.03), these differences became non-significant after adjusting for BMI. HROW were more likely to have a CVDRF-WC status (p < or = 0.0001) at age 4 years (10%, 5%, vs. 58%), 5 years (3%, 10%, vs. 60%), 6 years (0%, 0%, vs. 70%), 7 years (0%, 0%, vs. 50%) to 8 years (0%, 0%, vs. 55%) than LR and HRNW. Although 60-100% of the children tracked CVDRF-WC status, higher proportions of HROW children (0-40%) transitioned into having a CVDRF-WC, compared with LR (0-6%) and HRNW (0-9%).
HROW were more likely to have or develop a CVDRF-WC. Although the effects of obesity risk on WC may be secondary to BMI, clinically assessing WC in obese-prone children may help identify youth at risk for obesity-related complications.
本研究旨在测试与低肥胖风险(LR)儿童相比,高肥胖风险(HR)出生的儿童是否更有可能拥有与心血管疾病风险因素相关的腰围(WC)(CVDRF-WC),并测试CVDRF-WC状态是否随时间推移而保持。
这项前瞻性队列研究涉及71名3至8岁的儿童,根据母亲孕前体重指数(BMI)将他们分为两组,LR组(n = 37)和HR组(n = 34)。根据BMI≥85%,HR组受试者再细分为HR正常体重(HRNW)和HR超重(HROW)组。每年使用特定年龄和性别的WC临界值将儿童分类为有或没有CVDRF-WC。每年评估人体测量学指标。
尽管在5至8岁时HR儿童的平均WC显著高于LR儿童(p < 0.03),但在调整BMI后,这些差异变得不显著。在4岁(10%,5%,vs. 58%)、5岁(3%,10%,vs. 60%)、6岁(0%,0%,vs. 70%)、7岁(0%,0%,vs. 50%)至8岁(0%,0%,vs. 55%)时,HROW组比LR组和HRNW组更有可能处于CVDRF-WC状态(p≤0.0001)。尽管60%至100%的儿童保持CVDRF-WC状态,但与LR组(0%至6%)和HRNW组(0%至9%)相比,HROW组儿童转变为具有CVDRF-WC的比例更高(0%至40%)。
HROW组更有可能拥有或发展为CVDRF-WC。尽管肥胖风险对WC的影响可能继发于BMI,但对肥胖倾向儿童进行临床WC评估可能有助于识别有肥胖相关并发症风险的青少年。