Campbell Michele Wen-Chien, Williams Joanne, Carlin John B, Wake Melissa
Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
Int J Pediatr Obes. 2011 Jun;6(2-2):e207-15. doi: 10.3109/17477166.2010.526613. Epub 2010 Nov 22.
Early adiposity rebound ([AR], when body mass index [BMI] rises after reaching a nadir) strongly predicts later obesity. We investigated whether the upswing in BMI at AR is accompanied by an increase in body fat.
Community-based cohort study.
A total of 299 first-born children (49% male). Measurements. Six-monthly anthropometry and bioelectrical impedance, 4-6.5 years; lean and fat mass index (kg/m(2)) for direct comparison with BMI. Supplementary (0-2 years) weight and length measures (needed for growth curve modelling) were drawn from subjects' child health records.
AR was estimated from individually modelled BMI curves from birth to 6.5 years. Two main analyses were performed: 1) cross-sectional comparisons of BMI, fat mass index (FMI), lean mass index (LMI) and percent body fat in children with early (<5 years) and later (>5 years) rebound; and 2) investigation of linear trends in BMI, FMI, LMI and percent body fat before and after AR. Results. The 81 children (27%) experiencing early AR had higher BMI, FMI, LMI and percent fat at 6.5 years. Overall, FMI decreased steeply pre-AR, at -0.56 (0.02) kg/m(2) per year (mean [Standard Error]), then flattened post-AR to 0.07 (0.05) kg/m(2) per year. In contrast, LMI increased pre-AR (0.34 [0.01]) and steepened post-AR (0.47 [0.03] kg/m(2) per year).
The 'adiposity rebound' is characterised by increasing lean mass index, coupled with cessation of the decline in fat mass index. Understanding what controls the dynamics of childhood body composition and mechanisms that delay AR could help prevent obesity.
早期肥胖反弹（当体重指数[BMI]在达到最低点后上升时）强烈预测后期肥胖。我们研究了肥胖反弹时BMI的上升是否伴随着体脂增加。
基于社区的队列研究。
共299名头胎儿童（49%为男性）。测量。4至6.5岁时每六个月进行一次人体测量和生物电阻抗测量；瘦体重和脂肪量指数（kg/m²）用于与BMI直接比较。补充的（0至2岁）体重和身长测量值（生长曲线建模所需）取自受试者的儿童健康记录。
根据从出生到6.5岁的个体建模BMI曲线估计肥胖反弹。进行了两项主要分析：1）对早期（<5岁）和后期（>5岁）反弹儿童的BMI、脂肪量指数（FMI）、瘦体重指数（LMI）和体脂百分比进行横断面比较；2）研究肥胖反弹前后BMI、FMI、LMI和体脂百分比的线性趋势。结果。81名（27%）经历早期肥胖反弹的儿童在6.5岁时BMI、FMI、LMI和体脂百分比更高。总体而言，FMI在肥胖反弹前急剧下降，每年下降-0.56（0.02）kg/m²（均值[标准误]），然后在肥胖反弹后趋于平稳，每年为0.07（0.05）kg/m²。相比之下，LMI在肥胖反弹前增加（0.34[0.01]），在肥胖反弹后变陡（每年0.47[0.03]kg/m²）。
“肥胖反弹”的特征是瘦体重指数增加，同时脂肪量指数下降停止。了解控制儿童身体成分动态的因素以及延迟肥胖反弹的机制可能有助于预防肥胖。
