Asociación Benéfica PRISMA, Lima, Peru.
Am J Phys Anthropol. 2012 Jul;148(3):451-61. doi: 10.1002/ajpa.22073. Epub 2012 May 3.
While childhood malnutrition is associated with increased morbidity and mortality, less well understood is how early childhood growth influences height and body composition later in life. We revisited 152 Peruvian children who participated in a birth cohort study between 1995 and 1998, and obtained anthropometric and bioimpedance measurements 11-14 years later. We used multivariable regression models to study the effects of childhood anthropometric indices on height and body composition in early adolescence. Each standard deviation decrease in length-for-age at birth was associated with a decrease in adolescent height-for-age of 0.7 SD in both boys and girls (all P < 0.001) and 9.7 greater odds of stunting (95% CI 3.3-28.6). Each SD decrease in length-for-age in the first 30 months of life was associated with a decrease in adolescent height-for-age of 0.4 in boys and 0.6 standard deviation in girls (all P < 0.001) and with 5.8 greater odds of stunting (95% CI 2.6-13.5). The effect of weight gain during early childhood on weight in early adolescence was more complex to understand. Weight-for-length at birth and rate of change in weight-for-length in early childhood were positively associated with age- and sex-adjusted body mass index and a greater risk of being overweight in early adolescence. Linear growth retardation in early childhood is a strong determinant of adolescent stature, indicating that, in developing countries, growth failure in height during early childhood persists through early adolescence. Interventions addressing linear growth retardation in childhood are likely to improve adolescent stature and related-health outcomes in adulthood.
虽然儿童期营养不良与发病率和死亡率增加有关,但人们对幼儿期生长如何影响成年后身高和身体成分知之甚少。我们重新研究了 1995 年至 1998 年间参加出生队列研究的 152 名秘鲁儿童,并在 11-14 年后获得了人体测量和生物阻抗测量数据。我们使用多变量回归模型研究了儿童期人体测量指标对青少年身高和身体成分的影响。出生时的年龄与身长比每降低一个标准差,男孩和女孩的青少年身高与年龄比都会降低 0.7 个标准差(所有 P<0.001),且矮身材的风险增加 9.7 倍(95%CI 3.3-28.6)。生命头 30 个月的年龄与身长比每降低一个标准差,男孩的青少年身高与年龄比会降低 0.4 个标准差,女孩则降低 0.6 个标准差(所有 P<0.001),且矮身材的风险增加 5.8 倍(95%CI 2.6-13.5)。理解儿童早期体重增加对青少年早期体重的影响要复杂一些。出生时的身长与体重比以及儿童早期体重与身长比的变化率与年龄和性别调整后的身体质量指数呈正相关,且超重的风险更高。儿童早期线性生长迟缓是青少年身高的一个重要决定因素,这表明在发展中国家,儿童早期身高增长失败会持续到青少年期。针对儿童期线性生长迟缓的干预措施可能会改善青少年的身高和成年后的相关健康结果。