Evelein Annemieke M V, Visseren Frank L J, van der Ent Cornelis K, Grobbee Diederick E, Uiterwaal Cuno S P M
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85060, Utrecht, The Netherlands.
Int J Pediatr. 2012;2012:141656. doi: 10.1155/2012/141656. Epub 2012 May 9.
Background. Increased childhood weight gain has been associated with later adiposity. Whether excess early postnatal weight gain plays a role in childhood abdominal fat is unknown. Design. In the ongoing Wheezing Illnesses Study Leidsche Rijn (WHISTLER), birth cohort weight and length from birth to age 3 months were obtained. In the first 316 five-year-olds, intra-abdominal and subcutaneous fat were measured ultrasonographically. Individual weight and length gain rates were assessed in each child. Internal Z-scores of weight for length gain (WLG) were calculated. Multiple imputation was used to deal with missing covariates. Results. Per-1-unit increase in Z-score WLG from birth to 3 months, BMI, waist circumference, and subcutaneous fat were significantly higher; 0.51 kg/m(2), 0.84 cm, and 0.50 mm, respectively. After multiple imputation, a trend towards significance was observed for intra-abdominal fat as well (0.51 mm/SD). In the associations with 5-year adiposity, no interaction between postnatal Z-score WLG and birth size was found. Conclusion. Excess early postnatal weight gain is associated with increased general and central adiposity, characterized by more subcutaneous and likely more intra-abdominal fat at 5 years of age.
背景。儿童期体重增加过多与日后肥胖相关。出生后早期体重过度增加是否在儿童腹部脂肪形成中起作用尚不清楚。设计。在正在进行的莱顿莱茵河喘息疾病研究（WHISTLER）中，获取了出生至3个月大的队列儿童的体重和身长数据。在首批316名5岁儿童中，通过超声测量了腹内脂肪和皮下脂肪。评估了每个儿童的个体体重和身长增加率。计算了身长增加体重（WLG）的内部Z评分。采用多重填补法处理协变量缺失问题。结果。从出生到3个月，Z评分WLG每增加1个单位，BMI、腰围和皮下脂肪显著增加，分别增加0.51kg/m²、0.84cm和0.50mm。多重填补后，腹内脂肪也观察到显著趋势（0.51mm/标准差）。在与5岁时肥胖的关联中，未发现出生后Z评分WLG与出生时大小之间存在相互作用。结论。出生后早期体重过度增加与全身和中心性肥胖增加相关，表现为5岁时皮下脂肪增多，可能腹内脂肪也增多。
