Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Obes Rev. 2012 Nov;13(11):985-1000. doi: 10.1111/j.1467-789X.2012.01015.x. Epub 2012 Jun 26.
The objective of this study was to evaluate the evidence on whether childhood obesity is a risk factor for adult disease, independent of adult body mass index (BMI). Ovid MEDLINE (1948-May 2011), EMBASE (1980-2011 week 18) and the Cochrane Library (1990-2011) were searched for published studies of BMI from directly measured weight and height in childhood (2-19 years) and disease outcomes in adulthood. Data were synthesized in a narrative fashion. Thirty-nine studies (n 181-1.1 million) were included in the review. There was evidence for associations between childhood BMI and type 2 diabetes, hypertension and coronary heart disease. Few studies examined associations independent of adult BMI; these showed that effect sizes were attenuated after adjustment for adult BMI in standard regression analyses. Although there is a consistent body of evidence for associations between childhood BMI and cardiovascular outcomes, there is a lack of evidence for effects independent of adult BMI. Studies have attempted to examine independent effects using standard adjustment for adult BMI, which is subject to over-adjustment and problems with interpretation. Studies that use more robust designs and analytical techniques are needed to establish whether childhood obesity is an independent risk factor for adult disease.
本研究旨在评估儿童肥胖是否是成人疾病的独立风险因素，而不考虑成人体重指数（BMI）。我们检索了 Ovid MEDLINE（1948 年至 2011 年 5 月）、EMBASE（1980 年至 2011 年第 18 周）和 Cochrane 图书馆（1990 年至 2011 年），以获取关于儿童时期（2-19 岁）直接测量体重和身高与成年后疾病结果的 BMI 发表研究。数据以叙述的方式进行综合。共纳入 39 项研究（n=181-110 万人）。有证据表明儿童 BMI 与 2 型糖尿病、高血压和冠心病有关。很少有研究独立于成人 BMI 检查相关性；这些研究表明，在标准回归分析中调整成人 BMI 后，效应大小减弱。尽管有大量证据表明儿童 BMI 与心血管结局之间存在关联，但缺乏独立于成人 BMI 的证据。研究试图使用标准的成人 BMI 调整来检验独立的影响，但这可能会过度调整并导致解释问题。需要进行更可靠的设计和分析技术研究，以确定儿童肥胖是否是成人疾病的独立风险因素。
