Institute of Preventive Medicine, Copenhagen University Hospital, Copenhagen, Denmark.
Int J Obes (Lond). 2012 Oct;36(10):1306-11. doi: 10.1038/ijo.2012.134. Epub 2012 Aug 21.
Infant weight and weight gain are positively associated with later obesity, but whether there is a particular critical time during infancy remains uncertain.
The aim was to investigate when and how weight and weight gain during infancy become associated with childhood obesity.
In a cohort representing 28 340 children born from 1959-67 and measured in Copenhagen schools, 962 obese children (2007 World Health Organization criteria), were compared with a 5% randomly selected sub-cohort of 1417 children. Information on weight at birth, 2 weeks, 1, 2, 3, 4, 6 and 9 months was retrieved from health visitors' records. Odds ratios and 95% confidence intervals (CI) for childhood obesity by tertiles of weight at each age and by change in tertiles of weight between two consecutive measurements were estimated using multivariate logistic regression with adjustment for indicators of socioeconomic status, preterm birth, and breastfeeding.
Compared with children in the middle weight-tertile, children with a weight in the upper tertile had a 1.36-fold (CI, 1.10-1.69) to 1.72-fold (CI, 1.36-2.18) higher risk of childhood obesity from birth through 9 months, whereas children in the lower weight-tertile had almost half the risk of obesity from 2 through 9 months. The risk of childhood obesity associated with change in weight-tertile in each interval was stable at ∼1.5-fold per weight-tertile increase throughout infancy.
Infant weight and weight gain are associated with obesity in childhood already during the first months of life. Determinants of weight gain shortly after birth may be a suitable target for prevention of obesity.
婴儿的体重和体重增加与日后肥胖呈正相关,但婴儿期是否存在特定的关键时期仍不确定。
本研究旨在探讨婴儿期体重和体重增加何时以及如何与儿童肥胖相关。
在一个代表 1959-67 年出生并在哥本哈根学校接受测量的队列中,将 962 名肥胖儿童(2007 年世界卫生组织标准)与随机选择的 1417 名儿童的 5%子队列进行比较。从健康访视员的记录中检索出生时、2 周、1、2、3、4、6 和 9 个月时的体重信息。使用多变量逻辑回归,根据每个年龄的体重三分位数和两次连续测量之间体重三分位数的变化,调整社会经济状况、早产和母乳喂养的指标,估计儿童肥胖的比值比和 95%置信区间(CI)。
与处于中等体重三分位的儿童相比,出生至 9 个月时体重处于较高三分位的儿童肥胖的风险比为 1.36 倍(95%CI,1.10-1.69)至 1.72 倍(95%CI,1.36-2.18);而体重处于较低三分位的儿童在 2 至 9 个月期间肥胖的风险几乎减半。每个间隔体重三分位变化与肥胖相关的风险在整个婴儿期保持在约 1.5 倍/体重三分位增加。
婴儿期的体重和体重增加与儿童期肥胖相关,甚至在生命的最初几个月就已经相关。出生后不久体重增加的决定因素可能是肥胖预防的合适目标。