Royal Prince Alfred Hospital, Camperdown, Australia.
Pediatrics. 2013 Jun;131(6):e1821-8. doi: 10.1542/peds.2012-2789. Epub 2013 May 27.
We hypothesized that early weight gain would be associated with incident obesity, higher blood pressure, systemic inflammation, and arterial wall thickening in later childhood.
A longitudinal birth cohort was recruited antenatally from 2 maternity hospitals in Sydney, Australia, between September 1997 and December 1999. Three hundred ninety-five nondiabetic children who were followed to age 8 years had complete data for early weight gain and arterial wall thickness.
Independent predictors of excess early weight gain (age 0-18 months; adjusted for height gain) included male gender (0.411 kg [SE: 0.103], P < .001), fewer weeks' gestation (-0.121 kg [SE: 0.044] per week, P = .006), birth length (0.156 kg [SE: 0.024] per cm, P < .001), and failure to breastfeed to 6 months of age (0.498 kg [SE: 0.108], P < .001). Early height-adjusted weight gain was significantly associated with later childhood overweight (odds ratio [OR]: 1.67 [95% confidence interval (CI): 1.26 to 2.20] per kg) and obesity (OR: 2.07 [95% CI: 1.53 to 2.79] per kg), excess central adiposity (OR: 1.54 [95% CI: 1.20 to 1.98] per kg), higher systolic blood pressure (1.24 mm Hg [SE: 0.33] per kg, P < .001), higher C-reactive protein (0.17 mg/dL [SE: 0.06] per 100% increase in weight gain, P = .006), and greater carotid intima-media thickness (0.012 mm [SE: 0.004] per kg, P = .002).
Early postnatal weight gain from birth to age 18 months is significantly associated with later childhood overweight and obesity, excess central adiposity, and greater arterial wall thickness.
我们假设,儿童早期体重增加与日后肥胖、血压升高、全身炎症和动脉壁增厚有关。
1997 年 9 月至 1999 年 12 月,我们在澳大利亚悉尼的 2 家妇产医院,从产前招募了一个纵向出生队列。395 名非糖尿病儿童在 8 岁时完成了早期体重增加和动脉壁厚度的完整数据采集。
(调整身高增长后),男性(0.411kg[SE:0.103],P<.001)、胎龄较少(每减少一周-0.121kg[SE:0.044],P=.006)、出生身长较长(每增加 1cm 体重增加 0.156kg[SE:0.024],P<.001)和 6 月龄时未能母乳喂养的儿童,更容易出现早期体重过度增加。早期身高调整体重增加与儿童后期超重(比值比[OR]:每增加 1kg 为 1.67[95%置信区间(CI):1.26 至 2.20])和肥胖(OR:每增加 1kg 为 2.07[95%CI:1.53 至 2.79])、中心性肥胖(OR:每增加 1kg 为 1.54[95%CI:1.20 至 1.98])、收缩压升高(1.24mmHg[SE:0.33]每增加 1kg,P<.001)、C 反应蛋白升高(体重增加 100%时每增加 0.17mg/dL[SE:0.06],P=.006)和颈动脉内膜中层厚度增加(0.012mm[SE:0.004]每增加 1kg,P=.002)显著相关。
出生后 18 个月内的新生儿体重增加与儿童后期超重和肥胖、中心性肥胖、动脉壁增厚有关。