Gittner Lisaann S, Ludington-Hoe Susan M, Haller Harold S
Frances Payne Bolton School of Nursing and Case Statistical Computing Center, Case Western Reserve University, Cleveland, Ohio, United States.
J Paediatr Child Health. 2013 Jul;49(7):564-74. doi: 10.1111/jpc.12283. Epub 2013 Jun 16.
This study determines if an early life growth pattern in healthy infants can predict obesity at age 5.
Randomly selected from all healthy children born from 1997 to 2001 in a Midwestern US Health Maintenance Organization; growth patterns from birth to 5 years were described for children who were categorised by obesity classification at 5 years into normal weight (n = 61), overweight (n = 47), obese (n = 41) and morbidly obese (n = 72) cohorts using World Health Organization body mass index (BMI) criteria. A retrospective longitudinal analysis based on weighted least squares was performed on BMI by age (1 week; 2, 4, 6, 9, 12, 15 and 18 months; and 2, 3, 4 and 5 years). Graphs of the longitudinal repeated measures analysis of variance of means allowed identification of the earliest significant divergence of a cohort's average BMI pattern from other cohorts' patterns.
Distinctions in growth patterns and BMIs were evident before 1-year post-birth. Children who were obese or morbidly obese at 5 years demonstrated a BMI pattern that differed from children who were normal weight at 5 years.
Identifying obesity development in early life may assist with prevention of later obesity. The results merit future study. An early life BMI growth pattern is clinically important because it permits discrimination of those who do and do not fit a normal weight pattern, guiding individualised interventions in the first year of life while precursors of later health are still forming.
本研究旨在确定健康婴儿的早期生长模式是否能够预测其5岁时的肥胖情况。
从美国中西部一家健康维护组织1997年至2001年出生的所有健康儿童中随机选取;根据世界卫生组织体重指数(BMI)标准,对5岁时被分类为正常体重(n = 61)、超重(n = 47)、肥胖(n = 41)和病态肥胖(n = 72)队列的儿童描述其从出生到5岁的生长模式。对按年龄(1周;2、4、6、9、12、15和18个月;以及2、3、4和5岁)划分的BMI进行基于加权最小二乘法的回顾性纵向分析。均值的纵向重复测量方差分析图有助于识别一个队列的平均BMI模式与其他队列模式最早出现的显著差异。
出生后1年内,生长模式和BMI的差异就很明显。5岁时肥胖或病态肥胖的儿童表现出与5岁时正常体重儿童不同的BMI模式。
识别早期生活中的肥胖发展情况可能有助于预防后期肥胖。这些结果值得未来进一步研究。早期生活中的BMI生长模式在临床上很重要,因为它能够区分符合和不符合正常体重模式的儿童,在生命的第一年,当后期健康的先兆仍在形成时,指导个性化干预。