Kori Hiroka, Sei Masako, Nakahori Yutaka, Imoto Issei
Department of Human Genetics, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan.
Pediatr Int. 2013 Dec;55(6):761-6. doi: 10.1111/ped.12172. Epub 2013 Sep 20.
Effective timing of preventive intervention for adolescent obesity in non-obese school-aged children remains unclear. The aim of this study was to examine the impact of annual body mass index (BMI) gain on the development of adolescent obesity in 6-year-old non-obese Japanese children.
Longitudinal weight and height data were collected annually from 9723 children aged 6-14 years, and individual per-year BMI gains were calculated. The BMI ≥ the 95th percentile for each age and sex defined obesity. In 6-year-old non-obese children, logistic regression analyses were applied to correlate the annual BMI gain at each age with obesity at a final survey.
The 6-year-old non-obese children who became obese at a final survey showed larger annual BMI gains at any age compared with their peers with respect to baseline BMI. Increases in annual BMI gain, even in early school age, raised the risk of adolescent obesity. Categorical analysis also showed that children aged 6-7 years with higher annual BMI gains than 1-SD above the mean had a significant risk for adolescent obesity (OR: 4.39 [95%CI: 2.98-6.46] in boys and 3.83 [95%CI: 2.60-5.63] in girls, respectively).
A larger annual BMI gain at any school age is a risk for adolescent obesity in 6-year-old non-obese children with no critical period. This suggests the need for earlier and continuous school-based surveillance using annual BMI gain for preventive intervention of adolescent obesity development.
对于非肥胖学龄儿童，青少年肥胖预防干预的有效时机仍不明确。本研究旨在探讨每年体重指数（BMI）增长对6岁非肥胖日本儿童青少年肥胖发生发展的影响。
每年收集9723名6 - 14岁儿童的纵向体重和身高数据，并计算个体每年的BMI增长值。BMI≥各年龄和性别的第95百分位数定义为肥胖。对于6岁非肥胖儿童，应用逻辑回归分析将各年龄的年BMI增长值与最终调查时的肥胖情况相关联。
在最终调查中变为肥胖的6岁非肥胖儿童，与基线BMI水平相当的同龄人相比，在任何年龄的年BMI增长值都更大。即使在学龄早期，年BMI增长值的增加也会增加青少年肥胖的风险。分类分析还显示，6 - 7岁儿童年BMI增长值高于均值1个标准差以上者，青少年肥胖风险显著增加（男孩的比值比[OR]：4.39[95%置信区间（CI）：2.98 - 6.46]，女孩的OR：3.83[95%CI：2.60 - 5.63]）。
在任何学龄期，年BMI增长值较大都是6岁非肥胖儿童发生青少年肥胖的危险因素，且不存在关键时期。这表明需要通过每年监测BMI增长值，进行更早且持续的学校监测，以预防青少年肥胖的发生发展。
