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在不断演变的肥胖流行趋势下,早期生活风险指标与青少年超重之间关联的稳定性。

Stability of the associations between early life risk indicators and adolescent overweight over the evolving obesity epidemic.

作者信息

Graversen Lise, Sørensen Thorkild I A, Petersen Liselotte, Sovio Ulla, Kaakinen Marika, Sandbæk Annelli, Laitinen Jaana, Taanila Anja, Pouta Anneli, Järvelin Marjo-Riitta, Obel Carsten

机构信息

Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus, Denmark.

Institute of Preventive Medicine, Bispebjerg and Frederiksberg University Hospital, The Capital Region, Copenhagen, Denmark; Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.

出版信息

PLoS One. 2014 Apr 18;9(4):e95314. doi: 10.1371/journal.pone.0095314. eCollection 2014.

Abstract

BACKGROUND

Pre- and perinatal factors and preschool body size may help identify children developing overweight, but these factors might have changed during the development of the obesity epidemic.

OBJECTIVE

We aimed to assess the associations between early life risk indicators and overweight at the age of 9 and 15 years at different stages of the obesity epidemic.

METHODS

We used two population-based Northern Finland Birth Cohorts including 4111 children born in 1966 (NFBC1966) and 5414 children born in 1985-1986 (NFBC1986). In both cohorts, we used the same a priori defined prenatal factors, maternal body mass index (BMI), birth weight, infant weight (age 5 months and 1 year), and preschool BMI (age 2-5 years). We used internal references in early childhood to define percentiles of body size (<50, 50-75, 75-90 and >90) and generalized linear models to study the association with overweight, according to the International Obesity Taskforce (IOTF) definitions, at the ages of 9 and 15 years.

RESULTS

The prevalence of overweight at the age of 15 was 9% for children born in 1966 and 16% for children born in 1986. However, medians of infant weight and preschool BMI changed little between the cohorts, and we found similar associations between maternal BMI, infant weight, preschool BMI, and later overweight in the two cohorts. At 5 years, children above the 90th percentile had approximately a 12 times higher risk of being overweight at the age of 15 years compared to children below the 50th percentile in both cohorts.

CONCLUSIONS

The associations between early body size and adolescent overweight showed remarkable stability, despite the increase in prevalence of overweight over the 20 years between the cohorts. Using consequently defined internal percentiles may be a valuable tool in clinical practice.

摘要

背景

围产期及出生前因素和学龄前儿童的体型可能有助于识别超重儿童,但在肥胖流行过程中这些因素可能已发生变化。

目的

我们旨在评估在肥胖流行的不同阶段,生命早期风险指标与9岁和15岁时超重之间的关联。

方法

我们使用了两个基于人群的芬兰北部出生队列,包括1966年出生的4111名儿童(NFBC1966)和1985 - 1986年出生的5414名儿童(NFBC1986)。在这两个队列中,我们使用相同的预先定义的产前因素、母亲体重指数(BMI)、出生体重、婴儿体重(5个月和1岁时)以及学龄前BMI(2 - 5岁时)。我们使用幼儿期的内部参考标准来定义体型百分位数(<50、50 - 75、75 - 90和>90),并使用广义线性模型,根据国际肥胖特别工作组(IOTF)的定义研究与9岁和15岁时超重的关联。

结果

对于1966年出生的儿童,15岁时超重患病率为9%,对于1986年出生的儿童为16%。然而,两个队列之间婴儿体重和学龄前BMI的中位数变化不大,并且我们在两个队列中发现母亲BMI、婴儿体重、学龄前BMI与后期超重之间的关联相似。在5岁时,两个队列中处于第90百分位数以上的儿童在15岁时超重的风险比处于第50百分位数以下的儿童大约高12倍。

结论

尽管两个队列相隔20年超重患病率有所增加,但早期体型与青少年超重之间的关联显示出显著的稳定性。因此,使用定义好的内部百分位数可能是临床实践中的一个有价值的工具。

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