Hughes Adrienne R, Sherriff Andrea, Ness Andrew R, Reilly John J
Physical Activity for Health, School of Psychological Sciences and Health, University of Strathclyde, Glasgow, United Kingdom;
College of Medical, Veterinary Life Sciences, University of Glasgow Dental School, Glasgow, United Kingdom;
Pediatrics. 2014 Nov;134(5):e1354-61. doi: 10.1542/peds.2014-1908. Epub 2014 Oct 13.
To investigate associations between timing of adiposity rebound (AR; the period in childhood where BMI begins to increase from its nadir) and adiposity (BMI, fat mass) at age 15 years in the Avon Longitudinal Study of Parents and Children (ALSPAC).
The sample consisted of 546 children with AR derived in childhood and BMI and fat mass index (FMI; fat mass measured by dual-energy radiograph absorptiometry/height in m(2)) measured at 15 years. Multivariable linear regression models were based on standardized residuals of log BMI and log FMI to allow comparison of regression coefficients across outcomes.
There were strong dose-response associations between timing of AR and both adiposity outcomes at 15 years independent of confounders. BMI was markedly higher in adolescence for those with very early AR (by 3.5 years; β = 0.70; 95% confidence interval [CI]: 0.33-1.07; P ≤ .001) and was also higher for those with early AR (between 3.5 and 5 years; β = 0.34; 95% CI: 0.08-0.59; P = .009) compared with those with later AR (>5 years) after full adjustment for a range of potential confounders. Similar magnitudes of association were found for FMI after full adjustment for confounders (compared with later AR: very early AR β = 0.74; 95% CI: 0.34-1.15; P ≤ .001; early AR β = 0.35; 95% CI: 0.07-0.63; P = .02).
Early AR is strongly associated with increased BMI and FMI in adolescence. Preventive interventions should consider targeting modifiable factors in early childhood to delay timing of AR.
在阿冯父母与儿童纵向研究（ALSPAC）中，调查肥胖反弹时间（AR，即儿童期BMI从最低点开始上升的时期）与15岁时肥胖程度（BMI、脂肪量）之间的关联。
样本包括546名在儿童期出现AR的儿童，以及在15岁时测量的BMI和脂肪量指数（FMI，通过双能X线吸收法测量的脂肪量/身高的平方米数）。多变量线性回归模型基于对数BMI和对数FMI的标准化残差，以便比较不同结局的回归系数。
AR时间与15岁时的肥胖结局之间存在强烈的剂量反应关联，且不受混杂因素影响。与AR较晚（>5岁）的儿童相比，在对一系列潜在混杂因素进行全面调整后，AR非常早（提前3.5年；β = 0.70；95%置信区间[CI]：0.33 - 1.07；P≤.001）和AR早（3.5至5年；β = 0.34；95%CI：0.08 - 0.59；P = 0.009）的儿童在青春期的BMI明显更高。在对混杂因素进行全面调整后，FMI也发现了类似程度的关联（与AR较晚相比：AR非常早β = 0.74；95%CI：0.34 - 1.15；P≤.001；AR早β = 0.35；95%CI：0.07 - 0.63；P = 0.02）。
早期AR与青春期BMI和FMI升高密切相关。预防性干预应考虑针对幼儿期可改变的因素，以延迟AR时间。
