Liang Yajun, Hou Dongqing, Zhao Xiaoyuan, Wang Liang, Hu Yuehua, Liu Junting, Cheng Hong, Yang Ping, Shan Xinying, Yan Yinkun, Cruickshank J Kennedy, Mi Jie
Department of Epidemiology, Capital Institute of Pediatrics, Beijing, China.
Endocrine. 2015 Sep;50(1):87-92. doi: 10.1007/s12020-015-0560-7. Epub 2015 Mar 10.
We seek to observe the association between childhood obesity by different measures and adult obesity, metabolic syndrome (MetS), and diabetes. Thousand two hundred and nine subjects from "Beijing Blood Pressure Cohort Study" were followed 22.9 ± 0.5 years in average from childhood to adulthood. We defined childhood obesity using body mass index (BMI) or left subscapular skinfold (LSSF), and adult obesity as BMI ≥ 28 kg/m(2). MetS was defined according to the joint statement of International Diabetes Federation and American Heart Association with modified waist circumference (≥ 90/85 cm for men/women). Diabetes was defined as fasting plasma glucose ≥ 7.0 mmol/L or blood glucose 2 h after oral glucose tolerance test ≥ 11.1 mmol/L or currently using blood glucose-lowering agents. Multiple linear and logistic regression models were used to assess the association. The incidence of adult obesity was 13.4, 60.0, 48.3, and 65.1 % for children without obesity, having obesity by BMI only, by LSSF only, and by both, respectively. Compared to children without obesity, children obese by LSSF only or by both had higher risk of diabetes. After controlling for adult obesity, childhood obesity predicted independently long-term risks of diabetes (odds ratio 2.8, 95 % confidence interval 1.2-6.3) or abdominal obesity (2.7, 1.6-4.7) other than MetS as a whole (1.2, 0.6-2.4). Childhood obesity predicts long-term risk of adult diabetes, and the effect is independent of adult obesity. LSSF is better than BMI in predicting adult diabetes.
我们旨在观察通过不同测量方法得出的儿童肥胖与成人肥胖、代谢综合征（MetS）及糖尿病之间的关联。来自“北京血压队列研究”的1209名受试者从儿童期到成年期平均随访了22.9±0.5年。我们使用体重指数（BMI）或左肩胛下皮褶厚度（LSSF）来定义儿童肥胖，将成人肥胖定义为BMI≥28 kg/m²。MetS根据国际糖尿病联盟和美国心脏协会的联合声明，采用改良腰围（男性/女性≥90/85 cm）来定义。糖尿病定义为空腹血糖≥7.0 mmol/L或口服葡萄糖耐量试验后2小时血糖≥11.1 mmol/L或目前正在使用降糖药物。采用多元线性和逻辑回归模型来评估这种关联。对于无肥胖、仅通过BMI肥胖、仅通过LSSF肥胖以及两者皆肥胖的儿童，成人肥胖的发生率分别为13.4%、60.0%、48.3%和65.1%。与无肥胖的儿童相比，仅通过LSSF肥胖或两者皆肥胖的儿童患糖尿病的风险更高。在控制成人肥胖因素后，儿童肥胖独立预测糖尿病的长期风险（比值比2.8，95%置信区间1.2 - 6.3）或腹部肥胖（2.7，1.6 - 4.7），而非整体的MetS（1.2，0.6 - 2.4）。儿童肥胖可预测成人糖尿病的长期风险，且该效应独立于成人肥胖。在预测成人糖尿病方面，LSSF比BMI更具优势。
