成年中后期出生体重与肥胖指标的性别特异性关联：巴西成人健康纵向研究（ELSA-Brasil）
Sex-specific associations of birth weight with measures of adiposity in mid-to-late adulthood: the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
作者信息
Rockenbach G, Luft V C, Mueller N T, Duncan B B, Stein M C, Vigo Á, Matos S M A, Fonseca M J M, Barreto S M, Benseñor I M, Appel L J, Schmidt M I
机构信息
Postgraduate Program in Epidemiology, School of Medicine, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
出版信息
Int J Obes (Lond). 2016 Aug;40(8):1286-91. doi: 10.1038/ijo.2016.76. Epub 2016 Apr 28.
BACKGROUND/OBJECTIVES: To investigate sex-specific associations of birth weight with body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) in mid-to-late adulthood.
SUBJECTS/METHODS: ELSA-Brasil is a multicenter cohort study of adults aged 35-74 years affiliated with universities or research institutions of six capital cities in Brazil. After exclusions, we investigated 11 636 participants. Socio-demographic factors and birth weight were obtained by interview. All anthropometry was directly measured at baseline. We categorized birth weight as low (⩽2.5 kg); normal (2.5-4 kg) and high (⩾4 kg). We performed analysis of covariance (ANCOVA) for continuous outcomes and ordinal logistic regression for categorical adiposity outcomes. We examined interaction on the multiplicative scale by sex and by race.
RESULTS
High birth weight uniformly predicted greater overall and central obesity in men and women. However, low (vs normal) birth weight, in ANCOVA models adjusted for participant age, family income, race, education, maternal education, and maternal and paternal history of diabetes, was associated with lower BMI, WC and WHR means for men, but not for women (Pinteraction=0.01, <0.0001 and <0.0001, respectively). In similarly adjusted ordinal logistic regression models, odds of obesity (odds ratio (OR)=0.65, 0.46-0.90) and of being in the high (vs low) tertile of WC (OR=0.66, 0.50-0.87) and of WHR (OR=0.79, 0.60-1.03) were lower for low (vs normal) birth weight men, but trended higher (BMI: OR=1.18, 0.92-1.51; WC: OR=1.21, 0.97-1.53; WHR: OR=1.44, 1.15-1.82) for low (vs normal) birth weight women.
CONCLUSIONS
In this Brazilian sample of middle-aged and elderly adults who have lived through a rapid nutritional transition, low birth weight was associated with adult adiposity in a sex-specific manner. In men, low birth weight was associated with lower overall and central adult adiposity, while in women low birth weight was generally associated with greater central adiposity.
背景/目的：调查成年中后期出生体重与体重指数（BMI）、腰围（WC）和腰臀比（WHR）的性别特异性关联。
对象/方法：ELSA-巴西研究是一项针对巴西六个首府城市的大学或研究机构中35-74岁成年人的多中心队列研究。排除相关因素后，我们对11636名参与者进行了调查。通过访谈获取社会人口学因素和出生体重信息。所有人体测量指标均在基线时直接测量。我们将出生体重分为低体重（≤2.5千克）、正常体重（2.5-4千克）和高体重（≥4千克）。我们对连续性结果进行协方差分析（ANCOVA），对分类肥胖结果进行有序逻辑回归分析。我们按性别和种族在乘法尺度上检验交互作用。
结果
高出生体重一致预示着男性和女性总体肥胖和中心性肥胖程度更高。然而，在针对参与者年龄、家庭收入、种族、教育程度、母亲教育程度以及母亲和父亲糖尿病病史进行调整的ANCOVA模型中，低出生体重（与正常出生体重相比）与男性较低的BMI、WC和WHR均值相关，但与女性无关（交互作用P值分别为0.01、<0.0001和<0.0001）。在类似调整的有序逻辑回归模型中，低出生体重男性肥胖的几率（优势比（OR）=0.65，0.46-0.90）以及WC（OR=0.66，0.50-0.87）和WHR处于高（与低）三分位数的几率（OR=0.79，0.60-1.03）较低，而低出生体重女性的这些几率则呈上升趋势（BMI：OR=1.18，0.92-1.51；WC：OR=1.21，0.97-1.53；WHR：OR=1.44，1.15-1.82）。
结论
在这个经历了快速营养转型的巴西中老年样本中，低出生体重与成年肥胖存在性别特异性关联。在男性中，低出生体重与较低的总体和中心性成年肥胖相关，而在女性中，低出生体重通常与较高的中心性肥胖相关。
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