Scheurer Johannah M, Zhang Lei, Gray Heather L, Weir Katherine, Demerath Ellen W, Ramel Sara E
*Division of Neonatology, Department of Pediatrics †Biostatistical Design and Analysis Center ‡Medical School §Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
J Pediatr Gastroenterol Nutr. 2017 Jun;64(6):e147-e153. doi: 10.1097/MPG.0000000000001494.
The aim of the study was to longitudinally characterize infancy to preschool body composition trajectories and the association of early fat and fat-free mass gains with preschool age body composition in children born premature versus full-term.
A cohort of appropriate-for-gestational age preterm (n = 20) and term (n = 51) infants were followed at 3 visits: "neonatal" visit 1 at 2 weeks of age for term and near term corrected age for preterm; "infancy" visit 2 at 3 to 4 months (preterm corrected age); "preschool" visit 3 at 4 years. Body composition via air displacement plethysmography and anthropometrics were measured at all visits. Tracking of infancy weight and body composition with preschool measurements was tested using Pearson partial correlation coefficients. Associations between serial body composition measurements were assessed using multiple linear regression.
Early differences in body composition between premature (mean gestational age 31.9 weeks, mean birth weight 1843 g) and full-term (mean gestational age 39.8 weeks) infants were not present at preschool age. Visit 1 body composition was not correlated with preschool measurements in the preterm infants. Visit 2 measurements were correlated with preschool measures. Fat-free mass accretion from visit 1 to visit 2 was positively associated with preschool lean mass (β = 0.038, P = 0.049) in preterm children, whereas fat accretion was not associated with preschool body composition.
Children born prematurely and full-term have similar body composition at preschool age. For preterms infancy fat-free mass gains, and not adiposity gains, are positively associated with preschool fat-free mass; this may be associated with lower risk of later obesity and adverse metabolic outcomes.
本研究旨在纵向描述从婴儿期到学龄前儿童的身体成分轨迹，以及早产与足月出生儿童早期脂肪和去脂体重增加与学龄前身体成分之间的关联。
选取一组适于胎龄的早产（n = 20）和足月（n = 51）婴儿，进行3次随访：足月婴儿在2周龄时进行“新生儿期”第1次随访，早产婴儿在接近足月校正年龄时进行；在3至4个月（早产校正年龄）时进行“婴儿期”第2次随访；在4岁时进行“学龄前”第3次随访。在所有随访中均通过空气置换体积描记法和人体测量学测量身体成分。使用Pearson偏相关系数检验婴儿期体重和身体成分与学龄前测量值之间的追踪情况。使用多元线性回归评估连续身体成分测量值之间的关联。
早产（平均胎龄31.9周，平均出生体重1843克）和足月（平均胎龄39.8周）婴儿在学龄前身体成分的早期差异不存在。早产婴儿第1次随访时的身体成分与学龄前测量值不相关。第2次随访测量值与学龄前测量值相关。早产儿童从第1次随访到第2次随访期间去脂体重增加与学龄前瘦体重呈正相关（β = 0.038，P = 0.049），而脂肪增加与学龄前身体成分无关。
早产和足月出生的儿童在学龄前身体成分相似。对于早产儿童，婴儿期去脂体重增加而非肥胖增加与学龄前去脂体重呈正相关；这可能与后期肥胖和不良代谢结局的风险较低有关。
