Murdoch Childrens Research Institute, Parkville, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia.
Arch Dis Child. 2017 Oct;102(10):915-922. doi: 10.1136/archdischild-2016-311568. Epub 2017 Feb 24.
To determine which of multiple early-life exposures predict onset or resolution of overweight/obesity during a 9-year period.
: longitudinal cohort from three harmonised community-based cohorts enriched for overweight and obesity. : child-gestational age; delivery; birth weight; breast feeding; solids introduction; baseline body mass index (BMI); waist circumference; diet; activity; global, physical and psychosocial health. Mother-baseline BMI; education; age; neighbourhood disadvantage; concern for child's weight. : change in BMI category. : adjusted logistic regression.
On average, the 363 children (57% retention) were 6 and 15 years old at baseline and follow-up. Children were classified as 'never' overweight/obese (38%), 'resolving' overweight/obese (15%), 'becoming' overweight/obese (8%) or 'always' overweight/obese (39%). Compared with 'never overweight/obese' children, odds of 'becoming overweight/obese' were greater with higher child (OR 2.33, 95% CI 1.02 to 5.29) and maternal BMI (OR 1.18, CI 1.07 to 1.31), and lower with higher maternal education (OR 0.09, CI 0.02 to 0.34). Compared with 'always overweight/obese' children, odds of 'resolving overweight/obese' were lower with higher maternal BMI (OR 0.87, CI 0.78 to 0.97), and higher with better child physical health (OR 1.06, CI 1.02 to 1.10) and higher maternal age (OR 1.11, CI 1.01 to 1.22) and education (OR 4.07, CI 1.02 to 16.19).
Readily available baseline information (child/maternal BMI, maternal age, education and child health) were the strongest predictors of both onset and resolution of overweight/obesity between the primary school and adolescent years. Perinatal, breastfeeding and lifestyle exposures were not strongly predictive. Results could stimulate development of algorithms identifying children most in need of targeted prevention or treatment.
确定多个生命早期暴露因素中哪些因素可预测超重/肥胖在 9 年内的发生或缓解。
本研究为一项纵向队列研究，来自三个基于社区的、超重和肥胖人群丰富的队列。 儿童胎龄；分娩；出生体重；母乳喂养；固体食物引入；基线体重指数（BMI）；腰围；饮食；活动；整体、身体和心理健康。母亲基线 BMI；教育；年龄；社区劣势；对孩子体重的关注。 BMI 分类的变化。 调整后的逻辑回归。
平均而言，363 名儿童（57%保留率）在基线和随访时分别为 6 岁和 15 岁。儿童被分为“从不超重/肥胖”（38%）、“正在缓解”超重/肥胖（15%）、“变为超重/肥胖”（8%）或“一直超重/肥胖”（39%）。与“从不超重/肥胖”的儿童相比，儿童（比值比 2.33，95%置信区间 1.02 至 5.29）和母亲 BMI（比值比 1.18，95%置信区间 1.07 至 1.31）较高者发生“变为超重/肥胖”的几率更高，而母亲教育程度较高者（比值比 0.09，95%置信区间 0.02 至 0.34）的几率较低。与“一直超重/肥胖”的儿童相比，母亲 BMI 较高（比值比 0.87，95%置信区间 0.78 至 0.97）者“缓解超重/肥胖”的几率较低，而儿童身体状况较好（比值比 1.06，95%置信区间 1.02 至 1.10）和母亲年龄较大（比值比 1.11，95%置信区间 1.01 至 1.22）和教育程度较高（比值比 4.07，95%置信区间 1.02 至 16.19）者“缓解超重/肥胖”的几率较高。
在小学和青少年时期，基线时（儿童/母亲 BMI、母亲年龄、教育程度和儿童健康）即可获得的信息是超重/肥胖发生和缓解的最强预测因素。围产期、母乳喂养和生活方式的暴露因素预测能力并不强。结果可能会激发制定算法的灵感，以确定最需要有针对性预防或治疗的儿童。
