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儿童时期体重指数的增长轨迹:相关因素与成年后的健康结果。

Growth Trajectories of Body Mass Index during Childhood: Associated Factors and Health Outcome at Adulthood.

机构信息

Paris 13 University, Nutritional Epidemiology Research Team (EREN), Center of Research in Epidemiology and Statistics Sorbonne Paris Cité (CRESS), Inserm (U1153), Inra (U1125), Cnam, COMUE Sorbonne Paris Cité, Bobigny, France.

Inter-Regional Institute for Health (IRSA), La Riche, France.

出版信息

J Pediatr. 2017 Jul;186:64-71.e1. doi: 10.1016/j.jpeds.2017.02.010. Epub 2017 Mar 7.

Abstract

OBJECTIVE

To identify body mass index (BMI) trajectories from birth to age 10 years and to assess their association with child and parental characteristics and with adult nutritional status and metabolic risk factors.

STUDY DESIGN

Retrospective cohort study with 1188 subjects aged 20-60 years. Childhood growth was assessed using measured weight and height data collected retrospectively from health booklets, which also provided information on gestational age, birth weight, and early nutrition. Height, weight, waist circumference, fasting blood glucose, lipids profile, and blood pressure were measured at adulthood. Participants self-reported parental silhouette based on a 9-figural scale. Group-based modeling was applied to identify BMI trajectories. Associations were assessed using ANOVA and multiple logistic regression.

RESULTS

Five growth trajectories following or crossing BMI percentiles emerged: stable-25th (15.3% of the sample), stable-50th (35.9%), stable-75th (28.0%), ascending-75th (19.2%), and ascending-obesity (1.6%). Overall, associated factors from early life were mother's corpulence (higher in the ascending-obesity group), gestational age (higher in the stable-50th, stable-75th, and in the ascending-obesity groups), and birth weight (higher in the ascending-obesity group) (all P < .05). Childhood trajectories were associated with adult BMI and waist circumference (higher in the stable-75th and in the ascending groups) (all P < .0001).

CONCLUSIONS

This study shows heterogeneity in patterns of growth trajectories. Specific trajectories were associated with greater BMI and waist circumference during adulthood. Monitoring growth trajectories may improve chronic disease prevention.

摘要

目的

确定从出生到 10 岁的体重指数(BMI)轨迹,并评估其与儿童和父母特征以及成人营养状况和代谢危险因素的关系。

研究设计

这是一项回顾性队列研究,共纳入 1188 名年龄在 20-60 岁的受试者。使用从健康手册中回顾性收集的体重和身高数据评估儿童期的生长情况,这些手册还提供了胎龄、出生体重和早期营养信息。在成年时测量身高、体重、腰围、空腹血糖、血脂谱和血压。参与者根据 9 个数字刻度自我报告父母体型。采用基于分组的建模方法识别 BMI 轨迹。使用方差分析和多因素逻辑回归评估关联。

结果

出现了 5 种符合或超过 BMI 百分位的生长轨迹:稳定-25 百分位(占样本的 15.3%)、稳定-50 百分位(35.9%)、稳定-75 百分位(28.0%)、上升-75 百分位(19.2%)和上升-肥胖(1.6%)。总体而言,早期生活中的相关因素包括母亲肥胖(上升-肥胖组更高)、胎龄(稳定-50 百分位、稳定-75 百分位和上升-肥胖组更高)和出生体重(上升-肥胖组更高)(均 P<.05)。儿童时期的轨迹与成年后的 BMI 和腰围有关(稳定-75 百分位和上升组更高)(均 P<.0001)。

结论

本研究显示生长轨迹存在异质性。特定轨迹与成年后更高的 BMI 和腰围有关。监测生长轨迹可能有助于预防慢性疾病。

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