Lynch Brian A, Rutten Lila J Finney, Ebbert Jon O, Kumar Seema, Yawn Barbara P, Jacobson Debra, Sauver Jennifer St
1 Mayo Clinic, Rochester, MN, USA.
2 Olmsted Medical Center, Rochester, MN, USA.
J Prim Care Community Health. 2017 Oct;8(4):278-284. doi: 10.1177/2150131917704326. Epub 2017 Apr 22.
The prevalence of childhood obesity has increased over the past 3 decades. This study was designed to understand how childhood body mass index (BMI) influences later risk of obesity. We calculated BMIs for children residing in Olmsted County, Minnesota, between January 1, 2005 and December 31, 2012 using medical records data. We defined homogenous BMI trajectory clusters using a nonparametric hill-climbing algorithm. Overall, 16,538 (47%) children had >3 weight assessments at least 1 year apart and were included in the analyses. Within the 8-year follow-up period, children who were younger than 2 years and overweight had a 3- fold increase of obesity (adjusted hazard ratio [HR] = 3.24; 95% confidence interval [CI] = 2.69-3.89) and those aged 5 years and overweight had a 10-fold increased risk of obesity (adjusted HR = 9.97, 95% CI = 8.55-11.62). Three distinct BMI trajectories could be distinguished prior to 5 years of age. The risk of developing obesity in those who are overweight increased dramatically with increasing age. Interventions to prevent obesity need to occur prior to school age to prevent children from entering unhealthy BMI trajectories.
在过去30年里，儿童肥胖症的患病率有所上升。本研究旨在了解儿童体重指数（BMI）如何影响日后患肥胖症的风险。我们利用医疗记录数据，计算了2005年1月1日至2012年12月31日期间居住在明尼苏达州奥尔姆斯特德县的儿童的BMI。我们使用非参数爬山算法定义了同质的BMI轨迹集群。总体而言，16,538名（47%）儿童至少间隔1年进行了3次以上体重评估，并被纳入分析。在8年的随访期内，2岁以下且超重的儿童患肥胖症的风险增加了3倍（调整后的风险比[HR]=3.24；95%置信区间[CI]=2.69-3.89），5岁且超重的儿童患肥胖症的风险增加了10倍（调整后的HR=9.97，95%CI=8.55-11.62）。在5岁之前，可以区分出三种不同的BMI轨迹。超重儿童患肥胖症的风险随着年龄的增长而急剧增加。预防肥胖症的干预措施需要在学龄期之前进行，以防止儿童进入不健康的BMI轨迹。
