Munthali Richard J, Kagura Juliana, Lombard Zané, Norris Shane A
1 Faculty of Science, School of Molecular and Cell Biology, University of the Witwatersrand , Johannesburg, South Africa .
2 Sydney Brenner Institute for Molecular Bioscience (SBIMB), University of the Witwatersrand , Johannesburg, South Africa .
Child Obes. 2017 Oct;13(5):384-391. doi: 10.1089/chi.2016.0310. Epub 2017 May 18.
There is growing evidence of variations in adiposity trajectories among individuals, but the influence of early life growth patterns on these trajectories is underresearched in low- and middle-income countries. Therefore, our aim was to examine the association between early life conditional weight gain and childhood adiposity trajectories.
We previously identified distinct adiposity trajectories (four for girls and three for boys) in black South African children (boys = 877; girls = 947). The association between the trajectories and early life growth patterns, and future obesity risk was assessed by multivariate linear and multinomial logistic and logistic regressions. Conditional weight gain independent of height was computed for infancy (0-2 years) and early childhood (2-4 years).
Conditional weight gain before 5 years of age was significantly associated with early onset of obesity or overweight (excess weight) BMI trajectories in both boys and girls. In girls, greater conditional weight gain in infancy was associated with increased relative risk of being in the early-onset obese to morbid obese trajectory, with relative risk ratios of 2.03 (95% confidence interval: 1.17-3.52) compared to belonging to a BMI trajectory in the normal range. Boys and girls in the early-onset obesity or overweight BMI trajectories were more likely to be overweight or obese in early adulthood.
Excessive weight gain in infancy and early childhood, independent of linear growth, predicts childhood and adolescent BMI trajectories toward obesity. These results underscore the importance of early life factors in the development of obesity and other NCDs in later life.
越来越多的证据表明个体间肥胖轨迹存在差异，但在低收入和中等收入国家，早期生长模式对这些轨迹的影响研究不足。因此，我们的目的是研究早期有条件体重增加与儿童肥胖轨迹之间的关联。
我们之前在南非黑人儿童（男孩 = 877 名；女孩 = 947 名）中确定了不同的肥胖轨迹（女孩有四种，男孩有三种）。通过多变量线性、多项逻辑和逻辑回归评估轨迹与早期生长模式以及未来肥胖风险之间的关联。计算了婴儿期（0 - 2岁）和幼儿期（2 - 4岁）独立于身高的有条件体重增加。
5岁前的有条件体重增加与男孩和女孩肥胖或超重（体重超标）BMI轨迹的早发显著相关。在女孩中，婴儿期更大的有条件体重增加与处于早发肥胖至病态肥胖轨迹的相对风险增加相关，与处于正常范围的BMI轨迹相比，相对风险比为2.03（95%置信区间：1.17 - 3.52）。处于早发肥胖或超重BMI轨迹的男孩和女孩在成年早期更有可能超重或肥胖。
婴儿期和幼儿期与线性生长无关的过度体重增加预示着儿童和青少年BMI轨迹走向肥胖。这些结果强调了早期生活因素在晚年肥胖和其他非传染性疾病发展中的重要性。
