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儿童早期促动脉粥样硬化血脂谱:与4岁时的体重状况及父母肥胖的关联

Proatherogenic Lipid Profile in Early Childhood: Association with Weight Status at 4 Years and Parental Obesity.

作者信息

Riaño-Galán Isolina, Fernández-Somoano Ana, Rodríguez-Dehli Cristina, Valvi Damaskini, Vrijheid Martine, Tardón Adonina

机构信息

Pediatric Service, Hospital San Agustin, Avilés, Asturias, Spain; Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain.

Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Madrid, Spain; Department of Medicine, Universidad de Oviedo, Oviedo, Asturias, Spain.

出版信息

J Pediatr. 2017 Aug;187:153-157.e2. doi: 10.1016/j.jpeds.2017.04.042. Epub 2017 May 18.

Abstract

OBJECTIVES

To determine lipid profiles in early childhood and evaluate their association with weight status at 4 years of age. Additionally, we evaluated whether the risk of overweight or having an altered lipid profile was associated with parental weight status.

STUDY DESIGN

Five hundred eighty two mothers and their 4-year-old children from 2 Spanish population-based cohorts were studied. Weight status in children at 4 years of age was classified as overweight or obese using the International Obesity Task Force criteria. Plasma total cholesterol, triglycerides, high-density lipoprotein cholesterol, and low-density lipoprotein cholesterol were determined in children and lipid ratios were calculated. A proatherogenic lipid profile was defined as having the 3 lipid ratios in the third tertile.

RESULTS

A total of 12.9% of children were overweight and 6.4% were obese. Weight status at 4 years of age was related to maternal prepregnancy body mass index, paternal body mass index, gestational diabetes, and birth weight, but not with other sociodemographic characteristics of the mother. We found no association with gestational age, sex of the child, or breastfeeding. The risk of overweight/obesity was increased 4.17-fold if mothers were overweight/obese (95% CI 1.76-9.88) and 5.1-fold (95% CI 2.50-10.40) if both parents were overweight/obese. There were 133 children (22.8%) with a proatherogenic lipid profile. The risk of a proatherogenic lipid profile was increased 2.44-fold (95% CI 1.54-3.86) if they were overweight/obese at 4 years of age and 2-fold if the father was overweight/obese (95% CI 1.22-3.35).

CONCLUSIONS

Four-year-old overweight/obese children have higher lipid risk profiles. Offspring of overweight/obese parents have an increased risk for obesity and a proatherogenic lipid profile.

摘要

目的

确定幼儿期的血脂谱,并评估其与4岁时体重状况的关联。此外,我们评估了超重风险或血脂谱改变是否与父母的体重状况相关。

研究设计

对来自西班牙两个基于人群的队列中的582名母亲及其4岁孩子进行了研究。根据国际肥胖特别工作组的标准,将4岁儿童的体重状况分为超重或肥胖。测定了儿童的血浆总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇,并计算了血脂比值。将促动脉粥样硬化血脂谱定义为血脂比值处于第三个三分位数。

结果

共有12.9%的儿童超重,6.4%的儿童肥胖。4岁时的体重状况与母亲孕前体重指数、父亲体重指数、妊娠期糖尿病和出生体重有关,但与母亲的其他社会人口学特征无关。我们发现其与胎龄、孩子性别或母乳喂养无关。如果母亲超重/肥胖,超重/肥胖的风险增加4.17倍(95%可信区间1.76 - 9.88);如果父母双方都超重/肥胖,风险增加5.1倍(95%可信区间2.50 - 10.40)。有133名儿童(22.8%)具有促动脉粥样硬化血脂谱。如果他们在4岁时超重/肥胖,促动脉粥样硬化血脂谱的风险增加2.44倍(95%可信区间1.54 - 3.86);如果父亲超重/肥胖,风险增加2倍(95%可信区间1.22 - 3.35)。

结论

4岁超重/肥胖儿童具有更高的血脂风险谱。超重/肥胖父母的后代肥胖风险和促动脉粥样硬化血脂谱的风险增加。

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