Berents Teresa Løvold, Carlsen Karin Cecilie Lødrup, Mowinckel Petter, Skjerven Håvard Ove, Rolfsjord Leif Bjarte, Nordhagen Live Solveig, Kvenshagen Bente, Hunderi Jon Olav Gjengstø, Bradley Maria, Thorsby Per Medbøe, Carlsen Kai-Håkon, Gjersvik Petter
Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
Department of Dermatology, Oslo University Hospital, Oslo, Norway.
BMC Pediatr. 2017 Jun 7;17(1):141. doi: 10.1186/s12887-017-0889-6.
Overweight and atopic dermatitis (AD) are major health problems in most industrialised countries, but the relationship between overweight and AD in infants and young children is unclear. We investigated if weight-for-length at birth, in infancy and at two years, as well as early weight-gain velocity, are associated with the development of AD in early life.
Cohort study of infants (n = 642), all living in south-east Norway, hospitalized with acute bronchiolitis (n = 404) or recruited from the general population (n = 238), examined at mean age 5.1 months (enrolment) and at a two-year follow-up visit (n = 499; 78%) at mean age 24.6 months. Exposures were weight-for-length (g/cm) at birth, enrolment and two-year follow-up, and early weight-gain velocity (gram/month from birth to enrolment). Excessive weight-for-length was defined as weight-for-length >95 percentile of WHO child-growth standards. Data on weight-for-length at the three time points were obtained for 435, 428 and 473 children. AD was diagnosed according to the Hanifin & Rajka criteria or from a history of physician-diagnosed AD. We performed multivariate analyses with weight-for-length at birth, at enrolment and at the two-year follow-up visit and with early weight gain velocity for the endpoint AD at each visit.
In adjusted analyses, excessive weight-for-length at enrolment was associated with concurrent AD (OR 3.03; 95% CI 1.23-7.50) and with AD at two years (OR 2.40; 1.11-5.17). In infants without AD, weight-for-length at enrolment increased the risk of AD at two years, with OR being 1.02 (95% CI 1.00-1.04) per increased gram/cm. AD at two years was not associated with concurrent excessive weight-for-length, nor was AD at any time associated with weight-for-length at birth or with early weight-gain velocity.
The results suggest that overweight in infancy may contribute to the development of AD in early life, highlighting the need for child health-care professionals to address potential overweight and atopic disease when advising infants' caregivers.
ClinicalTrials.gov number, NCT00817466 , EudraCT number, 2009-012667-34.
超重和特应性皮炎（AD）是大多数工业化国家的主要健康问题，但婴幼儿超重与AD之间的关系尚不清楚。我们调查了出生时、婴儿期和两岁时的身长体重比以及早期体重增长速度是否与生命早期AD的发生有关。
对所有居住在挪威东南部的婴儿（n = 642）进行队列研究，其中因急性细支气管炎住院的婴儿（n = 404）或从普通人群中招募的婴儿（n = 238），在平均年龄5.1个月（入组时）和平均年龄244.6个月的两年随访时进行检查（n = 499；78%）。暴露因素为出生时、入组时和两年随访时的身长体重比（g/cm）以及早期体重增长速度（从出生到入组的克/月）。身长体重比过高定义为身长体重比>世界卫生组织儿童生长标准的第95百分位数。在435、428和473名儿童中获得了三个时间点的身长体重比数据。AD根据Hanifin & Rajka标准或医生诊断的AD病史进行诊断。我们对出生时、入组时和两年随访时的身长体重比以及每次随访时AD终点的早期体重增长速度进行了多变量分析。
在调整分析中，入组时身长体重比过高与同期AD（比值比3.03；95%置信区间1.23 - 7.50）以及两年时的AD（比值比2.40；1.11 - 5.17）相关。在无AD的婴儿中，入组时的身长体重比增加了两年时患AD的风险，每增加克/厘米，比值比为1.02（95%置信区间1.00 - 1.04）。两年时的AD与同期身长体重比过高无关，在任何时候AD都与出生时的身长体重比或早期体重增长速度无关。
结果表明，婴儿期超重可能有助于生命早期AD的发展，这突出了儿童保健专业人员在为婴儿护理人员提供建议时应对潜在超重和特应性疾病的必要性。
ClinicalTrials.gov编号，NCT00817466，EudraCT编号，2009 - 012667 - 34。
