5岁儿童体重过轻、超重和肥胖的社会及身体决定因素：一项挪威地区队列研究。
Social and somatic determinants of underweight, overweight and obesity at 5 years of age: a Norwegian regional cohort study.
作者信息
Donkor Hilde Mjell, Grundt Jacob Holter, Júlíusson Pétur Benedikt, Eide Geir Egil, Hurum Jørgen, Bjerknes Robert, Markestad Trond
机构信息
Department of Paediatrics, Innlandet Hospital Trust, Lillehammer, Norway.
Department of Clinical Science, Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway.
出版信息
BMJ Open. 2017 Aug 18;7(8):e014548. doi: 10.1136/bmjopen-2016-014548.
OBJECTIVE
To identify associations between the weight groups underweight (UW), overweight (OW) and obesity (OB) at 5 years of age and exposures related to pregnancy, anthropometric measures at birth, sociodemographic factors, and family health, anthropometric measures and habits.
DESIGN
Regional cohort study.
SETTING
Oppland County, Norway.
METHODS
Pregnancy data were obtained from a prospective perinatal register for children born in the county, and weight and height were measured by midwives at birth and by public health nurses at 5 years. Other information was obtained from questionnaires completed by parents.
PARTICIPANTS
Of 1895 eligible children, current weight and height were obtained for all, weight and length at birth and information from parents for 1119 (59%) and pregnancy register data for 749 (40%) of the children. The significance of potential explanatory variables from descriptive statistics was tested in multinomial logistic regression analysis.
RESULTS
The prevalence of UW, OW and OB among participants was 7.8%, 10.6% and 3.5%, respectively. UW was associated with anthropometric measures at birth and those of parents, but not with sociodemographic or behavioural characteristics. OW and OB were associated with anthropometric measures of parents and siblings and with a variety of unfavourable social characteristics, lack of prolonged breast feeding, sedentary behaviour and dental caries, but not with current dietary habits. After adjustments, OW and OB were marginally related to birth parameters and diet and unrelated to physical activity, but significantly related to parental body mass index, low parental education and maternal smoking.
CONCLUSION
The strong associations between sociodemographic and behavioural factors and OW and OB, but not with UW, may suggest that environmental factors are major contributing causes of OW and particularly OB at 5 years. These results may be helpful in targeting preventive measures against OW and OB.
目的
确定5岁时体重过轻（UW）、超重（OW）和肥胖（OB）体重组与妊娠相关因素、出生时人体测量指标、社会人口统计学因素以及家庭健康、人体测量指标和习惯之间的关联。
设计
区域队列研究。
地点
挪威奥普兰郡。
方法
妊娠数据来自该县出生儿童的前瞻性围产期登记册，出生时由助产士测量体重和身高，5岁时由公共卫生护士测量。其他信息通过父母填写的问卷获得。
参与者
在1895名符合条件的儿童中，获取了所有儿童的当前体重和身高，1119名（59%）儿童的出生体重和身长以及父母提供的信息，749名（40%）儿童的妊娠登记数据。在多项逻辑回归分析中检验了描述性统计中潜在解释变量的显著性。
结果
参与者中UW、OW和OB的患病率分别为7.8%、10.6%和3.5%。UW与出生时的人体测量指标以及父母的指标有关，但与社会人口统计学或行为特征无关。OW和OB与父母和兄弟姐妹的人体测量指标以及各种不利的社会特征、缺乏延长母乳喂养、久坐行为和龋齿有关，但与当前饮食习惯无关。调整后，OW和OB与出生参数和饮食略有相关，与身体活动无关，但与父母体重指数、父母低教育程度和母亲吸烟显著相关。
结论
社会人口统计学和行为因素与OW和OB之间存在密切关联，但与UW无关，这可能表明环境因素是5岁时OW尤其是OB的主要促成原因。这些结果可能有助于针对OW和OB制定预防措施。
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