Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Int J Obes (Lond). 2018 Mar;42(3):501-506. doi: 10.1038/ijo.2017.250. Epub 2017 Oct 9.
Studying the determinants and the long-term consequences of fetal adipose accretion requires accurate assessment of neonatal body composition. In large epidemiological studies, in-depth body composition measurement methods are usually not feasible for cost and logistical reasons, and there is a need to identify anthropometric measures that adequately reflect neonatal adiposity.
In a multiethnic Asian mother-offspring cohort in Singapore, anthropometric measures (weight, length, abdominal circumference, skinfold thicknesses) were measured using standardized protocols in newborn infants, and anthropometric indices (weight/length, weight/length (body mass index, BMI), weight/length (ponderal index, PI)) derived. Neonatal total adiposity was measured using air displacement plethysmography (ADP) and abdominal adiposity using magnetic resonance imaging (MRI). Correlations of the anthropometric measures with ADP- and MRI-based adiposity were assessed using Pearson's correlation coefficients (r), including in subsamples stratified by sex and ethnicity.
Study neonates (n=251) had a mean (s.d.) age of 10.2 (2.5) days. Correlations between ADP-based fat mass (ADP) and anthropometric measures were moderate (r range: 0.44-0.67), with the strongest being with weight/length, weight, BMI and sum of skinfolds (r=0.67, 0.66, 0.62, 0.62, respectively, all P<0.01). All anthropometric measures except skinfold thicknesses correlated more strongly with ADP-based fat-free mass than ADP, indicating that skinfold measures may have more discriminative power in terms of neonatal total body adiposity. For MRI-based measures, weight and weight/length consistently showed strong positive correlations (r⩾0.7) with abdominal adipose tissue compartments. These correlations were consistent in boys and girls, across different ethnic groups, and when conventional determinants of neonatal adiposity were adjusted for potential confounding. Abdominal circumference was not strongly associated with ADP or abdominal fat mass.
Simple anthropometric measures (weight and weight/length) correlated strongly with neonatal adiposity, with some evidence for greater discriminative power for skinfold measures. These simple measures could be of value in large epidemiological studies.
研究胎儿脂肪堆积的决定因素和长期后果需要准确评估新生儿的身体成分。在大型的流行病学研究中，由于成本和后勤原因，通常无法使用深入的身体成分测量方法，因此需要确定能够充分反映新生儿肥胖程度的人体测量指标。
在新加坡的一个多民族亚洲母婴队列中，使用标准化方案在新生儿中测量人体测量指标（体重、身长、腹围、皮褶厚度），并衍生出人体测量指数（体重/身长、体重/身长（体重指数，BMI）、体重/身长（比重指数，PI））。使用空气置换体积描记法（ADP）测量新生儿总脂肪量，使用磁共振成像（MRI）测量腹部脂肪量。使用 Pearson 相关系数（r）评估人体测量指标与 ADP 和 MRI 测量的肥胖程度之间的相关性，包括按性别和种族分层的亚组。
研究新生儿（n=251）的平均（标准差）年龄为 10.2（2.5）天。ADP 测量的脂肪量（ADP）与人体测量指标之间的相关性为中度（r 范围：0.44-0.67），最强的相关性是体重/身长、体重、BMI 和皮褶厚度总和（r=0.67、0.66、0.62、0.62，均 P<0.01）。所有人体测量指标（皮褶厚度除外）与 ADP 测量的脂肪量相比，与 ADP 测量的无脂肪量的相关性更强，表明皮褶测量可能在新生儿总身体肥胖方面具有更强的判别力。对于 MRI 测量的指标，体重和体重/身长与腹部脂肪组织成分始终显示出强烈的正相关性（r≥0.7）。这些相关性在男孩和女孩、不同种族以及在调整潜在混杂因素后，均在新生儿肥胖的常规决定因素中具有一致性。腹围与 ADP 或腹部脂肪量没有很强的相关性。
简单的人体测量指标（体重和体重/身长）与新生儿肥胖程度密切相关，皮褶测量的判别力可能更强。这些简单的指标在大型的流行病学研究中可能具有价值。
