Monjardino Teresa, Rodrigues Teresa, Inskip Hazel, Harvey Nicholas, Cooper Cyrus, Santos Ana Cristina, Lucas Raquel
Instituto de Saúde Pública, Universidade do Porto (Epidemiology Research Unit [EPIUnit], Institute of Public Health of the University of Porto), Porto, Portugal; Department of Public Health, Forensic Sciences and Medical Education, Faculdade de Medicina, Universidade do Porto (University of Porto Medical School), Porto, Portugal.
Instituto de Saúde Pública, Universidade do Porto (Epidemiology Research Unit [EPIUnit], Institute of Public Health of the University of Porto), Porto, Portugal; Department of Public Health, Forensic Sciences and Medical Education, Faculdade de Medicina, Universidade do Porto (University of Porto Medical School), Porto, Portugal; Department of Gynecology and Obstetrics, S. João Hospital Center, Porto, Portugal.
J Pediatr. 2017 Dec;191:117-124.e2. doi: 10.1016/j.jpeds.2017.08.033. Epub 2017 Oct 21.
To assess whether different trajectories of weight gain since birth influence bone mineral content (BMC) and areal bone mineral density (aBMD) at 7 years of age.
We studied a subsample of 1889 children from the Generation XXI birth cohort who underwent whole-body dual-energy radiograph absorptiometry. Weight trajectories identified through normal mixture modeling for model-based clustering and labeled "normal weight gain," "weight gain during infancy," "weight gain during childhood," and "persistent weight gain" were used. Differences in subtotal BMC, aBMD, and size-corrected BMC (scBMC) at age 7 years according to weight trajectories were estimated through analysis of covariance.
Compared with the "normal weight gain" trajectory, children in the remaining trajectories had significantly greater BMC, aBMD, and scBMC at age 7 years, with the strongest associations for "persistent weight gain" (girls [BMC: 674.0 vs 559.8 g, aBMD: 0.677 vs 0.588 g/cm, scBMC: 640.7 vs 577.4 g], boys [BMC: 689.4 vs 580.8 g, aBMD: 0.682 vs 0.611 g/cm, scBMC: 633.0 vs 595.6 g]). After adjustment for current weight, and alternatively for fat and lean mass, children with a "weight gain during childhood" trajectory had greater BMC and aBMD than those with a "normal weight gain" trajectory, although significant differences were restricted to girls (BMC: 601.4 vs 589.2 g, aBMD: 0.618 vs 0.609 g/cm).
Overall, children following a trajectory of persistent weight gain since birth had clearly increased bone mass at 7 years, but weight gain seemed slightly more beneficial when it occurred later rather than on a normal trajectory during the first 7 years of life.
评估自出生以来不同的体重增加轨迹是否会影响7岁时的骨矿物质含量(BMC)和骨面积密度(aBMD)。
我们对来自二十一世纪出生队列的1889名儿童的子样本进行了研究,这些儿童接受了全身双能X线吸收法检查。通过基于模型的聚类的正态混合模型确定体重轨迹,并标记为“正常体重增加”、“婴儿期体重增加”、“儿童期体重增加”和“持续体重增加”。通过协方差分析估计了7岁时根据体重轨迹的BMC、aBMD和大小校正后的BMC(scBMC)的差异。
与“正常体重增加”轨迹相比,其他轨迹的儿童在7岁时的BMC、aBMD和scBMC显著更高,与“持续体重增加”的关联最强(女孩[BMC:674.0对559.8克,aBMD:0.677对0.588克/厘米,scBMC:640.7对577.4克],男孩[BMC:689.4对580.8克,aBMD:0.682对0.611克/厘米,scBMC:633.0对595.6克])。在调整当前体重后,以及替代地调整脂肪和瘦体重后,“儿童期体重增加”轨迹的儿童比“正常体重增加”轨迹的儿童具有更高的BMC和aBMD,尽管显著差异仅限于女孩(BMC:601.4对589.2克,aBMD:0.618对0.609克/厘米)。
总体而言,自出生以来遵循持续体重增加轨迹的儿童在7岁时骨量明显增加,但体重增加在生命的前7年后期发生而非正常轨迹时似乎更有益。