Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia;
Centre for Research in Mathematics, School of Computing, Engineering and Mathematics, Western Sydney University, Sydney, New South Wales, Australia.
Pediatrics. 2018 Jan;141(1). doi: 10.1542/peds.2017-2003. Epub 2017 Dec 19.
Youth with high BMI who become nonobese adults have the same cardiovascular risk factor burden as those who were never obese. However, the early-life BMI trajectories for overweight or obese youth who avoid becoming obese adults have not been described. We aimed to determine and compare the young-childhood BMI trajectories of participants according to their BMI status in youth and adulthood.
Bayesian hierarchical piecewise regression modeling was used to analyze the BMI trajectories of 2717 young adults who had up to 8 measures of BMI from childhood (ages 3-18 years) to adulthood (ages 34-49 years).
Compared with those with persistently high BMI, those who resolved their high youth BMI by adulthood had lower average BMI at age 6 years and slower rates of BMI change from young childhood. In addition, their BMI levels started to plateau at 16 years old for females and 21 years old for males, whereas the BMI of those whose high BMI persisted did not stabilize until 25 years old for male subjects and 27 years for female subjects. Compared with those youth who were not overweight or obese and who remained nonobese in adulthood, those who developed obesity had a higher BMI rate of change from 6 years old, and their BMI continued to increase linearly until age 30 years.
Efforts to alter BMI trajectories for adult obesity should ideally commence before age 6 years. The natural resolution of high BMI starts in adolescence for males and early adulthood for females, suggesting a critical window for secondary prevention.
青少年时期 BMI 较高但成年后不肥胖的人群与从不肥胖的人群具有相同的心血管危险因素负担。然而，超重或肥胖的青少年在成年后避免肥胖的早期 BMI 轨迹尚未得到描述。我们旨在确定并比较参与者的儿童期和成年期 BMI 轨迹，根据他们在青少年和成年期的 BMI 状态。
使用贝叶斯分层分段回归模型分析了 2717 名年轻成年人的 BMI 轨迹，这些成年人一生中最多有 8 次 BMI 测量值，从儿童期（3-18 岁）到成年期（34-49 岁）。
与持续高 BMI 的人相比，那些成年后 BMI 恢复正常的人在 6 岁时的平均 BMI 较低，并且从小儿期开始 BMI 变化的速度较慢。此外，女性的 BMI 水平在 16 岁左右开始趋于平稳，而男性的 BMI 在 21 岁左右开始趋于平稳，而那些 BMI 持续较高的人的 BMI 直到 25 岁的男性和 27 岁的女性才稳定下来。与那些在青少年时期不超重或肥胖且成年后保持非肥胖的人相比，那些发展为肥胖的人从 6 岁开始 BMI 变化率更高，并且他们的 BMI 一直线性增加，直到 30 岁。
改变成年肥胖 BMI 轨迹的努力最好在 6 岁之前开始。男性的高 BMI 自然缓解始于青春期，而女性则始于成年早期，这表明二级预防的关键窗口期。
