Inova Translational Medicine Institute, Falls Church, VA.
Inova Translational Medicine Institute, Falls Church, VA.
J Pediatr. 2018 May;196:175-181.e7. doi: 10.1016/j.jpeds.2017.12.042. Epub 2018 Feb 9.
To examine genomic, social, and clinical risk factors of ≥85 weight for length percentile (WFLP) at 12 months.
Children in this study had whole-genome sequencing, and clinical and social data were collected. WFLPs at 12 months of age were grouped as follows: (1) <85th, (2) ≥85th to <95th, (3) ≥95th to <99th, and (4) ≥99th. Whole-genome sequencing data were used to analyze rare and common variants, and association of clinical and social factors was examined.
A total of 690 children were included; WFLPs were 422 (61.2%) <85th, 112 (16.2%) ≥85th-<95th, 89 (12.9%) ≥95th-<99th, and 67 (9.7%) ≥99th. Family-related risk factors associated with greater WFLP were greater paternal body mass index, WFLP ≥99th OR 1.10 (1.03-1.16), and greater than recommended weight gain in pregnancy, WFLP ≥85th-<95th OR 1.90 (1.09-3.26). More breast milk at 6 months was protective factor: WFLP ≥85th-<95th, OR 0.98 (0.97-0.99), WFLP ≥95th-<99th OR 0.98 (0.97-0.99), and WFLP ≥99th OR 0.98 (0.96-0.99). Although none of the variants reached genome-wide significance, there was a trend toward increased prevalence of genetic variants within or near genes previously associated with obesity in children with WFLP ≥99th.
This cross-sectional study identified several modifiable factors, including increased weight gain in pregnancy and decreased breast milk at 6 months, associated with greater WFLP at 12 months. Strong genetic factors were not identified.
探讨 12 个月时体重长度百分位数（WFLP）≥85 岁的基因组、社会和临床危险因素。
本研究中的儿童进行了全基因组测序，并收集了临床和社会数据。12 个月时的 WFLP 分为以下几组：（1）<85 岁，（2）≥85 至<95 岁，（3）≥95 至<99 岁，（4）≥99 岁。使用全基因组测序数据分析罕见和常见变异，并检查临床和社会因素的关联。
共纳入 690 名儿童；WFLP 为 422 名（61.2%）<85 岁，112 名（16.2%）≥85-<95 岁，89 名（12.9%）≥95-<99 岁，67 名（9.7%）≥99 岁。与较大 WFLP 相关的家庭相关危险因素是父亲的体重指数较大，WFLP≥99 岁的 OR 为 1.10（1.03-1.16），以及怀孕期间体重增加超过推荐值，WFLP≥85-<95 岁的 OR 为 1.90（1.09-3.26）。6 个月时更多的母乳是保护因素：WFLP≥85-<95 岁的 OR 为 0.98（0.97-0.99），WFLP≥95-<99 岁的 OR 为 0.98（0.97-0.99），WFLP≥99 岁的 OR 为 0.98（0.96-0.99）。尽管没有一个变异达到全基因组显著水平，但在 WFLP≥99 岁的儿童中，与肥胖相关的基因内或附近的遗传变异的患病率呈增加趋势。
本横断面研究确定了一些可改变的因素，包括怀孕期间体重增加和 6 个月时母乳减少，与 12 个月时更大的 WFLP 相关。没有发现强烈的遗传因素。
