Oyarzún María Fernanda, Barja Salesa, Domínguez María Angélica, Villarroel Luis, Arnaiz Pilar, Mardones Francisco
Pontificia Universidad Católica de Chile, Chile.
Departamento de Gastroenterología y Nutrición Pediátrica, División de Pediatría. Facultad de Medicina, Pontificia Universidad Católica de Chile, Chile.
Rev Chil Pediatr. 2018 Apr;89(2):173-181. doi: 10.4067/S0370-41062018000200173. Epub 2018 Apr 6.
Breastfeeding (BF) can be a protective factor against obesity and its associated metabolic complications.
To determine the association between breastfeeding history and present obesity, metabolic syndrome (MS) and insulin resistance (IR).
Cross-sectio nal study in 20 public schools in Santiago, Chile. Anthropometry and blood pressure were assessed. Blood lipids, glucose, insulin and HOMA index were measured in a fast blood sample. Parents answe red a survey on BF. MS was defined according to Cook's criteria and IR as HOMA > 90th percentile. Parents answered a survey about the antecedent of breastfeeding. Chi2 and Fischer tests were used (SSPS).
3,278 surveys were valid. Average age: 11.4 ± 1 years, 52.3% were female. Most of them (98.2%) were breasted, with a 15.9% prevalence of obesity versus 18.6% in the group that was not breastfed (p = 0.039). There was a non-significant trend of higher prevalence in MS and its components (except IR) in the non-breastfed group. The group breastfed from three to six months had a lower prevalence of obesity and MS components than the 0 to 3 months group ; the effect was the opposite when BF lsted longer than nine months.
The prevalence of obesity was higher in children that did not received breastfeeding. A longer breastfeeding time during the first semester of life was associated with lower prevalence of obesity and metabolic complications.
母乳喂养（BF）可能是预防肥胖及其相关代谢并发症的一个保护因素。
确定母乳喂养史与当前肥胖、代谢综合征（MS）和胰岛素抵抗（IR）之间的关联。
在智利圣地亚哥的20所公立学校进行横断面研究。评估人体测量学指标和血压。采集空腹血样测量血脂、血糖、胰岛素和HOMA指数。家长回答关于母乳喂养的调查问卷。MS根据库克标准定义，IR定义为HOMA>第90百分位数。家长回答关于母乳喂养情况的调查问卷。使用卡方检验和费舍尔检验（SPSS）。
3278份调查问卷有效。平均年龄：11.4±1岁，52.3%为女性。他们中的大多数（98.2%）曾接受母乳喂养，肥胖患病率为15.9%，而未接受母乳喂养组为18.6%（p=0.039）。未接受母乳喂养组中MS及其各组分（IR除外）的患病率有升高趋势，但无统计学意义。母乳喂养3至6个月的组肥胖和MS组分的患病率低于母乳喂养0至3个月的组；母乳喂养时间超过9个月时情况则相反。
未接受母乳喂养的儿童肥胖患病率更高。生命第一学期母乳喂养时间较长与肥胖和代谢并发症患病率较低相关。
