Department of Human Development and Quantitative Methodology, University of Maryland, College Park, MD, USA.
Shool of Public Health, University of Maryland, College Park, MD, USA.
Pediatr Res. 2018 Dec;84(6):842-848. doi: 10.1038/s41390-018-0196-4. Epub 2018 Oct 1.
Reduced prenatal growth followed by rapid postnatal weight gain are risk factors for developing metabolic and cardiovascular disease. Children reared in institutions experience a similar pattern of growth restriction followed by catch-up growth after removal. We explored whether patterns of catch-up growth affect metabolic and cardiovascular outcomes in previously institutionalized adolescents.
A longitudinal study of institutionalized infants randomized to care as usual (n = 68) or foster care intervention (n = 68), and never institutionalized controls (n = 127). Body mass index (BMI) was measured at baseline (20 months), 30, 42 months, and ages 8, 12, 16. At age 16, metabolic and pro-inflammatory markers were derived from blood samples.
Four BMI trajectories were derived (i.e., average-stable, low-stable, elevated, and accelerated). The accelerated trajectory was comprised predominately of children randomized to foster care, who also exhibited higher levels of glycosylated hemoglobin and C-reactive protein than the other three trajectories. Also, children placed in foster care at younger ages were more likely to be on the accelerated rather than the average-stable trajectory.
Although catch-up growth is viewed as a positive improvement among post-institutionalized children, rapid/continuous increases in body size pose a health concern. Attention should be given to monitoring weight gain, diet, and physical activity.
产前生长受限，随后快速的产后体重增加，是发生代谢和心血管疾病的危险因素。在机构中长大的儿童经历了类似的生长受限模式，随后在离开机构后出现追赶性生长。我们探讨了追赶性生长模式是否会影响以前在机构中长大的青少年的代谢和心血管结局。
对随机接受常规护理（n=68）或寄养干预（n=68）的机构内婴儿进行的纵向研究，并纳入从未在机构中长大的对照组（n=127）。在基线（20 个月）、30 个月、42 个月和 8 岁、12 岁、16 岁时测量体重指数（BMI）。在 16 岁时，从血液样本中得出代谢和促炎标志物。
得出了 4 种 BMI 轨迹（即平均稳定、低稳定、升高和加速）。加速轨迹主要由接受寄养的儿童组成，他们的糖化血红蛋白和 C 反应蛋白水平也高于其他 3 种轨迹。此外，在较小年龄被安置在寄养家庭的儿童更有可能处于加速而不是平均稳定的轨迹。
尽管追赶性生长被视为机构中长大的儿童的积极改善，但身体大小的快速/持续增加是一个健康问题。应注意监测体重增加、饮食和身体活动。
