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婴儿期体重增加或维持超重对幼儿代谢稳态指标的影响:智利儿童的一项纵向研究。

Impact of gaining or maintaining excessive weight in infancy on markers of metabolic homeostasis in young children: A longitudinal study in Chilean children.

作者信息

Vasquez Fabian, Corvalan Camila, Uauy Ricardo, Kain Juliana

机构信息

Institute of Nutrition and Food Technology (INTA), University of Chile, Santiago, Chile.

出版信息

Prev Med Rep. 2018 Oct 23;12:298-303. doi: 10.1016/j.pmedr.2018.10.004. eCollection 2018 Dec.

Abstract

Childhood obesity in Chile is one of the highest in the world. The objective of this study was to assess the impact of excessive weight gained or maintained over a 3-year period, on markers of metabolic homeostasis in young children. This is a longitudinal study which includes 243 children followed from 4 to 7 years. We assessed BMI, body fat percentage, waist circumference (WC), waist-hip ratio (WHR), waist-height (WH) and trunk fat as well as the following metabolic parameters: glucose, insulin, triglycerides, total cholesterol, LDL, HDL and metabolic risk score. Kruskal- Wallis was used to assess differences in metabolic markers by nutritional status and logistic regression to determine the effect of maintaining or gaining excess weight over the 3-year period, compared with children who maintained a normal weight. Children who were obese at both ages compared with those who were normal weight, had a significantly higher WC, serum concentrations of total fat, total cholesterol, triglycerides, LDL cholesterol and metabolic risk score ( < 0.05). Children who were overweight or obese at 4 and 7 years, had a greater risk of having a high WC (OR: 3.37;  = 0.03), total cholesterol (OR: 4.17;  < 0.003), triglycerides (OR: 1.96;  = 0.04); thus a higher metabolic risk score (OR: 3.21;  = 0.003). Excess weight maintained over time in early childhood, significantly increases the risk of having higher serum biomarkers of cardiovascular risk, which in turn determines the magnitude of cardiovascular and metabolic risks later in life.

摘要

智利儿童肥胖率位居世界前列。本研究旨在评估幼儿在3年期间体重过度增加或维持对代谢稳态指标的影响。这是一项纵向研究,包括243名4至7岁的儿童。我们评估了体重指数(BMI)、体脂百分比、腰围(WC)、腰臀比(WHR)、腰高比(WH)和躯干脂肪,以及以下代谢参数:血糖、胰岛素、甘油三酯、总胆固醇、低密度脂蛋白(LDL)、高密度脂蛋白(HDL)和代谢风险评分。采用Kruskal-Wallis检验评估不同营养状况下代谢指标的差异,并通过逻辑回归确定与体重正常的儿童相比,在3年期间体重维持或增加过多的影响。与体重正常的儿童相比,在两个年龄段均肥胖的儿童腰围、总脂肪血清浓度、总胆固醇、甘油三酯、低密度脂蛋白胆固醇和代谢风险评分显著更高(P<0.05)。在4岁和7岁时超重或肥胖的儿童,腰围较高(比值比:3.37;P=0.03)、总胆固醇较高(比值比:4.17;P<0.003)、甘油三酯较高(比值比:1.96;P=0.04)的风险更大;因此代谢风险评分更高(比值比:3.21;P=0.003)。幼儿期长期维持超重会显著增加心血管风险血清生物标志物升高的风险,进而决定日后心血管和代谢风险的程度。

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