Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
Department of Community, Environment, and Policy, University of Arizona, Tucson, AZ, United States of America.
PLoS One. 2019 May 16;14(5):e0216959. doi: 10.1371/journal.pone.0216959. eCollection 2019.
BACKGROUND/OBJECTIVES: Antibiotic use in early life has been associated with weight gain in several populations. However, associations between chronic antibiotic use and weight among adults in the general population are unknown.
SUBJECTS/METHODS: The NIEHS Sister Study is a longitudinal cohort of sisters of women with breast cancer. We examined associations between chronic antibiotic use (≥ 3 months) during the fourth decade of life (30-39 years) and subsequent obesity at enrollment (mean age = 55) via logistic regression. We also examined associations between chronic antibiotic use in the 5 years and 12 months prior to enrollment and weight gain after enrollment in linear mixed models. Models were adjusted for race/ethnicity, education, urban/rural status, age, and smoking.
In adjusted analyses (n = 50,237), chronic penicillin use during the 4th decade of life was associated with obesity at enrollment (OR 2.00, 95% CI 1.40, 2.87), and use in the 5 years prior to enrollment was associated with increased BMI change after enrollment (β 1.00 95% CI 0.01, 2.00). Use of bactericidals (OR 1.71, 95% CI 1.29, 2.26) during the 4th decade of life was also associated with obesity at enrollment. Associations for penicillins and bactericidals were consistent across indications for use. Bacteriostatic use in the 5 years prior to enrollment was associated with a reduction in BMI after enrollment (β -0.52, 95% CI -1.04, 0.00), and tetracycline use during the 4th decade of life was associated with reduced odds of obesity at enrollment (OR 0.72, 95% CI 0.56, 0.92). However, these inverse associations were only present for those who reported taking antibiotics for skin purposes. Cephalosporins, macrolides, quinolones, and sulfonamides were not associated with BMI change over time.
Chronic use of antibiotics during adulthood may have long-lasting impacts on BMI. Associations may differ by antibiotic class, and confounding by indication may be important for some antibiotic classes.
背景/目的：在多个人群中，生命早期使用抗生素与体重增加有关。然而，一般人群中成年人慢性抗生素使用与体重之间的关联尚不清楚。
受试者/方法：NIEHS 姐妹研究是一项针对乳腺癌女性姐妹的纵向队列研究。我们通过逻辑回归检查了在第四十年（30-39 岁）期间慢性使用抗生素（≥3 个月）与随后在入组时肥胖（平均年龄=55 岁）之间的关联。我们还通过线性混合模型检查了在入组前 5 年和 12 个月内慢性使用抗生素与入组后体重增加之间的关联。模型调整了种族/民族、教育、城乡状况、年龄和吸烟状况。
在调整后的分析中（n=50237），生命第四十年期间慢性使用青霉素与入组时肥胖有关（OR 2.00，95%CI 1.40，2.87），在入组前 5 年使用与入组后 BMI 变化增加有关（β 1.00，95%CI 0.01，2.00）。生命第四十年期间使用杀菌抗生素（OR 1.71，95%CI 1.29，2.26）也与入组时肥胖有关。青霉素和杀菌抗生素的关联在使用指征上是一致的。在入组前 5 年使用抑菌抗生素与入组后 BMI 降低有关（β-0.52，95%CI-1.04，0.00），生命第四十年期间使用四环素与入组时肥胖的几率降低有关（OR 0.72，95%CI 0.56，0.92）。然而，这些负相关仅存在于那些报告因皮肤原因使用抗生素的人。头孢菌素类、大环内酯类、喹诺酮类和磺胺类药物与 BMI 随时间的变化无关。
成年期慢性使用抗生素可能对 BMI 有持久的影响。关联可能因抗生素类别而异，某些抗生素类别的指示性混杂可能很重要。
