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婴儿期体重增加、父母社会经济地位与儿童超重和肥胖:一项丹麦基于登记的队列研究。

Infancy weight gain, parental socioeconomic position, and childhood overweight and obesity: a Danish register-based cohort study.

机构信息

Public Health and Epidemiology Group, Department of Health Science and Technology, Aalborg University, Niels Jernes Vej 14, 9220, Aalborg East, Denmark.

DECIPHer, Cardiff School of Social Sciences, Cardiff University, 1-3 Museum Place, Cardiff, CF10 3BD, Wales, UK.

出版信息

BMC Public Health. 2019 Sep 2;19(1):1209. doi: 10.1186/s12889-019-7537-z.

Abstract

BACKGROUND

Rapid infant weight gain (RIWG) is a very strong predictor of childhood overweight and obesity (COO). Socioeconomic position (SEP) is also related to the risk of COO and parents of different SEP may differ in their reaction to accelerated infant weight gain. Together this could lead to differences in how weight gain and COO risk relate across SEP. This study aimed to analyse possible interaction of SEP and RIWG on COO risk.

METHODS

A register-based longitudinal cohort study followed 19,894 healthy, term infants, born in Denmark between December 2011 and May 2015. Logistic regression models were used to estimate odds ratios (OR) of COO risk at 2 years (22-26 months) of age with 95% confidence intervals (95% CI) for categories of infancy weight gain based on changes in weight-for-age z-scores between 0 and 8-10 months of age (slow (<- 0.67), mean (- 0.67-0.67), rapid (> 0.67-1.34) and very rapid (> 1.34)). Possible multiplicative and additive interaction of SEP (based on household income and maternal education) on the relationship between infancy weight gain and COO were analysed.

RESULTS

In total, 19.1 and 15.1% experienced rapid or very rapid weight gain, respectively, and 1497 (7.5%) children were classified with COO at follow-up. These prevalences were higher in those with lower levels of SEP. Adjusted OR for COO were 3.09 (95% CI [2.66-3.59]) and 7.58 (95% CI [6.51-8.83]) for rapid and very rapid weight gain, respectively, when household income was included in the model. Results were similar in the model including maternal education. No signs of interactions were detected on a multiplicative scale. Weak signs of additive interaction were present, but these values did not reach significance.

CONCLUSION

Both rapid and very rapid weight gain were associated with substantially higher risks of COO but these associations were not modified by SEP. This indicates that promotion of healthy weight gain should take place in all population groups irrespective of their SEP.

摘要

背景

快速婴儿体重增加(RIWG)是儿童超重和肥胖(COO)的一个非常强的预测指标。社会经济地位(SEP)也与 COO 的风险有关,不同 SEP 的父母对婴儿体重加速增加的反应可能不同。这可能导致 SEP 之间体重增加和 COO 风险的关系存在差异。本研究旨在分析 SEP 和 RIWG 对 COO 风险的可能相互作用。

方法

一项基于登记的纵向队列研究,对 19894 名健康、足月婴儿进行了随访,这些婴儿于 2011 年 12 月至 2015 年 5 月在丹麦出生。使用逻辑回归模型估计了 2 岁(22-26 个月)时 COO 风险的比值比(OR),95%置信区间(95%CI)为基于 0 至 8-10 个月龄体重-年龄 z 分数变化的婴儿体重增加类别(缓慢(<-0.67)、平均(-0.67-0.67)、快速(>0.67-1.34)和非常快速(>1.34))。分析了 SEP(基于家庭收入和母亲教育)与婴儿体重增加和 COO 之间关系的可能乘法和加法相互作用。

结果

共有 19.1%和 15.1%的婴儿分别经历了快速或非常快速的体重增加,1917 名(7.5%)儿童在随访时被归类为 COO。这些患病率在 SEP 水平较低的人群中更高。当将家庭收入纳入模型时,快速和非常快速体重增加的 COO 调整比值比(OR)分别为 3.09(95%CI[2.66-3.59])和 7.58(95%CI[6.51-8.83])。在包括母亲教育的模型中,结果相似。在乘法尺度上没有检测到相互作用的迹象。存在微弱的加法相互作用迹象,但这些值没有达到显著性。

结论

快速和非常快速的体重增加都与 COO 的风险显著增加相关,但这些关联不受 SEP 的影响。这表明,无论其 SEP 如何,都应在所有人群中促进健康的体重增加。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e06/6720844/464b765d777e/12889_2019_7537_Fig1_HTML.jpg

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