Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy.
Epidemiology Unit, Azienda Unità Sanitaria Locale - IRCCS di Reggio Emilia, Italy; Center for Environmental, Nutritional and Genetic Epidemiology (CREAGEN), Section of Public Health, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy.
Prev Med. 2020 May;134:106024. doi: 10.1016/j.ypmed.2020.106024. Epub 2020 Feb 13.
Childhood obesity is a major public health problem in industrialized countries. The aim of this study was to estimate the risk of obesity at age 5 based on BMI categories at age 3 and changes in BMI z-score from birth to 3 years of age. In this population-based study BMI data of 5173 children were collected at ages 3 and 5 and were linked to information relative to birth weight. The prevalence of obesity at age 5 was 3.8%. The risk of obesity for children born large for gestational age was 6.5%, while it was 18.6% for children overweight at age 3 and 62% for children who were obese at 3. An increase in BMI z-score from birth to 3 years increases the risk of obesity at age 5 (OR for increase of one standard deviation 2.8%; 95% CI: 2.46-3.20), but adjusting for BMI z-score at age 3, the effect of trajectory disappears (OR 1.08 95% CI: 0.9-1.29). In other words, if one targeted early preventive interventions to 3-year-olds affected by overweight/obesity (only 9.8% of the study cohort), one could possibly address 71% of children potentially affected by obesity at age 5.
儿童肥胖是工业化国家的一个主要公共卫生问题。本研究旨在根据 3 岁时的 BMI 类别以及出生至 3 岁时 BMI z 分数的变化，估计 5 岁时肥胖的风险。在这项基于人群的研究中，收集了 5173 名儿童在 3 岁和 5 岁时的 BMI 数据，并将其与出生体重相关信息相联系。5 岁时肥胖的患病率为 3.8%。对于出生时巨大儿的儿童，肥胖的风险为 6.5%，而对于 3 岁时超重的儿童，风险为 18.6%，对于 3 岁时肥胖的儿童，风险为 62%。从出生到 3 岁时 BMI z 分数的增加会增加 5 岁时肥胖的风险（增加一个标准差的 OR 为 2.8%；95%CI：2.46-3.20），但调整 3 岁时的 BMI z 分数后，轨迹的影响消失（OR 1.08 95%CI：0.9-1.29）。换句话说，如果将早期预防干预的目标设定在受超重/肥胖影响的 3 岁儿童（仅占研究队列的 9.8%），则有可能解决 71%的 5 岁时可能肥胖的儿童。
