高出生体重及其与体力活动的相互作用影响着学龄期儿童肥胖的风险。

High birth weight and its interaction with physical activity influence the risk of obesity in early school-aged children.

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, 283 Jianghai Road, Guangzhou, 510310, China.

Futian Hospital for Prevention and Treatment of Chronic Disease, Shenzhen, 518048, China.

出版信息

World J Pediatr. 2020 Aug;16(4):385-392. doi: 10.1007/s12519-020-00336-6. Epub 2020 Feb 25.

DOI:10.1007/s12519-020-00336-6

PMID:32100262

Abstract

BACKGROUND

High birth weight (HBW) is associated with childhood obesity, but with inconsistent results. This study investigated the relationship between HBW and childhood obesity, and further explored the interaction of HBW with behavioral and socio-economic determinants of obesity.

METHODS

This cross-sectional study enrolled 1906 grade-two children of Guangzhou, China, from June to November, 2016. Overweight/obesity corresponded to a body mass index higher than the sex-age-specific criteria. Abdominal obesity was assessed using the sex-specific waist-height ratio cutoffs. The association of HBW with obesity was evaluated in multivariable logistic regression model. The relative excess risk due to interaction (RERI) and the attributable proportion of interaction (AP) indices were used to measure additive interaction, while applying the interaction of OR index for multiplicative interaction assessment.

RESULTS

Children with HBW had an increased risk of overweight/obesity [odds ratio (OR) = 2.42, 95% confidence interval (CI) = 1.56-3.76] compared with those without HBW. Significant additive interaction of HBW with physical activity was found for overweight/obesity [relative excess risk due to interaction (RERI) = 2.69, 95% CI = 0.62-4.75; attributable proportion of interaction (AP) = 0.72, 95% CI = 0.42-1.02]. The HBW children with insufficient activity had higher odds of overweight/obesity compared to the non-HBW children with sufficient activity (OR = 3.75, 95% CI = 2.06-6.83). In addition, we identified a significant interaction of HBW with household income for abdominal obesity (RERI = 1.20, 95% CI = 0.02-2.37; AP = 0.76, 95% CI = 0.16-1.36).

CONCLUSIONS

HBW confers an increased risk for childhood overweight/obesity. Physical activity attenuates the effect of HBW on overweight/obesity, and HBW possibly synergistically interacts with high household income to promote abdominal obesity in childhood.

摘要

背景

高出生体重（HBW）与儿童肥胖有关，但结果不一致。本研究调查了 HBW 与儿童肥胖的关系，并进一步探讨了 HBW 与肥胖的行为和社会经济决定因素的相互作用。

方法

本横断面研究于 2016 年 6 月至 11 月招募了来自中国广州的 1906 名二年级儿童。超重/肥胖对应于高于性别年龄特定标准的体重指数。使用性别特异性腰围身高比切点评估腹型肥胖。使用多变量逻辑回归模型评估 HBW 与肥胖的相关性。相对超额交互作用风险（RERI）和交互归因比例（AP）指数用于测量加性相互作用，而应用交互作用 OR 指数进行乘法相互作用评估。

结果

与没有 HBW 的儿童相比，HBW 儿童超重/肥胖的风险增加[比值比（OR）=2.42，95%置信区间（CI）=1.56-3.76]。HBW 与体力活动之间存在显著的加性相互作用，与超重/肥胖有关[相对超额交互作用风险（RERI）=2.69，95%CI=0.62-4.75；交互归因比例（AP）=0.72，95%CI=0.42-1.02]。活动不足的 HBW 儿童超重/肥胖的几率高于活动充足的非 HBW 儿童（OR=3.75，95%CI=2.06-6.83）。此外，我们发现 HBW 与家庭收入对腹型肥胖存在显著的交互作用（RERI=1.20，95%CI=0.02-2.37；AP=0.76，95%CI=0.16-1.36）。