Research Unit EA3920 'Prognostic Markers and Regulatory Factors of Cardiovascular Diseases', University of Bourgogne Franche-Comté, 25000Besançon, France.
Brain Function Research Group, School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, 2193Johannesburg, Gauteng, South Africa.
Br J Nutr. 2020 Sep 14;124(5):501-512. doi: 10.1017/S0007114520000987. Epub 2020 Mar 16.
Early adiposity rebound (EAR) predicts paediatric overweight/obesity, but current approaches do not consider both the starting point of EAR and the BMI trajectory. We compared the clinical characteristics at birth, age 3-5 and 6-8 years of children, according to the EAR and to its type (type A/type B-EAR). We assessed the children's odds of being classified as overweight/obese at age 6-8 years, according to the type of EAR as defined at age 3-5 years. As part of this two-wave observational study, 1055 children were recruited and examined at age 3-5 years. Antenatal and postnatal information was collected through interviews with parents, and weight and height from the health records. Type A and type B-EAR were defined in wave 1 according to the BMI nadir and the variation of BMI z-score between the starting point of the adiposity rebound and the last point on the curve. At 6-8 years (wave 2), 867 children were followed up; 426 (40·4 %) children demonstrated EAR. Among them, 172 had type A-EAR, higher rates of parental obesity (P < 0·05) and greater birth weight compared with other children (P < 0·001). Odds for overweight/obesity at 6-8 years, when adjusting for antenatal and postnatal factors, was 21·35 (95 % CI 10·94, 41·66) in type A-EAR children and not significant in type B-EAR children (OR 1·76; 95 % CI 0·84, 3·68) compared with children without EAR. Classification of EAR into two subtypes provides physicians with a reliable approach to identify children at risk for overweight/obesity before the age of 5 years.
早期脂肪量反弹（EAR）可预测儿童超重/肥胖，但目前的方法并未同时考虑 EAR 的起始点和 BMI 轨迹。我们根据 EAR 及其类型（A型/EAR 型-B）比较了儿童在出生、3-5 岁和 6-8 岁时的临床特征。我们根据 3-5 岁时定义的 EAR 类型评估了儿童在 6-8 岁时超重/肥胖的分类几率。作为这项两波观察性研究的一部分，招募并检查了 1055 名 3-5 岁的儿童。通过与父母面谈收集了产前和产后信息，并从健康记录中获取了体重和身高数据。根据 BMI 最低点和肥胖反弹起点与曲线最后一点之间 BMI z 分数的变化，在第 1 波中定义了 A 型和 EAR 型-B。在 6-8 岁（第 2 波）时，对 867 名儿童进行了随访；426 名（40.4%）儿童出现 EAR。其中，172 名儿童为 A 型-EAR，其父母肥胖的比例更高（P<0.05），出生体重也高于其他儿童（P<0.001）。在调整了产前和产后因素后，EAR 儿童超重/肥胖的几率在 6-8 岁时为 21.35（95%CI 10.94，41.66），而 EAR 型-B 儿童则不显著（OR 1.76；95%CI 0.84，3.68），与没有 EAR 的儿童相比。EAR 分为两个亚型，为医生提供了一种可靠的方法，可以在 5 岁之前识别超重/肥胖风险的儿童。
