Fan Hui, Zhu Qi, Zhang Xingyu
Department of Preventive Medicine, North Sichuan Medical College, Nanchong, China.
Applied Biostatistics Laboratory, University of Michigan School of Nursing, Ann Arbor, MI, United States.
Front Pediatr. 2020 Jun 9;8:301. doi: 10.3389/fped.2020.00301. eCollection 2020.
The potential effects of excess weight status in childhood on later adult cardiometabolic risk factors have been undetermined in a Chinese population. Additionally, the potential mitigation of these effects if adult weight status returns to normalcy has been unresolved. Accordingly, we aimed to assess the association of childhood excess weight status and its long-term change with adult cardiometabolic risk factors. A cohort study from the China Health and Nutrition Survey 1991-2009 consisted of 541 participants who were measured in childhood (≥6 and <18 years) and underwent laboratory assessment in adulthood (≥18 years). In childhood, the participants were classified into four groups as age-sex-specific body mass index (BMI) z-score quartiles. The adult cardiometabolic risk factors included overweight and obesity, hypertension, high total cholesterol, high triglyceride, low high-density lipoprotein cholesterol, high low-density lipoprotein cholesterol, and high hemoglobin A1c. The prevalence was 61.0, 36.2, and 19.0% for ≥1, 2, and 3 cardiometabolic risk factors, respectively, with a mean 14.9-year follow-up. There was a significant trend in the progression of the number of adult cardiometabolic risk factors across childhood BMI quartiles ( < 0.001). Additionally, participants with childhood BMI z-scores ≥ 75th percentile and adult BMI z-scores < 75th percentile did not have increased cardiometabolic risks compared with those with both childhood and adulthood BMI z-scores < 75th percentile. Our findings revealed that child excess weight status increased adult cardiometabolic risks. However, the effects of excess weight status in childhood on adult cardiometabolic risk factors were mitigated if adult weight status returned to normalcy.
儿童期超重状态对成年后心血管代谢危险因素的潜在影响在中国人群中尚未明确。此外，如果成年后体重恢复正常，这些影响是否能得到潜在缓解也尚无定论。因此，我们旨在评估儿童期超重状态及其长期变化与成年后心血管代谢危险因素之间的关联。一项基于1991 - 2009年中国健康与营养调查的队列研究，纳入了541名在儿童期（≥6岁且<18岁）接受测量并在成年期（≥18岁）接受实验室评估的参与者。在儿童期，参与者根据年龄和性别特异性体重指数（BMI）z评分四分位数分为四组。成年后的心血管代谢危险因素包括超重、肥胖、高血压、高总胆固醇、高甘油三酯、低高密度脂蛋白胆固醇、高低密度脂蛋白胆固醇和高糖化血红蛋白A1c。在平均14.9年的随访中，患有≥1、2和3种心血管代谢危险因素的患病率分别为61.0%、36.2%和19.0%。成年心血管代谢危险因素的数量在儿童BMI四分位数之间存在显著的递增趋势（<0.001）。此外，儿童期BMI z评分≥第75百分位数且成年期BMI z评分<第75百分位数的参与者，与儿童期和成年期BMI z评分均<第75百分位数的参与者相比，心血管代谢风险并未增加。我们的研究结果表明，儿童期超重状态会增加成年后的心血管代谢风险。然而，如果成年后体重恢复正常，儿童期超重状态对成年心血管代谢危险因素的影响会得到缓解。
