Kenyon Chris, Laumen Jolein, Manoharan-Basil Sheeba S, Buyze Jozefien
HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium; Division of Infectious Diseases and HIV Medicine, University of Cape Town, Anzio Road, Observatory 7700, South Africa.
HIV/STI Unit, Institute of Tropical Medicine, Antwerp, Belgium.
J Infect Public Health. 2020 Oct;13(10):1517-1521. doi: 10.1016/j.jiph.2020.06.024. Epub 2020 Jul 4.
The reasons underpinning the large variations in the prevalence of childhood obesity are inadequately understood. Individual level studies have found that macrolide consumption at a young age increases the risk of subsequent obesity. We hypothesized that differences in population level consumption of macrolides may explain part of the variation in the prevalence of childhood obesity.
Mixed effects beta regression was used to assess the association between the prevalence of childhood obesity in countries in Europe/ states in the United States and population level consumption of macrolides and total antibiotics. Different time lags between consumption and obesity measurement were used.
We found that in both the USA and Europe, population level consumption of macrolides was positively associated with subsequent childhood obesity prevalence. According to our model, the observed differences in population-level macrolide consumption in Europe/USA would translate into a 13%/72% higher odds of childhood obesity 5 years later. The association held regardless of the lag period used between exposure and outcome. The association with total antibiotic consumption was more equivocal.
Reducing macrolide consumption to that of low consumption countries may result in considerable reductions in childhood obesity.
儿童肥胖患病率存在巨大差异的根本原因尚未得到充分理解。个体层面的研究发现，幼年时期使用大环内酯类药物会增加日后肥胖的风险。我们推测，不同人群中大环内酯类药物的使用差异可能是儿童肥胖患病率差异的部分原因。
采用混合效应β回归评估欧洲各国/美国各州儿童肥胖患病率与大环内酯类药物及总抗生素的人群使用水平之间的关联。使用了药物使用与肥胖测量之间的不同时间间隔。
我们发现，在美国和欧洲，大环内酯类药物的人群使用水平均与随后的儿童肥胖患病率呈正相关。根据我们的模型，在欧洲/美国观察到的人群大环内酯类药物使用差异会导致5年后儿童肥胖几率分别增加13%/72%。无论暴露与结果之间使用的时间间隔如何，这种关联都成立。与总抗生素使用的关联则更为模糊。
将大环内酯类药物的使用量降至低使用量国家的水平，可能会使儿童肥胖率大幅降低。
