Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands.
Danone Nutricia Research, Utrecht, the Netherlands.
JAMA Pediatr. 2020 Dec 1;174(12):1141-1148. doi: 10.1001/jamapediatrics.2020.2673.
A rapid increase in weight in early life is associated with an increased risk for adiposity and cardiovascular diseases at age 21 years and beyond. However, data on associations of early change in measured fat mass percentage (FM%) with adiposity development are lacking.
To investigate whether a rapid increase in FM% in the first months of life is associated with higher trajectories of body fat mass during the first 2 years of life.
DESIGN, SETTING, AND PARTICIPANTS: A birth cohort consisting of 401 healthy, term-born infants of the Sophia Pluto Cohort Study was analyzed. Participants were born between January 7, 2013, and October 13, 2017. Data were analyzed from February 1, 2020, to May 20, 2020.
Longitudinal measurements of FM% by air-displacement plethysmography and dual-energy x-ray absorptiometry, and abdominal subcutaneous and visceral fat mass (FM) by ultrasonography in infants at ages 1, 3, 6, 9, 12, 18, and 24 months. A rapid increase in FM% was defined as a change in FM% of greater than 0.67 standard deviation scores (SDS).
Associations between change in FM% SDS in the first and second 6-month period of life with body composition at age 2 years and whether a rapid increase in FM% SDS during the first 6 months leads to higher body FM and abdominal FM trajectories during the first 2 years of life.
Of the 401 participants, 228 infants (57%) were male. Change in FM% SDS from age 1 to 6 months was positively associated with FM% (β, 0.044; 95% CI, 0.017-0.068), FMI (β, 0.061; 95% CI, 0.032-0.091), and abdominal subcutaneous FM (β, 0.064; 95% CI, 0.036-0.092) at age 2 years, but not with visceral FM. In contrast, no associations were found within the 6- to 12-month period. Infants with a rapid increase in FM% of greater than 0.67 SDS in the first 6 months of life had higher trajectories of FM%, FM index, and subcutaneous FM during the first 2 years of life (all P≤.001), but visceral FM index was not significantly different compared with infants without a rapid increase (P = .12).
In this study, only the change in FM% in the first 6 months of life was associated with more adiposity at age 2 years. Infants with a rapid increase in FM% had higher trajectories of FM% and FM index during the first 2 years of life. These findings appear to support a critical window for adiposity programming in early life.
生命早期体重快速增加与 21 岁及以后的肥胖和心血管疾病风险增加有关。然而，目前缺乏关于生命早期测量的脂肪百分比（FM%）早期变化与脂肪量发展之间关联的研究数据。
研究生命最初几个月 FM%的快速增加是否与生命前 2 年期间更高的体脂肪量轨迹相关。
设计、地点和参与者：对 Sophia Pluto 队列研究中的 401 名健康、足月出生的婴儿进行了一项出生队列研究。参与者于 2013 年 1 月 7 日至 2017 年 10 月 13 日之间出生。数据分析于 2020 年 2 月 1 日至 2020 年 5 月 20 日进行。
在婴儿 1、3、6、9、12、18 和 24 个月时通过空气置换体积描记法和双能 X 射线吸收仪进行 FM%的纵向测量，以及通过超声进行腹部皮下和内脏脂肪量（FM）的测量。FM%的快速增加定义为 FM%的变化大于 0.67 个标准差分数（SDS）。
生命最初和第二个 6 个月期间 FM%SDS 的变化与 2 岁时的身体成分之间的关系，以及 FM%SDS 在生命最初 6 个月期间的快速增加是否导致生命最初 2 年期间更高的身体 FM 和腹部 FM 轨迹。
在 401 名参与者中，有 228 名婴儿（57%）为男性。从 1 个月到 6 个月 FM%SDS 的变化与 FM%（β，0.044；95%置信区间，0.017-0.068）、FMI（β，0.061；95%置信区间，0.032-0.091）和 2 岁时腹部皮下 FM（β，0.064；95%置信区间，0.036-0.092）呈正相关，但与内脏 FM 无关。相比之下，在 6 至 12 个月期间未发现任何关联。生命最初 6 个月内 FM%增加大于 0.67 SDS 的婴儿在生命最初 2 年期间的 FM%、FM 指数和皮下 FM 轨迹更高（均 P≤.001），但与没有快速增加的婴儿相比，内脏 FM 指数无显著差异（P = .12）。
在这项研究中，只有生命最初 6 个月的 FM%变化与 2 岁时的肥胖有关。FM%快速增加的婴儿在生命最初 2 年期间的 FM%和 FM 指数轨迹更高。这些发现似乎支持生命早期肥胖编程的关键窗口期。
