Gannon James, Pollock Allison J, Allen David B, Kling Pamela J
University of Wisconsin-Madison, Madison, WI, USA.
Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.
Clin Pediatr (Phila). 2021 Mar;60(3):178-183. doi: 10.1177/0009922820971006. Epub 2020 Nov 4.
Children obese at the age of 5 years are at greater risk of lifelong obesity. Because certain risks of obesity can be identified in early infancy, a tool for obesity risk prediction in early life would be clinically useful. We investigated predictors of obesity risk in a novel, prospectively collected healthy birth cohort recruited for demographic risks to develop iron deficiency at 1 year, a cohort leveraged because risk factors for iron deficiency and obesity overlap. Obesity at the age of 5 years was defined as age- and sex-specific body mass index -score (BMI) >2SD. For each child, obesity risk factors were summed. Of 10 total risk factors, the following 4 key risks were identified: maternal obesity, maternal diabetes, large for gestational age, or breastfeeding <6 months. Childhood obesity was predicted by either ≥3 total number of risks ( < .033), any key risk ( < .002), or summing key risks ( < .0001). In clinical practice, summing early life risk factors may be a useful strategy for preemptive counseling.
5岁时肥胖的儿童终生肥胖风险更高。由于肥胖的某些风险在婴儿早期就可以识别，因此一种用于预测早期肥胖风险的工具在临床上会很有用。我们在一个新的、前瞻性收集的健康出生队列中调查了肥胖风险的预测因素，该队列因存在1岁时患缺铁性贫血的人口统计学风险而被招募，之所以利用这个队列是因为缺铁和肥胖的风险因素有重叠。5岁时的肥胖定义为按年龄和性别划分的体重指数评分（BMI）>2个标准差。对每个孩子的肥胖风险因素进行汇总。在总共10个风险因素中，确定了以下4个关键风险：母亲肥胖、母亲患糖尿病、大于胎龄儿或母乳喂养时间<6个月。儿童肥胖可通过以下情况预测：风险因素总数≥3（P<0.033）、存在任何一个关键风险（P<0.002）或汇总关键风险（P<0.0001）。在临床实践中，汇总早期生活风险因素可能是一种进行预防性咨询的有用策略。
