Department of Pediatrics, Korea University Ansan Hospital, Ansan, Korea.
Department of Pediatrics, Korea University College of Medicine, Seoul, Korea.
Epidemiol Health. 2021;43:e2021005. doi: 10.4178/epih.e2021005. Epub 2020 Dec 29.
We aimed to evaluate the association between early-life weight status and urinary tract infection (UTI) risk in children.
A nationwide study was conducted using Korean National Health Screening (NHS) data and National Health Insurance Service data. A sample cohort was selected using data from the 2014 and 2015 NHS for infants and children (4-71 months) and followed up until the end of 2017. Participants were divided into 4 groups (underweight, normal weight, overweight, and obese) based on the weight-for-age (< 2 years) or body mass index (≥ 2 years). Hazard ratios (HRs) with 95% confidence intervals (CIs) for developing UTIs, cystitis, and acute pyelonephritis (APN) were calculated using a Cox proportional hazard model.
Of 1,653,106 enrolled children, 120,142 (7.3%) developed UTIs, cystitis, and APN during follow-up. The underweight, overweight, and obese groups had higher risks of UTIs than the reference group after adjusting for age, sex, birth weight, and preterm birth. Between 2 years and 6 years of age, boys with underweight had a high risk of UTI and APN, while girls with overweight and obesity revealed elevated risks of UTIs, cystitis, and APN. The HRs for APN in boys with underweight and in girls with obesity were 1.46 (95% CI, 1.03 to 2.07) and 1.41 (95% CI, 1.13 to 1.75), respectively, after adjusting for age, sex, birth weight, and preterm birth. The incidence of APN did not decrease with age in underweight and obese children aged 2-6 years.
Children with underweight, overweight, and obesity may be at high risk for UTIs.
我们旨在评估儿童生命早期体重状况与尿路感染（UTI）风险之间的关联。
本研究使用韩国国家健康筛查（NHS）数据和国家健康保险服务数据进行了一项全国性研究。选择了 2014 年和 2015 年 NHS 中 4-71 个月婴儿和儿童的数据作为样本队列，并随访至 2017 年底。根据体重与年龄的比值（< 2 岁）或体重指数（≥ 2 岁），将参与者分为 4 组（体重不足、正常体重、超重和肥胖）。使用 Cox 比例风险模型计算发生 UTI、膀胱炎和急性肾盂肾炎（APN）的风险比（HR）及其 95%置信区间（CI）。
在纳入的 1653106 名儿童中，有 120142 名（7.3%）在随访期间发生 UTI、膀胱炎和 APN。在校正年龄、性别、出生体重和早产等因素后，体重不足、超重和肥胖组发生 UTI 的风险高于参考组。在 2 至 6 岁之间，体重不足的男孩发生 UTI 和 APN 的风险较高，而超重和肥胖的女孩发生 UTI、膀胱炎和 APN 的风险较高。在校正年龄、性别、出生体重和早产等因素后，体重不足男孩和肥胖女孩的 APN 的 HR 分别为 1.46（95%CI，1.03 至 2.07）和 1.41（95%CI，1.13 至 1.75）。在 2-6 岁体重不足和肥胖儿童中，APN 的发病率并未随着年龄的增长而降低。
体重不足、超重和肥胖的儿童可能面临 UTI 的高风险。
