Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brasil.
Hospital das Clínicas de Porto Alegre, Porto Alegre, Brasil.
Cad Saude Publica. 2021 Mar 12;37(2):e00061619. doi: 10.1590/0102-311X00061619. eCollection 2021.
Intrauterine life is a critical period for the development of body fat and metabolic risk. This study investigated associations between birth weight and total and truncal body fat in adults. To do so, we analyzed data on 10,011 adults participating in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) who self-reported birth weight as < 2.5kg, 2.5-4.0kg, or > 4.0kg at baseline (2008-2010) and underwent bioimpedance in the next follow-up visit (2012-2014). Greater mean total and truncal fat mass were seen in those with high birth weight compared with adequate birth weight (p < 0.001) in both sexes (total fat: 25.2 vs. 23.1kg in men and 31.4 vs. 27.7kg in women, and truncal fat: 13.5 vs. 12.4kg in men and 15.9 vs. 14.2kg in women). U-shaped patterns were observed in restricted cubic-spline analyses in the subset of 5,212 individuals reporting exact birth weights, although statistically significant only for those with high birth weight. In the whole sample, in comparing high to adequate birth weight, the latter predicted having a large (> 85 percentile) total and truncal fat mass, respectively: OR = 1.76, 95%CI: 1.37-2.25 (men) and OR = 1.86, 95%CI: 1.42-2.44 (women); OR = 1.68, 95% CI: 1.31-2.16 (men) and OR = 1.73, 95%CI: 1.31-2.28 (women). However, low birth weight predicted having a large (> 85 percentile) % truncal fat only in women (OR = 1.40, 95%CI: 1.03-1.91). In conclusion, in these men and women born in a period in which fetal malnutrition was prevalent, birth weight showed complex, frequently non-linear associations with adult body fat, highlighting the need for interventions to prevent low and high birth weight during pregnancy.
宫内生活是身体脂肪和代谢风险发育的关键时期。本研究调查了出生体重与成年人总体和躯干体脂之间的关系。为此，我们分析了巴西成人健康纵向研究（ELSA-Brasil）中 10011 名成年人的数据，这些人在基线时（2008-2010 年）自我报告出生体重<2.5kg、2.5-4.0kg 或>4.0kg，并在接下来的随访中（2012-2014 年）进行了生物阻抗测量。在男性和女性中，与出生体重正常的成年人相比，高出生体重的成年人的总脂肪和躯干脂肪质量平均值更高（p<0.001）（总脂肪：男性为 25.2kg 比 23.1kg，女性为 31.4kg 比 27.7kg；躯干脂肪：男性为 13.5kg 比 12.4kg，女性为 15.9kg 比 14.2kg）。在报告准确出生体重的 5212 名个体的受限立方样条分析中观察到 U 型模式，尽管仅对高出生体重的个体具有统计学意义。在整个样本中，与出生体重正常的成年人相比，高出生体重预测总脂肪和躯干脂肪质量较大（分别为>85 百分位）：男性的 OR=1.76，95%CI：1.37-2.25；女性的 OR=1.86，95%CI：1.42-2.44；男性的 OR=1.68，95%CI：1.31-2.16；女性的 OR=1.73，95%CI：1.31-2.28。然而，低出生体重仅预测女性躯干脂肪（>85 百分位）较大（OR=1.40，95%CI：1.03-1.91）。总之，在这些出生于胎儿营养不良流行时期的男性和女性中，出生体重与成人体脂之间存在复杂且经常呈非线性的关系，这突出表明需要干预措施以防止孕期低出生体重和高出生体重。
