Center for Infectious Diseases, Epidemiology, and Surveillance, National Institute for Public Health and the Environment, Bilthoven, The Netherlands.
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Int J Obes (Lond). 2021 May;45(5):1143-1151. doi: 10.1038/s41366-021-00806-5. Epub 2021 Mar 26.
The incidence of childhood overweight and obesity is rising. It is hypothesized that infections in early childhood are associated with being overweight. This study investigated the association between the number of symptomatic infections or antibiotic prescriptions in the first 3 years of life and body mass index (BMI) in adolescence.
The current study is part of the Prevention and Incidence of Asthma and Mite Allergy population-based birth cohort study. Weight and height were measured by trained research staff at ages 12 and 16 years. The 3015 active participants at age 18 years were asked for informed consent for general practitioner (GP) data collection and 1519 gave written informed consent. Studied exposures include (1) GP-diagnosed infections, (2) antibiotic prescriptions, and (3) parent-reported infections in the first 3 years of life. Generalized estimating equation analysis was used to determine the association between each of these exposures and BMI z-score.
Exposure data and BMI measurement in adolescence were available for 622 participants. The frequencies of GP-diagnosed infections and antibiotic prescriptions were not associated with BMI z-score in adolescence with estimates being 0.14 (95% CI -0.09-0.37) and 0.10 (95% CI -0.14-0.34) for the highest exposure categories, respectively. Having ≥6 parent-reported infections up to age 3 years was associated with a 0.23 (95% CI 0.01-0.44) higher BMI z-score compared to <2 parent-reported infections.
For all infectious disease measures an increase in BMI z-score for the highest childhood exposure to infectious disease was observed, although only statistically significant for parent-reported infections. These results do not show an evident link with infection severity, but suggest a possible cumulative effect of repeated symptomatic infections on overweight development.
儿童超重和肥胖的发病率正在上升。据推测,儿童早期的感染与超重有关。本研究调查了生命前 3 年中症状性感染或抗生素处方的数量与青春期体重指数(BMI)之间的关系。
本研究是基于人群的预防和哮喘及螨变应性的出生队列研究的一部分。研究人员在 12 岁和 16 岁时由经过培训的研究人员测量体重和身高。在 18 岁时,有 3015 名活跃参与者被要求同意收集全科医生(GP)的数据,其中 1519 人书面同意。研究的暴露因素包括:(1)GP 诊断的感染;(2)抗生素处方;(3)生命前 3 年父母报告的感染。广义估计方程分析用于确定这些暴露因素与 BMI z 评分之间的关系。
有 622 名参与者提供了暴露数据和青春期 BMI 测量值。在青春期,GP 诊断的感染和抗生素处方的频率与 BMI z 评分无关,最高暴露组的估计值分别为 0.14(95% CI -0.09-0.37)和 0.10(95% CI -0.14-0.34)。与<2 次父母报告的感染相比,在 3 岁前有≥6 次父母报告的感染与 BMI z 评分升高 0.23(95% CI 0.01-0.44)有关。
对于所有传染病指标,最高儿童传染病暴露的 BMI z 评分都有所增加,尽管仅在父母报告的感染方面具有统计学意义。这些结果并没有显示出感染严重程度与感染之间的明显联系,但表明反复出现的症状性感染可能对超重发展有累积影响。