胎儿过度生长以及婴儿期体重轨迹与儿童早期肥胖

Fetal overgrowth and weight trajectories during infancy and adiposity in early childhood.

作者信息

Tao Min-Yi, Liu Xin, Chen Zi-Lin, Yang Meng-Nan, Xu Ya-Jie, He Hua, Fang Fang, Chen Qian, Mao Xuan-Xia, Zhang Jun, Ouyang Fengxiu, Shen Xiu-Hua, Li Fei, Luo Zhong-Cheng, Shen Xiaoming, Huang Hong, Sun Kun, Zhang Jun, Wang Weiye, Xu Weiping, Ouyang Fengxiu, Li Fei, Huang Yin, Zhang Jinsong, Yan Chonghuai, Shen Lisong, Bao Yixiao, Tian Ying, Chen Weiwei, Zhang Huijuan, Tong Chuanliang, Xu Jian, Zhang Lin, Zhang Yiwen, Jiang Fang, Yu Xiaodan, Yu Guangjun, Chen Jinjin, Zhang Yu, Li Xiaotian, Cheng Haidong, Zhang Qinying, Duan Tao, Hua Jing, Peng Hua

机构信息

Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, 200092, Shanghai, China.

Lunenfeld-Tanenbaum Research Institute, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerity Faculty of Medicine, and Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, M5G 1X5, Canada.

出版信息

Pediatr Res. 2024 Apr;95(5):1372-1378. doi: 10.1038/s41390-023-02991-7. Epub 2024 Jan 10.

DOI:10.1038/s41390-023-02991-7

PMID:38200323

Abstract

BACKGROUND

Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood. Little is known about how infancy growth trajectories affect adiposity in early childhood in LGA.

METHODS

In the Shanghai Birth Cohort, we followed up 259 LGA (birth weight >90th percentile) and 1673 appropriate-for-gestational age (AGA, 10th-90th percentiles) children on body composition (by InBody 770) at age 4 years. Adiposity outcomes include body fat mass (BFM), percent body fat (PBF), body mass index (BMI), overweight/obesity, and high adiposity (PBF >85th percentile).

RESULTS

Three weight growth trajectories (low, mid, and high) during infancy (0-2 years) were identified in AGA and LGA subjects separately. BFM, PBF and BMI were progressively higher from low- to mid-to high-growth trajectories in both AGA and LGA children. Compared to the mid-growth trajectory, the high-growth trajectory was associated with greater increases in BFM and the odds of overweight/obesity or high adiposity in LGA than in AGA children (tests for interactions, all P < 0.05).

CONCLUSIONS

Weight trajectories during infancy affect adiposity in early childhood regardless of LGA or not. The study is the first to demonstrate that high-growth weight trajectory during infancy has a greater impact on adiposity in early childhood in LGA than in AGA subjects.

IMPACT

Large-for-gestational age (LGA), a marker of fetal overgrowth, has been linked to obesity in adulthood, but little is known about how weight trajectories during infancy affect adiposity during early childhood in LGA subjects. The study is the first to demonstrate a greater impact of high-growth weight trajectory during infancy (0-2 years) on adiposity in early childhood (at age 4 years) in subjects with fetal overgrowth (LGA) than in those with normal birth size (appropriate-for-gestational age). Weight trajectory monitoring may be a valuable tool in identifying high-risk LGA children for close follow-ups and interventions to decrease the risk of obesity.

摘要

背景

大于胎龄儿（LGA）是胎儿过度生长的一个指标，与成年期肥胖有关。关于婴儿期生长轨迹如何影响LGA儿童幼儿期肥胖情况，人们知之甚少。

方法

在上海出生队列研究中，我们对259名LGA儿童（出生体重>第90百分位数）和1673名适于胎龄儿（AGA，第10 - 90百分位数）儿童在4岁时进行了身体成分（通过InBody 770测量）随访。肥胖结局包括体脂肪量（BFM）、体脂百分比（PBF）、体重指数（BMI）、超重/肥胖以及高肥胖（PBF>第85百分位数）。

结果

分别在AGA和LGA受试者中确定了婴儿期（0 - 2岁）的三种体重增长轨迹（低、中、高）。AGA和LGA儿童的BFM、PBF和BMI从低增长轨迹到中增长轨迹再到高增长轨迹逐渐升高。与中增长轨迹相比，高增长轨迹与LGA儿童BFM的更大增加以及超重/肥胖或高肥胖几率的增加相关，且这种关联在LGA儿童中比AGA儿童更明显（交互作用检验，所有P<0.05）。

结论

无论是否为LGA，婴儿期体重轨迹都会影响幼儿期肥胖情况。该研究首次表明，婴儿期高增长体重轨迹对LGA儿童幼儿期肥胖的影响比对AGA受试者更大。

影响

大于胎龄儿（LGA）是胎儿过度生长的一个指标，与成年期肥胖有关，但关于婴儿期体重轨迹如何影响LGA受试者幼儿期肥胖情况，人们知之甚少。该研究首次表明，婴儿期（0 - 2岁）高增长体重轨迹对胎儿过度生长（LGA）受试者幼儿期（4岁）肥胖的影响比对出生大小正常（适于胎龄）的受试者更大。体重轨迹监测可能是识别高风险LGA儿童进行密切随访和干预以降低肥胖风险的有价值工具。