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与足月出生的同龄人相比,极低出生体重早产儿青少年肥胖和不健康中心性肥胖的风险。

Risk of Obesity and Unhealthy Central Adiposity in Adolescents Born Preterm With Very Low Birthweight Compared to Term-Born Peers.

机构信息

Amsterdam University Medical Centers, Amsterdam, The Netherlands.

Wake Forest University School of Medicine, Winston Salem, NC, USA.

出版信息

Child Obes. 2024 Oct;20(7):485-493. doi: 10.1089/chi.2023.0115. Epub 2024 Feb 22.

Abstract

Early-life factors such as preterm birth or very low birthweight (VLBW) are associated with increased cardiovascular disease risk. However, it remains unknown whether this is due to an increased risk of obesity (unhealthy central adiposity) because studies have predominantly defined obesity based on BMI, an imprecise adiposity measure. Investigate if adolescents born preterm with VLBW have a higher risk of unhealthy central adiposity compared to term-born peers. Cross-sectional analysis of data from a prospective cohort study of 177 individuals born preterm with VLBW (<1500 g) and 51 term-born peers (birthweight ≥2500 g). Individuals with congenital anomalies, genetic syndromes, or major health conditions were excluded. Height, weight, waist circumference, skin fold thickness, and dual energy X-ray absorptiometry body composition were measured at age 14 years. We calculated BMI percentiles and defined overweight/obesity as BMI ≥85th percentile for age and sex. We estimated the preterm-term differences in overweight/obesity prevalence and adiposity distribution with multivariable generalized linear models. There was no difference in small for gestational age status or overweight/obesity prevalence. Compared to term, youth born preterm with VLBW had lower BMI z-score [ -0.38, 95% confidence limits (CL) -0.75 to -0.02] but no differences in adiposity apart from subscapular-to-triceps ratio (STR; 0.18, 95% CL 0.08 to 0.28). Adolescents born preterm with VLBW had smaller body size than their term-born peers and had no differences in central adiposity except greater STR.

摘要

早产或极低出生体重(VLBW)等生命早期因素与心血管疾病风险增加有关。然而,目前尚不清楚这是否是由于肥胖(不健康的中心性肥胖)风险增加所致,因为研究主要基于 BMI 定义肥胖,而 BMI 是一种不精确的肥胖衡量标准。本研究旨在探究与足月出生的同龄人相比,早产儿 VLBW 是否存在更高的不健康中心性肥胖风险。这是一项对前瞻性队列研究数据的横断面分析,研究对象为 177 名早产儿 VLBW(<1500g)和 51 名足月出生的同龄人(出生体重≥2500g)。排除了患有先天性异常、遗传综合征或重大健康问题的个体。在 14 岁时测量身高、体重、腰围、皮褶厚度和双能 X 射线吸收仪身体成分。我们计算了 BMI 百分位数,并将超重/肥胖定义为 BMI 年龄和性别≥第 85 百分位数。我们使用多变量广义线性模型估计了早产-足月之间超重/肥胖患病率和脂肪分布的差异。两组的小于胎龄儿发生率或超重/肥胖患病率无差异。与足月出生的同龄人相比,VLBW 早产儿的 BMI z 评分较低(-0.38,95%置信区间[CI] -0.75 至-0.02),但除了三角肌下皮褶厚度与三头肌皮褶厚度比值(STR;0.18,95%CI 0.08 至 0.28)外,两组的肥胖程度并无差异。VLBW 早产儿的身体尺寸小于足月出生的同龄人,除了 STR 较大外,两组的中心性肥胖程度无差异。

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