Liao Zijun, Wang Jing, Chen Yiren, Li Weiqin, Xie Xianghui, Zhang Ting, Liu Gongshu, Chen Fangfang
Capital Institute of Pediatrics, Beijing 100020, China.
Tianjin Women's and Children's Health Center, Tianjin 300070, China.
J Clin Endocrinol Metab. 2025 Apr 22;110(5):e1439-e1450. doi: 10.1210/clinem/dgae544.
To examine the relationship between body mass index (BMI) growth rates, body composition, and cardiometabolic markers in preschool children.
Three-year-old children were recruited for this cohort study. BMI and body composition measurements were obtained at enrollment, with multiple BMI measurements spanning ages 1 month to 3 years extracted from medical records. Levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol (non-HDL-C), remnant cholesterol (RC), uric acid (UA), and fasting plasma glucose were measured at 3 years. Data analyses employed piecewise linear mixed models and logistic regression models.
Out of 3822 children recruited, 3015 were included in the analysis. The accelerated BMI z-score growth rate between 6 and 24 months was positively correlated with high TG and LDL-C levels, with sex, birthweight, and size for gestational age disparities. Obesity increased the risks of high TG level and the highest RC quartile in boys. Fat mass index and percentage of fat mass were linked with high UA level and dyslipidemia, particularly high TG and non-HDL-C levels, in boys. Fat-free mass index showed negative associations with high levels of TC and non-HDL-C in boys and high LDL-C level in girls (P < .05).
This study underscores the significant impact of BMI growth rates and body composition on cardiometabolic markers in 3-year-old children. The effects of BMI growth rates in specific periods varied by sex, birthweight, and size for gestational age, and boys exhibited a higher susceptibility to adverse outcomes.
研究学龄前儿童体重指数（BMI）增长率、身体成分与心脏代谢指标之间的关系。
招募三岁儿童进行这项队列研究。在入组时测量BMI和身体成分，并从病历中提取1个月至3岁期间的多次BMI测量值。在三岁时测量总胆固醇（TC）、甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇、非高密度脂蛋白胆固醇（non-HDL-C）、残余胆固醇（RC）、尿酸（UA）和空腹血糖水平。数据分析采用分段线性混合模型和逻辑回归模型。
在招募的3822名儿童中，3015名纳入分析。6至24个月期间BMI z评分的加速增长率与高TG和LDL-C水平呈正相关，与性别、出生体重和胎龄差异有关。肥胖增加了男孩高TG水平和最高RC四分位数的风险。脂肪质量指数和脂肪质量百分比与男孩的高UA水平和血脂异常有关，特别是高TG和非HDL-C水平。无脂肪质量指数与男孩的高TC和非HDL-C水平以及女孩的高LDL-C水平呈负相关（P < .05）。
本研究强调了BMI增长率和身体成分对三岁儿童心脏代谢指标的重大影响。特定时期BMI增长率的影响因性别、出生体重和胎龄而异，男孩对不良后果的易感性更高。
