Whitaker R C, Wright J A, Pepe M S, Seidel K D, Dietz W H
Department of Pediatrics, Children's Hospital Medical Center and the University of Cincinnati College of Medicine, OH 45229-3039, USA.
N Engl J Med. 1997 Sep 25;337(13):869-73. doi: 10.1056/NEJM199709253371301.
Childhood obesity increases the risk of obesity in adulthood, but how parental obesity affects the chances of a child's becoming an obese adult is unknown. We investigated the risk of obesity in young adulthood associated with both obesity in childhood and obesity in one or both parents.
Height and weight measurements were abstracted from the records of 854 subjects born at a health maintenance organization in Washington State between 1965 and 1971. Their parents' medical records were also reviewed. Childhood obesity was defined as a body-mass index at or above the 85th percentile for age and sex, and obesity in adulthood as a mean body-mass index at or above 27.8 for men and 27.3 for women.
In young adulthood (defined as 21 to 29 years of age), 135 subjects (16 percent) were obese. Among those who were obese during childhood, the chance of obesity in adulthood ranged from 8 percent for 1- or 2-year-olds without obese parents to 79 percent for 10-to-14-year-olds with at least one obese parent. After adjustment for parental obesity, the odds ratios for obesity in adulthood associated with childhood obesity ranged from 1.3 (95 percent confidence interval, 0.6 to 3.0) for obesity at 1 or 2 years of age to 17.5 (7.7 to 39.5) for obesity at 15 to 17 years of age. After adjustment for the child's obesity status, the odds ratios for obesity in adulthood associated with having one obese parent ranged from 2.2 (95 percent confidence interval, 1.1 to 4.3) at 15 to 17 years of age to 3.2 (1.8 to 5.7) at 1 or 2 years of age.
Obese children under three years of age without obese parents are at low risk for obesity in adulthood, but among older children, obesity is an increasingly important predictor of adult obesity, regardless of whether the parents are obese. Parental obesity more than doubles the risk of adult obesity among both obese and nonobese children under 10 years of age.
儿童肥胖会增加成年后肥胖的风险，但父母肥胖如何影响孩子成年后肥胖的几率尚不清楚。我们调查了儿童期肥胖以及父母一方或双方肥胖与青年期肥胖风险之间的关系。
从华盛顿州一家健康维护组织1965年至1971年间出生的854名受试者的记录中提取身高和体重测量数据。他们父母的病历也进行了查阅。儿童肥胖定义为年龄和性别的体重指数处于或高于第85百分位数，成年肥胖定义为男性平均体重指数在27.8及以上，女性在27.3及以上。
在青年期（定义为21至29岁），135名受试者（16%）肥胖。在儿童期肥胖的人群中，成年后肥胖的几率从父母不肥胖的1至2岁儿童的8%到至少有一位肥胖父母的10至14岁儿童的79%不等。在对父母肥胖进行校正后，与儿童期肥胖相关的成年后肥胖的比值比范围为1岁或2岁时肥胖的1.3（95%置信区间，0.6至3.0）到15至17岁时肥胖的17.5（7.7至39.5）。在对儿童的肥胖状况进行校正后，与有一位肥胖父母相关的成年后肥胖的比值比范围为15至17岁时的2.2（95%置信区间，1.1至4.3）到1岁或2岁时的3.2（1.8至5.7）。
父母不肥胖的3岁以下肥胖儿童成年后肥胖风险较低，但在年龄较大的儿童中，无论父母是否肥胖，肥胖都是成年肥胖越来越重要的预测因素。父母肥胖使10岁以下肥胖和非肥胖儿童成年后肥胖的风险增加一倍以上。
