The Terneuzen birth cohort: BMI changes between 2 and 6 years correlate strongest with adult overweight.
The Terneuzen birth cohort: BMI changes between 2 and 6 years correlate strongest with adult overweight.
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DOI：
10.1371/journal.pone.0009155
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发表时间：
2010-02-11
期刊：
影响因子：
3.7
通讯作者：
Hirasing RA
中科院分区：
文献类型：
--
作者：
De Kroon ML;Renders CM;Van Wouwe JP;Van Buuren S;Hirasing RA
超重的并发症随着年龄的增长而加剧，不可逆转的损害已经存在于年轻人中。确定成人超重最敏感的年龄段与一级预防有关。该研究的目的是评估0至18岁之间体重指数（BMI）变化对成人超重的相对贡献，并确定最早的关键生长期。使用了来自泰尔诺伊岑出生队列中762例受试者的数据，每例受试者从出生至18岁平均有21次生长测量。主要的结果测量是年轻成年时的BMI标准差评分（SDS）。对于每个受试者，BMI SDS在8个不同年龄段通过分段线性模型拟合，并与成人BMI SDS相关。根据三个标准，之间的年龄间隔被认为是关键的，分别通过Students t检验、多元线性回归分析和Pearson相关性检验进行测试。在4个月~ 1岁、2-6岁、6-10岁和10-18岁年龄段，超重和非超重成人的BMI SDS变化存在差异（P≤0.001）。2-6岁和10-18岁的年龄间隔也符合第二个标准，这意味着除了在该阶段结束时的BMI SDS外，该阶段期间的BMI变化对成人BMI SDS具有预测价值。估计的BMI SDS和测量的成人BMI SDS之间的相关性的最大上升发生在2-6岁期间（从0.36到0.63），这导致6岁时的高灵敏度（0.6）和特异性（0.8）。2 ~ 6岁年龄段是成年人超重的最早和最关键的生长期。因此，成人超重的一级预防似乎最有可能是成功的，如果针对这个特定的年龄段。通过识别那些在2到6岁之间具有向上百分位数交叉的人，可能会逆转成人超重的发展。
Complications of overweight amplify with age, and irreversible damage already exists in young persons. Identifying the most sensitive age interval(s) for adult overweight is relevant for primary prevention. The aim of the study was to assess the relative contribution of body mass index (BMI) changes between 0 and 18 years to adult overweight, and to identify the earliest critical growth period. Data from 762 subjects in the Terneuzen Birth Cohort with an average of 21 growth measurements per subject from birth until 18 years were used. The main outcome measure was the BMI standard deviation score (SDS) at young adulthood. For each subject BMI SDS was fitted by a piecewise linear model at eight different ages and correlated to adult BMI SDS. The age intervals in between are considered critical according to three criteria, tested by respectively Students' t-tests, multiple linear regression analyses and Pearson's correlation tests. In the age intervals 4 months(m) -1 year(y), 2–6 y, 6–10 y and 10–18 y the BMI SDS change differs between adults with and without overweight (P≤0.001). The age intervals 2–6 y and 10–18 y also meet the second criterion, implying that the BMI change during this period has a predictive value for adult BMI SDS in addition to BMI SDS at the end of the period. The largest rise in correlation between estimated BMI SDS and measured adult BMI SDS occurs during the period 2–6 y (from 0.36 to 0.63), which results in a high sensitivity (0.6) and specificity (0.8) by the age of 6 y. The age interval from 2 y to 6 y is the earliest and most critical growth period for adult overweight. Therefore, primary prevention of adult overweight seems most likely to be successful if targeted at this specific age interval. By identifying those with an upwards centile crossing between 2 and 6 years, the development towards adult overweight might be reversed.
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