Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors
Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors
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DOI：
10.1056/nejmoa1010112
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发表时间：
2011-11-17
影响因子：
158.5
通讯作者：
Raitakari, Olli T.
中科院分区：
文献类型：
--
作者：
Juonala, Markus;Magnussen, Costan G.;Raitakari, Olli T.
背景儿童期肥胖与心血管风险增加有关。对于儿童时超重或肥胖但成人后不肥胖的人来说，这种风险是否会减弱尚不确定。 方法我们分析了四项前瞻性队列研究的数据，这些研究测量了儿童和成人的体重指数（BMI，以公斤为单位的体重除以以米为单位的身高的平方）。平均随访时间为 23 年。为了定义高肥胖状态，儿童使用国际年龄特定和性别特定的 BMI 临界点来衡量超重和肥胖，成人使用 BMI 临界点 30。 结果 数据适用于 6328 名受试者。与儿童时期体重指数正常且成年后不肥胖的人相比，从儿童期到成年期始终处于高肥胖状态的受试者患 2 型糖尿病（相对风险，5.4；95% 置信区间 [CI]，3.4 至 8.5）、高血压（相对风险，2.7；95% CI，2.2 至 3.3）、低密度脂蛋白胆固醇水平升高（相对风险，5.4；95% 置信区间 [CI]，3.4 至 8.5）的风险增加。风险，1.8；95% CI，1.4 至 2.3）、高密度脂蛋白胆固醇水平降低（相对风险，2.1；95% CI，1.8 至 2.5）、甘油三酯水平升高（相对风险，3.0；95% CI，2.4 至 3.8）和颈动脉粥样硬化（内膜中层厚度增加）颈动脉）（相对风险，1.7；95% CI，1.4 至 2.2）（所有比较 P <0.20）。结论 超重或肥胖儿童成年后肥胖，患 2 型糖尿病、高血压、血脂异常和颈动脉粥样硬化的风险增加。成年后不再肥胖的超重或肥胖儿童出现这些结果的风险与从未肥胖的人相似。 （由芬兰科学院等资助。）
BACKGROUNDObesity in childhood is associated with increased cardiovascular risk. It is uncertain whether this risk is attenuated in persons who are overweight or obese as children but not obese as adults.METHODSWe analyzed data from four prospective cohort studies that measured childhood and adult body-mass index (BMI, the weight in kilograms divided by the square of the height in meters). The mean length of follow-up was 23 years. To define high adiposity status, international age-specific and sex-specific BMI cutoff points for overweight and obesity were used for children, and a BMI cutoff point of 30 was used for adults.RESULTSData were available for 6328 subjects. Subjects with consistently high adiposity status from childhood to adulthood, as compared with persons who had a normal BMI as children and were nonobese as adults, had an increased risk of type 2 diabetes (relative risk, 5.4; 95% confidence interval [CI], 3.4 to 8.5), hypertension (relative risk, 2.7; 95% CI, 2.2 to 3.3), elevated low-density lipoprotein cholesterol levels (relative risk, 1.8; 95% CI, 1.4 to 2.3), reduced high-density lipoprotein cholesterol levels (relative risk, 2.1; 95% CI, 1.8 to 2.5), elevated triglyceride levels (relative risk, 3.0; 95% CI, 2.4 to 3.8), and carotid-artery atherosclerosis (increased intima-media thickness of the carotid artery) (relative risk, 1.7; 95% CI, 1.4 to 2.2) (P 0.20 for all comparisons).CONCLUSIONSOverweight or obese children who were obese as adults had increased risks of type 2 diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis. The risks of these outcomes among overweight or obese children who became nonobese by adulthood were similar to those among persons who were never obese. (Funded by the Academy of Finland and others.)