Risk Factors for Obesity: Further Evidence for Stronger Effects on Overweight Children and Adolescents Compared to Normal-Weight Subjects
Risk Factors for Obesity: Further Evidence for Stronger Effects on Overweight Children and Adolescents Compared to Normal-Weight Subjects
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DOI：
10.1371/journal.pone.0015739
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发表时间：
2011-01-20
期刊：
影响因子：
3.7
通讯作者：
von Kries, Ruediger
中科院分区：
文献类型：
--
作者：
Beyerlein, Andreas;Toschke, Andre M.;von Kries, Ruediger
背景：我们最近发现，在学龄前儿童中，超重的危险因素与 BMI 值较高的儿童的 BMI 存在更强的相关性。然而，尚不清楚这些发现是否也适用于青少年。 方法：我们从 2003 年至 2006 年间进行的德国代表性横断面健康调查 (KiGGS) 中提取了 3-10 岁 (n = 7,237) 和 11-17 岁 (n = 5,986) 儿童的数据，并计算了每个年龄组的分位数回归模型。我们使用儿童体重指数（BMI）的 z 分数作为结果变量，母亲 BMI、母亲怀孕期间吸烟、父母社会经济地位低、纯配方奶喂养和电视观看时间长作为解释变量。 结果：在两个年龄组中，除配方奶喂养外的所有危险因素对 BMI z 分数的估计影响对于 BMI z 分数最高的儿童最大。例如，观看电视时间较长的 11-17 岁儿童的 BMI z 得分中位数比观看电视时间较少的青少年儿童的 BMI z 得分中位数高 0.11 [95% CI：0.03，0.19] 个单位。该风险因素与 BMI z 分数第 90 个百分位处的平均差异 0.18 [0.06, 0.30] 个单位和第 97 个百分位处的 0.20 [0.07, 0.33] 个单位的平均差异相关。 结论：我们证实，儿童超重的风险因素与儿童 BMI 分布上部的变化大于中部和下部的变化相关。这些发现也适用于青少年，可能有助于解释儿童和青少年体重指数较高百分位数的长期变化。
Background: We recently showed that in preschoolers risk factors for overweight show stronger associations with BMI in children with high BMI values. However, it is unclear whether these findings might also pertain to adolescents.Methods: We extracted data on 3-10 year-old (n = 7,237) and 11-17 year-old (n = 5,986) children from a representative cross-sectional German health survey (KiGGS) conducted between 2003 and 2006 and calculated quantile regression models for each age group. We used z-scores of children's body mass index (BMI) as outcome variable and maternal BMI, maternal smoking in pregnancy, low parental socioeconomic status, exclusive formula-feeding and high TV viewing time as explanatory variables.Results: In both age groups, the estimated effects of all risk factors except formula-feeding on BMI z-score were greatest for children with the highest BMI z-score. The median BMI z-score of 11-17 year-old children with high TV viewing time, for example, was 0.11 [95% CI: 0.03, 0.19] units higher than the median BMI z-score of teenage children with low TV viewing time. This risk factor was associated with an average difference of 0.18 [0.06, 0.30] units at the 90(th) percentile of BMI z-score and of 0.20 [0.07, 0.33] units at the 97(th) percentile.Conclusions: We confirmed that risk factors for childhood overweight are associated with greater shifts in the upper parts of the children's BMI distribution than in the middle and lower parts. These findings pertain also to teenagers and might possibly help to explain the secular shift in the upper BMI percentiles in children and adolescents.