Factors predicting severe childhood obesity in kindergarteners
Factors predicting severe childhood obesity in kindergarteners
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DOI：
10.1038/ijo.2012.168
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发表时间：
2013-01-01
影响因子：
4.9
通讯作者：
Lin, H.
中科院分区：
文献类型：
--
作者：
Flores, G.;Lin, H.
背景技术背景：自1976年以来，美国儿童严重肥胖症的发病率增加了300%以上，并且与多种心血管危险因素和高成人肥胖率有关。采用多变量logistic回归和递归分割分析（RPA），和幼儿期严重肥胖的预测因子（体重指数（BMI）>= 99百分位数），这是一项全国性的纵向研究，从出生到幼儿园跟踪儿童。对于6800名儿童，幼儿园严重肥胖患病率为5.7%，2岁时超过BMI第85百分位数的校正比值较高（比值比（OR），8.0; 95%置信区间（CI），4.1-15.7），学龄前（OR，7.9; 95% CI，4.9-12.8）和9个月龄（OR，1.8; 95% CI，1.2-2.6）;母亲重度肥胖（OR，3.4; 95% CI，1.9-5.8）和妊娠期糖尿病（OR，2.9; 95% CI，1.5-5.5）; 2岁时在两餐之间/睡前喝茶或咖啡（OR，3.3; 95% CI，1.3-8.5）;拉丁裔（OR，2.3; 95% CI，1.4-3.7）和多种族（OR，2.3; 95% CI，1.1-4.8）种族/民族;在幼儿园年龄至少每周喝一次含糖饮料（OR，2.3; 95% CI，1.4-3.7）。经常参加日托中心（OR，0.3; 95%CI，0.1-0.9），在幼儿园年龄至少每周吃水果（OR，0.3; 95%CI，0.1-0.7），以及母亲先前新生儿出生体重≥ 4000 g（OR，0.1; 95%CI，0.02-0.6）与严重肥胖的几率降低有关。RPA发现重度肥胖患病率较低（1.9%）为非第85 BMI百分位数的学龄前交叉者和高重度肥胖（56-80%）的预测集群，其中包括跨越第85 BMI百分位数在较早的年龄，低父母教育，具体的母亲年龄截止，学龄前睡前规则，和户外散步/玩频率为9个月大的孩子。某些父母、产前/妊娠、婴儿和幼儿期因素，无论是单独的还是组合的，都是肥胖者严重肥胖的有力预测因素。International Journal of Obesity（2013）37，31-39; doi：10.1038/ijo.2012.168; 2012年11月13日在线发表
BACKGROUND: Severe obesity has increased >300% in US children since 1976, and is associated with multiple cardiovascular risk factors and high adult obesity rates.OBJECTIVE: The objective of this study was to identify predictors of severe obesity in kindergarteners.METHODS: Multivariable logistic regression and recursive partitioning analysis (RPA) were used to identify prenatal/pregnancy, infant, and early childhood predictors of severe kindergarten obesity (body mass index (BMI) >= 99th percentile) in the Early Childhood Longitudinal Study Birth Cohort, a nationally representative longitudinal study that followed children from birth through kindergarten.RESULTS: For the 6800 children, the severe kindergarten obesity prevalence was 5.7%, with higher adjusted odds for crossing the 85th percentile of BMI at 2 years old (odds ratio (OR), 8.0; 95% confidence interval (CI), 4.1-15.7), preschool age (OR, 7.9; 95% CI, 4.9-12.8) and 9 months old (OR, 1.8; 95% CI, 1.2-2.6); maternal severe obesity (OR, 3.4; 95% CI, 1.9-5.8) and gestational diabetes (OR, 2.9; 95% CI, 1.5-5.5); drinking tea or coffee between meals/before bedtime at 2 years old (OR, 3.3; 95% CI, 1.3-8.5); Latino (OR, 2.3; 95% CI, 1.4-3.7) and multiracial (OR, 2.3; 95% CI, 1.1-4.8) race/ethnicity; and drinking sugary beverages at kindergarten age at least weekly (OR, 2.3; 95% CI, 1.4-3.7). Ever-attending center-based daycare (OR, 0.3; 95% CI, 0.1-0.9), eating fruit at least weekly at kindergarten age (OR, 0.3; 95% CI, 0.1-0.7), and maternal history of a prior newborn birth weight >= 4000 g (OR, 0.1; 95% CI, 0.02-0.6) were associated with reduced odds of severe obesity. RPA identified low severe obesity prevalence (1.9%) for non-85th BMI-percentile preschool crossers and high severe obesity (56-80%) for predictor clusters which included crossing the 85th BMI percentile at earlier ages, low parental education, specific maternal age cutoffs, preschooler bedtime rules, and outside walking/play frequency for 9-month-olds.CONCLUSIONS: Certain parental, prenatal/pregnancy, infant, and early childhood factors, both alone and in combination, are potent predictors of severe obesity in kindergarteners. International Journal of Obesity (2013) 37, 31-39; doi: 10.1038/ijo.2012.168; published online 13 November 2012