The utility of childhood and adolescent obesity assessment in relation to adult health.
The utility of childhood and adolescent obesity assessment in relation to adult health.
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DOI：
10.1177/0272989x12447240
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发表时间：
2013-02
期刊：
影响因子：
--
通讯作者：
Wise PH
中科院分区：
文献类型：
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作者：
Goldhaber-Fiebert JD;Rubinfeld RE;Bhattacharya J;Robinson TN;Wise PH
儿童肥胖症的高流行率引起了人们对成人健康的长期模式的关注，并引发了对幼儿进行肥胖症筛查的呼吁。这项研究考察了肥胖的模式和不同年龄段儿童肥胖筛查在成人健康结果方面的预测效用。利用全国青年纵向调查、收入动态人口研究和国家健康和营养评估调查，我们估计了儿童BMI对识别2、5、10或15岁成年后肥胖的敏感性、特异性和预测值。我们构建了按性别和种族/民族分层的模型，评估儿童BMI与中年肥胖相关疾病的关系。在18岁的青少年中，有12%的人肥胖。虽然这些青少年中有50%在5岁时无法通过筛查发现，但9%在15岁时就会被漏掉。大约70%的5岁肥胖儿童在18岁时变得不肥胖。10岁以下肥胖筛查的预测效用很低，即使包括母亲肥胖在内。15岁时肥胖预测的中年患糖尿病、肥胖和高血压的风险显著高于5岁时(例如，15岁肥胖白人男性患糖尿病的相对危险度为4.5；5岁时为1.6)。儿童早期肥胖评估为也包括儿童后期评估的战略增加了有限的预测效用。应该考虑儿童后期的有针对性的方法或防止不健康体重增加的普遍战略。
The high prevalence of childhood obesity has raised concerns regarding long-term patterns of adult health and has generated calls for obesity screening of young children. This study examined patterns of obesity and the predictive utility of obesity screening for children of different ages in terms of adult health outcomes. Using the National Longitudinal Survey of Youth, the Population Study of Income Dynamics, and National Health and Nutrition Evaluation Surveys, we estimated the sensitivity, specificity and predictive value of childhood BMI to identify 2, 5, 10, or 15 year-olds who will become obese adults. We constructed models assessing the relationship of childhood BMI to obesity-related diseases through middle age stratified by sex and race/ethnicity. 12% of 18 year-olds were obese. While 50% of these adolescents would not have been identified by screening at age 5, 9% would have been missed at age 15. Approximately 70% of obese children at age 5 became non-obese at age 18. The predictive utility of obesity screening below the age of 10 was low, even when maternal obesity was also included. The elevated risk of diabetes, obesity, and hypertension in middle age predicted by obesity at age 15 was significantly higher than at age 5 (e.g., the RR of diabetes for obese white male 15 year-olds was 4.5; for 5 year-olds, it was 1.6). Early childhood obesity assessment adds limited predictive utility to strategies that also include later childhood assessment. Targeted approaches in later childhood or universal strategies to prevent unhealthy weight gain should be considered.