Obesity status trajectory groups among elementary school children.
Obesity status trajectory groups among elementary school children.
复制标题
小学生肥胖状态轨迹群体。
DOI：
10.1186/s12889-016-3159-x
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发表时间：
2016-07-07
影响因子：
4.5
通讯作者：
Johnston CA
中科院分区：
文献类型：
--
作者：
Chen TA;Baranowski T;Moreno JP;O'Connor TM;Hughes SO;Baranowski J;Woehler D;Kimbro RT;Johnston CA
在小学阶段，人们对从健康体重到超重或肥胖的转变模式知之甚少。摘要本研究旨在探讨小学生身体质量指数（BMI）是否存在明显的轨迹组，以及轨迹组成员的预测因子。这是对1651名小学生的二次分析，有从幼儿园到五年级开始的完整的两年一次的纵向数据。身高和体重由训练有素的学校护士在每学年开始和结束时使用标准程序进行连续11次评估。进行了基于群的轨迹聚类和多项logit建模。当使用BMIz评分时，确定了六个轨迹组，揭示了BMIz评分在时间上的实质性一致性。当使用分类变量将超重/肥胖儿童（BMI≥85%）与其他儿童分开时，确定了五种发育轨迹（持续非超重/肥胖体重：51.1%；早发性超重/肥胖：9.2%；晚发性超重/肥胖：9.7%；变为健康体重：8.2%；慢性超重/肥胖：21.8%）。当使用分类变量将肥胖儿童（BMI≥95%）与其他儿童分开时，确定了三种轨迹（持续不肥胖：74.1%，变肥胖：12.8%，慢性肥胖：13.2%）。对于两个临界值（BMI百分位数≥85%或95%），女孩比男孩更有可能被归类为持续非超重和/或肥胖组（比值比（or）范围为0.53至0.67）；西班牙裔儿童和非西班牙裔黑人儿童比非西班牙裔白人儿童更容易长期超重和/或肥胖（or范围从1.57到2.44）。当BMI百分位数≥95%时，西班牙裔儿童也比非西班牙裔白人儿童更容易肥胖（OR: 1.84）。男孩、西班牙裔和非西班牙裔黑人儿童在整个小学阶段超重或肥胖的风险更高，这支持了肥胖治疗的必要性。幼儿园毕业后和二年级毕业后的夏季是一些孩子过渡到超重/肥胖的时期。确定哪些行为因素（如饮食、身体活动、久坐行为和/或睡眠）易使儿童变得超重/肥胖，以及这些因素是否因时间（幼儿园与二年级）而异，将是很重要的。如果行为诱发因素能够及早发现，就应该提供有针对性的肥胖预防。
Little is known about patterns in the transition from healthy weight to overweight or obesity during the elementary school years. This study examined whether there were distinct body mass index (BMI) trajectory groups among elementary school children, and predictors of trajectory group membership. This is a secondary analysis of 1651 elementary school children with complete biannual longitudinal data from kindergarten to the beginning of 5th grade. Heights and weights were measured by trained school nurses using standard procedures at the beginning and end of each school year for 11 consecutive assessments. Group-based trajectory clustering and multinomial logit modeling were conducted. When using BMIz score, six trajectory groups were identified revealing substantial consistency in BMIz score across time. When using a categorical variable separating overweight/obese children (BMI ≥ 85%ile) from the rest, five developmental trajectories (persistently non-overweight/obese weight: 51.1 %; early-onset overweight/obese: 9.2 %; late-onset overweight/obese: 9.7 %; becoming healthy weight: 8.2 %; and chronically overweight/obese: 21.8 %) were identified. When using a categorical variable separating obese children (BMI ≥ 95%ile) from the rest, three trajectories (persistently non-obese: 74.1 %, becoming obese: 12.8 %; and chronically obese: 13.2 %) were identified. For both cutoffs (≥ BMI percentile 85 % or 95 %), girls were more likely than boys to be classified in the persistently non-overweight and/or obese group (odds ratios (OR) ranged from 0.53 to 0.67); and Hispanic children and non-Hispanic Black children were more likely to be chronically overweight and/or obese than non-Hispanic White children (OR ranged from 1.57 to 2.44). Hispanic children were also more likely to become obese (OR: 1.84) than non-Hispanic White children when ≥ BMI percentile 95 % was used. Boys, Hispanic and non-Hispanic Black children were at higher risk of being overweight or obese throughout their elementary school years, supporting the need for obesity treatment. Post kindergarten and post second grade summer months were times when some children transitioned into overweight/obesity. It will be important to identify which behavioral factors (e.g., diet, physical activity, sedentary behaviors, and/or sleep) predisposed children to becoming overweight/obese, and whether these factors differ by time (Kindergarten versus second grade). If behavioral predisposing factors could be identified early, targeted obesity prevention should be offered.