Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies.
Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies.
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DOI：
10.1016/s0140-6736(13)60103-8
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发表时间：
2013-08-10
期刊：
影响因子：
168.9
通讯作者：
Victora, Cesar G.
中科院分区：
文献类型：
--
作者：
Adair, Linda S.;Fall, Caroline H. D.;Osmond, Clive;Stein, Aryeh D.;Martorell, Reynaldo;Ramirez-Zea, Manuel;Sachdev, Harshpal Singh;Dahly, Darren L.;Bas, Isabelita;Norris, Shane A.;Micklesfield, Lisa;Hallal, Pedro;Victora, Cesar G.
低收入和中等收入国家儿童体重快速增加和线性增长与生存率提高和认知发育改善有关，但可能增加肥胖和相关成人心脏代谢疾病的风险。我们调查了婴儿期和儿童期的线性增长和相对体重增加与年轻人的健康和人力资本结果之间的关系。我们使用了来自巴西、危地马拉、印度、菲律宾和南非的五项前瞻性出生队列研究的数据。我们调查了年轻人的体重指数、收缩压和舒张压、血糖浓度、身高、受教育年限以及不良结局的相关分类指标。通过线性和逻辑回归模型，我们评估了这些结果与出生体重的关系，以及在三个年龄段（0-2岁，2岁至儿童中期，以及儿童中期至成年）中代表线性生长和体重增加的统计学独立指标。我们获得了8362名参与者的数据，这些参与者至少有一个成人结局。较高的出生体重与成人体重指数大于25 kg/m2（比值比1.28，95%CI 1.21 - 1.35）、成人身材矮小（0.49，0.44 - 0.54）和未完成中学学业（0.82，0.78 - 0.87）的可能性降低相关。更快的线性生长与成人身材矮小的风险降低密切相关（2岁：0·23、0·20-0·52;童年中期：0·39、0·36-0·43）和未完成中学教育（2岁：0·74，0·67-0·78;儿童中期：0·87，0·83-0·92），但确实增加了超重的可能性（2岁：1·24，1·17-1·31;儿童中期：1·12，1·06-1·18）和血压升高（2岁：1·12，1·06-1·19;儿童中期：1·07，1·01-1·13）。相对体重增加较快与成人超重（2岁：1.51，1.43 - 1.60;儿童中期：1.76，1.69 - 1.91）和血压升高（2岁：1.07，1.01 - 1.13;儿童中期：1.22，1.15 - 1.30）的风险增加相关。线性生长和相对体重增加与代谢异常无关，但出生体重较高与该疾病风险降低相关（0.89，0.81 - 0.98）。在低收入和中等收入国家采取干预措施，增加出生体重，并在出生后头两年实现线性增长，这可能会使身高和受教育程度大幅提高，并在一定程度上保护儿童免受成人慢性病风险因素的影响，而不会产生不利的权衡。Wellcome Trust和Bill & Melinda Gates Foundation。
Fast weight gain and linear growth in children in low-income and middle-income countries are associated with enhanced survival and improved cognitive development, but might increase risk of obesity and related adult cardiometabolic diseases. We investigated how linear growth and relative weight gain during infancy and childhood are related to health and human capital outcomes in young adults. We used data from five prospective birth cohort studies from Brazil, Guatemala, India, the Philippines, and South Africa. We investigated body-mass index, systolic and diastolic blood pressure, plasma glucose concentration, height, years of attained schooling, and related categorical indicators of adverse outcomes in young adults. With linear and logistic regression models, we assessed how these outcomes relate to birthweight and to statistically independent measures representing linear growth and weight gain independent of linear growth (relative weight gain) in three age periods: 0–2 years, 2 years to mid-childhood, and mid-childhood to adulthood. We obtained data for 8362 participants who had at least one adult outcome of interest. A higher birthweight was consistently associated with an adult body-mass index of greater than 25 kg/m2 (odds ratio 1·28, 95% CI 1·21–1·35) and a reduced likelihood of short adult stature (0·49, 0·44–0·54) and of not completing secondary school (0·82, 0·78–0·87). Faster linear growth was strongly associated with a reduced risk of short adult stature (age 2 years: 0·23, 0·20–0·52; mid-childhood: 0·39, 0·36–0·43) and of not completing secondary school (age 2 years: 0·74, 0·67–0·78; mid-childhood: 0·87, 0·83–0·92), but did raise the likelihood of overweight (age 2 years: 1·24, 1·17–1·31; mid-childhood: 1·12, 1·06–1·18) and elevated blood pressure (age 2 years: 1·12, 1·06–1·19; mid-childhood: 1·07, 1·01–1·13). Faster relative weight gain was associated with an increased risk of adult overweight (age 2 years: 1·51, 1·43–1·60; mid-childhood: 1·76, 1·69–1·91) and elevated blood pressure (age 2 years: 1·07, 1·01–1·13; mid-childhood: 1·22, 1·15–1·30). Linear growth and relative weight gain were not associated with dysglycaemia, but a higher birthweight was associated with decreased risk of the disorder (0·89, 0·81–0·98). Interventions in countries of low and middle income to increase birthweight and linear growth during the first 2 years of life are likely to result in substantial gains in height and schooling and give some protection from adult chronic disease risk factors, with few adverse trade-offs. Wellcome Trust and Bill & Melinda Gates Foundation.