Birth weight, infant growth, and childhood body mass index
Birth weight, infant growth, and childhood body mass index
复制标题
DOI：
10.1001/archpediatrics.2007.62
复制
发表时间：
2008-03-01
影响因子：
--
通讯作者：
Leung, Gabriel M.
中科院分区：
文献类型：
--
作者：
Hui, L. L.;Schooling, C. Mary;Leung, Gabriel M.
目的：研究具有近期和快速经济发展历史的中国人群中出生体重、婴儿生长速度和儿童肥胖之间的关系，并以此作为成人代谢或心血管风险的指标。设计：一项具有人口代表性的出生队列前瞻性研究。背景：香港华人。参与者：六千七十五名足月新生儿（77.5%成功随访）。主要暴露：0 - 3岁和3 - 12个月的出生体重和生长率（体重z评分变化）。主要观察指标：7岁左右体重指数（BMI）（以体重（公斤）除以身高（米）的平方计算）z分数。结果：0 ~ 3月龄和3 ~ 12月龄体重z评分每增加一个单位，BMI z评分分别增加0.52和0.33。出生体重和生长速度最高的年龄组的儿童BMI z得分最高。在最低出生体重分值中，0 ~ 3月龄体重z评分的增加对男孩BMI z评分的影响（平均差异为0.88,95%可信区间为0.69 ~ 1.07）大于女孩（平均差异为0.52,95%可信区间为0.33 ~ 0.71）；出生体重、0 ~ 3月龄生长率和性别差异有统计学意义（P= 0.007）。结论：在近期经济快速增长和出生体重相对较低的人群中，较快的产前和产后生长与较高的儿童BMI相关，这表明最大生长可能不是代谢风险的最佳选择。然而，在代谢风险和其他结果之间可能存在发育上的权衡。
Objective: To investigate the association between birth weight, infant growth rate, and childhood adiposity as a proxy for adult metabolic or cardiovascular risk in a Chinese population with a history of recent and rapid economic development.Design: Prospective study in a population-representative birth cohort.Setting: Hong Kong Chinese population.Participants: Six thousand seventy-five term births (77.5% successful follow-up).Main Exposures: Birth weight and growth rate (change in the weight z score) at ages 0 to 3 and 3 to 12 months.Main Outcome Measure: Body mass index (BMI) (calculated as the weight in kilograms divided by the height in meters squared) z score at about age 7 years.Results: Each unit increase in the weight z score at ages 0 to 3 and 3 to 12 months increased the BMI z score by 0.52 and 0.33, respectively. Children in the highest birth weight and growth rate tertiles had the highest BMI z scores. In the lowest birth weight tertile, increases in the weight z score at ages 0 to 3 months had a larger effect on the BMI z score in boys (mean difference, 0.88; 95% confidence interval 0.69-1.07) than in girls (mean difference, 0.52; 95% confidence interval, 0.33-0.71); these differences by birth weight, growth rate at ages 0 to 3 months, and sex were significant (P= .007).Conclusions: Faster prenatal and postnatal growth were associated with higher childhood BMI in a population with a recent history of rapid economic growth and relatively low birth weight, suggesting that maximal growth may not be optimal for metabolic risk. However, there may be a developmental trade-off between metabolic risk and other outcomes.