An observational cohort study of weight- and length-derived anthropometric indicators with body composition at birth and 5 mo: the Healthy Start study
An observational cohort study of weight- and length-derived anthropometric indicators with body composition at birth and 5 mo: the Healthy Start study
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DOI：
10.3945/ajcn.116.149617
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发表时间：
2017-08-01
影响因子：
7.1
通讯作者：
Dabelea, Dana
中科院分区：
文献类型：
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作者：
Perng, Wei;Ringham, Brandy M.;Dabelea, Dana
背景：尽管广泛使用基于体重和身长的人体测量指数作为肥胖的指标，但人们对它们与婴儿期脂肪量 (FM) 或去脂体重 (FFM) 的对应程度知之甚少。 目的：本研究旨在检查 3 个派生指标——年龄别体重 z 得分 (WFAZ)、身长体重体重 (WFLZ) 和体重指数 z 得分 (BMIZ)——与 FM、FM 百分比、设计：应用从科罗拉多州产前队列中的 1027 名婴儿前瞻性收集的数据，我们使用多元回归来评估导出指标与出生时和 5 个月时的身体成分以及随访期间变化 (D) 之间的关联。结果：出生时，所有 3 个导出指标与 FFM 的相关性比与 FM 的相关性更强。每个单位的WFAZ对应0.342 kg FFM（95% CI：0.331、0.351 kg FFM），与0.121 kg FM（95% CI：0.114、0.128 kg FM）相比（P < 0.0001）； WFLZ 和 BMIZ 也观察到类似的趋势。到 5 个月时，FLZ 和 BMIZ 与 FM 的相关性比与 FFM 的相关性更强，而 WFAZ 与身体成分的两个组成部分的相关性类似。达美 WFLZ 和达美 BMIZ 与达美 FM 的相关性均高于与达美 FFM 的相关性；然而，直接比较这 2 个指数与 FM 百分比变化的关系表明，Delta BMIZ 是肥胖增加的最佳指标（P < 0.0001，成对差异）。结论：基于体重和身长的指数不能很好地替代新生儿肥胖。然而，在 5 个月时，WFLZ 和 BMIZ 是 FM 的合适代表。在评估脂肪增加时，DBMIZ 是产后前 5 个月内脂肪累积的最佳指标。该试验已在临床试验中注册。政府编号为 NCT02273297。
Background: Despite widespread use of weight-and length-based anthropometric indexes as proxies for adiposity, little is known regarding the extent to which they correspond with fat mass (FM) or fat-free mass (FFM) during infancy.Objective: This study aimed to examine associations of 3 derived indicators-weight-for-age z score (WFAZ), weight-for-length score (WFLZ), and body mass index z score (BMIZ)-with FM, percentage of FM, and FFM measured by air-displacement plethysmography during the first 5 mo of life.Design: Applying prospectively collected data from 1027 infants in a Colorado prebirth cohort, we used multivariate regression to evaluate associations between the derived indicators and body composition at birth and at 5 mo, and with change (D) during follow-up.Results: At birth, all 3 derived indicators were more strongly associated with FFM than with FM. Each unit of WFAZ corresponded with 0.342 kg FFM (95% CI: 0.331, 0.351 kg FFM), compared with 0.121 kg FM (95% CI: 0.114, 0.128 kg FM)(P < 0.0001); similar trends were observed for WFLZ and BMIZ. By 5 mo, FLZ and BMIZ were more strongly associated with FM than with FFM, whereas WFAZ correlated similarly with the 2 components of body composition. Delta WFLZ and Delta BMIZ were both more strongly related to Delta FM than to Delta FFM; however, a direct comparison of the 2 indexes with respect to change in the percentage of FM indicated that Delta BMIZ was the optimal proxy of adiposity gain (P < 0.0001, pairwise difference).Conclusions: Weight-and length-based indexes are poor surrogates for newborn adiposity. However, at 5 mo, WFLZ and BMIZ are suitable proxies of FM. When assessing adiposity gain, DBMIZ is the best indicator of fat accrual during the first 5 postnatal months. This trial was registered at clinicaltrials. gov as NCT02273297.