Earlier mother's age at menarche predicts rapid infancy growth and childhood obesity.
Earlier mother's age at menarche predicts rapid infancy growth and childhood obesity.
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DOI：
10.1371/journal.pmed.0040132
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发表时间：
2007-04
期刊：
影响因子：
15.8
通讯作者：
Dunger DB
中科院分区：
文献类型：
--
作者：
Ong KK;Northstone K;Wells JC;Rubin C;Ness AR;Golding J;Dunger DB
初潮早期往往会导致婴儿期体重快速增加，并与儿童和成人肥胖风险增加相关。由于初潮年龄是一种遗传特征，我们假设母亲的初潮年龄可能反过来预测孩子的早期生长和肥胖风险。我们测试了来自英国基于人口的雅芳父母和儿童纵向研究 (ALSPAC) 出生队列的 6,009 名儿童的初潮年龄、母亲的成年体型和肥胖风险以及孩子的生长和肥胖风险之间的关联，这些儿童在 9 岁时通过双能 X 射线吸收测定法测量了生长和脂肪量。 914 名儿童组成的亚组还拥有详细的婴儿期和儿童期生长数据。在母亲中，初潮提前与成年身高较短（0.64 厘米/年）、体重增加（0.92 千克/年）和体重指数（BMI，0.51 千克/平方米/年；所有 p < 0.001）相关。相比之下，母亲初潮较早的孩子在 9 岁时身高会更高（0.41 厘米/年），体重也会更高（0.80 千克/年）、BMI（0.29 千克/平方米/年）和脂肪质量指数（0.22 千克/平方米/年；所有 p < 0.001）。母亲初潮最早五分位数（≤11 岁）的儿童比最年长五分位数（≥15 岁）的儿童更肥胖（OR，2.15，95% CI 1.46 至 3.17；p < 0.001，根据母亲的教育程度和 BMI 进行调整）。在该亚组中，最早五分位的儿童仅从出生到 2 岁体重 (p < 0.001) 和身高 (p < 0.001) 增长较快，但从 2 岁到 9 岁则没有 (p = 0.3–0.8)。初潮年龄较早可能是生长速度较快的跨代标志，其特征是体重快速增加和生长，特别是在婴儿期，并导致儿童期身材较高，但可能成熟较早，因此成年身材较短。这种生长模式导致儿童和成人肥胖风险增加。初潮年龄较早可能是生长较快的跨代标志，尤其是在婴儿期，导致儿童期身材较高，但成熟较早，因此成年后身材较短。儿童肥胖是一个迅速增长的问题。二十五年前，超重的儿童很少见。现在，世界上有 1.55 亿儿童超重，30-4500 万儿童肥胖。超重和肥胖儿童——那些体重指数（BMI；体重除以身高平方）高于其年龄和性别的平均水平的儿童——成为肥胖成年人的风险增加。这些人比瘦人更容易患心脏病、糖尿病和其他健康问题。儿童体型的不断增大与许多因素有关。例如，父母肥胖会使孩子容易超重。部分原因是父母影响后代的饮食习惯和运动量。此外，孩子还从父母那里继承了遗传因素，这使得他们更容易发胖。为了预防儿童肥胖，医疗保健专业人员需要有方法来预测哪些婴儿可能会肥胖，以便为父母提供控制孩子体重的建议。对于女孩来说，初潮提前（月经开始）与儿童和成人肥胖的风险增加有关，并且往往会在生命的头两年内体重快速增加。由于初潮年龄是遗传性的，本研究中的研究人员利用雅芳父母与儿童纵向研究 (ALSPAC) 的数据，调查了母亲初潮年龄是否预示着其后代婴儿期和儿童期肥胖症的快速增长。 1991年至1992年间，这项研究招募了近14,000名出生在英国布里斯托尔的儿童。从那时起，这些孩子们就定期接受检查，以调查他们的环境和遗传遗传如何相互作用影响他们的健康。研究人员测量了 6,009 名来自 ASPAC 的 9 岁儿童的生长和脂肪量。研究人员获得了其中 914 名儿童婴儿期和幼儿期成长的详细数据。然后，他们寻找母亲初潮年龄（怀孕期间回忆的年龄）、母亲成年体型以及孩子的生长和肥胖风险之间的关联。对于母亲来说，初潮提前与成年身高较短、体重和体重指数增加有关。在孩子中，初潮较早的母亲比初潮较晚的孩子更高、更重。他们的体重指数也较高，体脂也较高。母亲在 11 岁之前第一次来月经的孩子肥胖的可能性是母亲在 15 岁或以上才来月经的孩子的两倍。最后，对于有详细早期生长数据的孩子，那些初潮最早的母亲的孩子在出生后的头两年（但接下来的七年）体重和身高增长得比初潮最晚的母亲的孩子更快。这些发现表明，母亲初潮较早预示着后代的生长速度（个体达到成年身高的速度）更快，其特点是婴儿期体重和身高快速增加。这种更快的生长速度会导致儿童身高更高、性成熟更早，并且由于青春期年龄决定成年身高，因此成年身高会更矮。研究人员写道，像这样的遗传性生长模式会增加儿童和成人肥胖的风险。与所有寻找不同测量值之间关联的研究一样，这些发现将受到测量准确性的影响，例如，母亲对初潮年龄的回忆程度。此外，由于青春期，尤其是女孩的青春期，与身体脂肪的增加有关，九岁时的高体重指数可能表明青春期即将到来，而不是长期肥胖的风险——进一步的后续研究将澄清这一点。尽管如此，目前的研究结果提供了一个新因素——母亲初潮较早——可以帮助医疗保健专业人员确定哪些婴儿需要早期生长监测，以避免日后肥胖。请通过此摘要的在线版本访问这些网站：http://dx.doi.org/10.1371/journal.pmed.0040132。雅芳家长和儿童纵向研究描述了该研究和迄今为止的结果 美国疾病控制与预防中心提供了有关超重和肥胖的信息（英语和西班牙语） 美国卫生与公众服务部的计划 Smallstep Kids 是一个为儿童提供有关健康饮食的互动网站（英语和西班牙语） 国际肥胖工作组提供了有关肥胖及其预防的信息 世界心脏联盟的全球预防联盟提供了制止肥胖流行及其相关慢性疾病的国际努力的详细信息 儿童成长基金会有关于儿童成长及其测量的信息
Early menarche tends to be preceded by rapid infancy weight gain and is associated with increased childhood and adult obesity risk. As age at menarche is a heritable trait, we hypothesised that age at menarche in the mother may in turn predict her children's early growth and obesity risk. We tested associations between mother's age at menarche, mother's adult body size and obesity risk, and her children's growth and obesity risk in 6,009 children from the UK population-based Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort who had growth and fat mass at age 9 y measured by dual-energy X-ray absorptiometry. A subgroup of 914 children also had detailed infancy and childhood growth data. In the mothers, earlier menarche was associated with shorter adult height (by 0.64 cm/y), increased weight (0.92 kg/y), and body mass index (BMI, 0.51 kg/m2/y; all p < 0.001). In contrast, in her children, earlier mother's menarche predicted taller height at 9 y (by 0.41 cm/y) and greater weight (0.80 kg/y), BMI (0.29 kg/m2/y), and fat mass index (0.22 kg/m2/year; all p < 0.001). Children in the earliest mother's menarche quintile (≤11 y) were more obese than the oldest quintile (≥15 y) (OR, 2.15, 95% CI 1.46 to 3.17; p < 0.001, adjusted for mother's education and BMI). In the subgroup, children in the earliest quintile showed faster gains in weight (p < 0.001) and height (p < 0.001) only from birth to 2 y, but not from 2 to 9 y (p = 0.3–0.8). Earlier age at menarche may be a transgenerational marker of a faster growth tempo, characterised by rapid weight gain and growth, particularly during infancy, and leading to taller childhood stature, but likely earlier maturation and therefore shorter adult stature. This growth pattern confers increased childhood and adult obesity risks. Earlier age at menarche may be a transgenerational marker of faster growth, particularly during infancy, leading to taller childhood stature but earlier maturation and hence shorter adult stature. Childhood obesity is a rapidly growing problem. Twenty-five years ago, overweight children were rare. Now, 155 million of the world's children are overweight and 30–45 million are obese. Overweight and obese children—those having a higher than average body mass index (BMI; weight divided by height squared) for their age and sex—are at increased risk of becoming obese adults. Such people are more likely to develop heart disease, diabetes, and other health problems than lean people. Many factors are involved in the burgeoning size of children. Parental obesity, for example, predisposes children to being overweight. In part, this is because parents influence the eating habits of their offspring and the amount of exercise they do. In addition, though, children inherit genetic factors from their parents that make them more likely to put on weight. To prevent childhood obesity, health care professionals need ways to predict which infants are likely to become obese so that they can give parents advice on controlling their children's weight. In girls, early menarche (the start of menstruation) is associated with an increased risk of childhood and adult obesity and tends to be preceded by rapid weight gain in the first two years of life. Because age at menarche is inherited, the researchers in this study have investigated whether mothers' age at menarche predicts rapid growth in infancy and childhood obesity in their offspring using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). In 1991–1992, this study recruited nearly 14,000 children born in Bristol, UK. Since then, the children have been regularly examined to investigate how their environment and genetic inheritance interact to affect their health. The researchers measured the growth and fat mass of 6,009 children from ALSPAC at 9 years of age. For 914 of these children, the researchers had detailed data on their growth during infancy and early childhood. They then looked for any associations between the mother's age at menarche (as recalled during pregnancy), mother's adult body size, and the children's growth and obesity risk. In the mothers, earlier menarche was associated with shorter adult height and increased weight and BMI. In the children, those whose mothers had earlier menarche were taller and heavier than those whose mothers had a later menarche. They also had a higher BMI and more body fat. The children whose mothers had their first period before they were 11 were twice as likely to be obese as those whose mothers did not menstruate until they were 15 or older. Finally, for the children with detailed early growth data, those whose mothers had the earliest menarche had faster weight and height gains in the first two years of life (but not in the next seven years) than those whose mothers had the latest menarche. These findings indicate that earlier mother's menarche predicts a faster growth tempo (the speed at which an individual reaches their adult height) in their offspring, which is characterized by rapid weight and height gain during infancy. This faster growth tempo leads to taller childhood stature, earlier sexual maturity, and—because age at puberty determines adult height—shorter adult stature. An inherited growth pattern like this, the researchers write, confers an increased risk of childhood and adult obesity. As with all studies that look for associations between different measurements, these findings will be affected by the accuracy of the measurements—for example, how well the mothers recalled their age at menarche. Furthermore, because puberty, particularly in girls, is associated with an increase in body fat, a high BMI at age nine might indicate imminent puberty rather than a risk of long-standing obesity—further follow-up studies will clarify this point. Nevertheless, the current findings provide a new factor—earlier mother's menarche—that could help health care professionals identify which infants require early growth monitoring to avoid later obesity. Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0040132. The Avon Longitudinal Study of Parents and Children has a description of the study and results to date The US Centers for Disease Control and Prevention provides information on overweight and obesity (in English and Spanish) US Department of Health and Human Services's program, Smallstep Kids, is an interactive site for children about healthy eating (in English and Spanish) The International Obesity Taskforce has information on obesity and its prevention The World Heart Federation's Global Prevention Alliance provides details of international efforts to halt the obesity epidemic and its associated chronic diseases The Child Growth Foundation has information on childhood growth and its measurement