Infant antibiotic exposure and the development of childhood overweight and central adiposity
Infant antibiotic exposure and the development of childhood overweight and central adiposity
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DOI：
10.1038/ijo.2014.119
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发表时间：
2014-10-01
影响因子：
4.9
通讯作者：
Kozyrskyj, A. L.
中科院分区：
文献类型：
--
作者：
Azad, M. B.;Bridgman, S. L.;Kozyrskyj, A. L.
背景：肥胖与肠道微生物区系的破坏有关，肠道微生物区系是在婴儿期建立的，容易受到抗生素的破坏。目的：调查早期接触抗生素与随后超重和中心性肥胖症的关系。方法：将省级卫生保健记录与加拿大一项纵向出生队列研究的临床和调查数据联系起来。从处方记录中记录了生命第一年期间的抗生素暴露情况。超重和中心性肥胖是在9岁(n=616)和12岁(n=431)时通过人体测量确定的。结果：与未使用抗生素的婴儿相比，在出生第一年接受抗生素治疗的婴儿在童年后期超重的可能性更大(32.4%比18.2%，P=0.002)。在调整出生体重、母乳喂养、母亲超重和其他潜在混杂因素后，这种关联在男孩中持续存在(AOR 5.35，95%可信区间(CI)1.94-14.72)，但在女孩中不存在(AOR 1.13，CI 0.46-2.81)。在9岁时超重(男孩AOR 2.19，CI 1.06-4.54；女孩AOR 1.20，CI 0.53-2.70)和12岁时中心性肥胖症(男孩AOR 2.85，CI 1.24-6.51；女孩AOR 1.59，CI 0.68-3.68)存在相似的性别相关性。结论：在男孩中，出生第一年接触抗生素与超重和青春期前中心性肥胖的风险增加有关，这表明抗生素管理在婴儿期特别重要。鉴于目前儿童肥胖症的流行和婴儿接触抗生素的高流行率，有必要进行进一步的研究，以确定这种联系背后的机制，确定长期的健康后果，并制定在无法避免抗生素暴露的情况下减轻这些影响的战略。
BACKGROUND: Obesity has been associated with disruption of the gut microbiota, which is established during infancy and vulnerable to disruption by antibiotics.OBJECTIVES: To investigate the association between early-life antibiotic exposure and subsequent development of overweight and central adiposity.METHODS: Provincial health-care records were linked to clinical and survey data from a Canadian longitudinal birth cohort study. Antibiotic exposure during the first year of life was documented from prescription records. Overweight and central adiposity were determined from anthropometric measurements at ages 9 (n = 616) and 12 (n = 431). Associations were determined by multiple logistic regression.RESULTS: Infants receiving antibiotics in the first year of life were more likely to be overweight later in childhood compared with those who were unexposed (32.4 versus 18.2% at age 12, P = 0.002). Following adjustment for birth weight, breastfeeding, maternal overweight and other potential confounders, this association persisted in boys (aOR 5.35, 95% confidence interval (CI) 1.94-14.72) but not in girls (aOR 1.13, CI 0.46-2.81). Similar gender-specific associations were found for overweight at age 9 (aOR 2.19, CI 1.06-4.54 for boys; aOR 1.20, CI 0.53-2.70 for girls) and for high central adiposity at age 12 (aOR 2.85, CI 1.24-6.51 for boys; aOR 1.59, CI 0.68-3.68 for girls).CONCLUSIONS: Among boys, antibiotic exposure during the first year of life was associated with an increased risk of overweight and central adiposity in preadolescence, indicating that antibiotic stewardship is particularly important during infancy. Given the current epidemic of childhood obesity and the high prevalence of infant antibiotic exposure, further studies are necessary to determine the mechanisms underlying this association, to identify the long-term health consequences, and to develop strategies for mitigating these effects when antibiotic exposure cannot be avoided.