Childhood overweight and obesity at the start of primary school: External validation of pregnancy and early-life prediction models.
Childhood overweight and obesity at the start of primary school: External validation of pregnancy and early-life prediction models.
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DOI：
10.1371/journal.pgph.0000258
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Alwan, Nisreen A
中科院分区：
文献类型：
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作者：
Ziauddeen, Nida;Roderick, Paul J;Santorelli, Gillian;Wright, John;Alwan, Nisreen A
在早期阶段对家庭进行风险分层，以获得预防干预和额外支持，可能有助于解决儿童肥胖症流行问题。使用出生在布拉德福德(BIB)队列的数据，这项分析旨在外部验证作为汉普郡研究生命周期肥胖预测因素(SLOPE)研究的一部分开发的儿童超重和肥胖预测模型。BIB是一项纵向的多种族出生队列研究，在2007年至2010年期间在布拉德福德招募了怀孕约28周的妇女。结果是4-5岁时超重/肥胖的体重指数(BMI)≥第91个百分位数。用受试者工作曲线下面积(AUC)评估辨别能力。通过计算预测风险与观察风险的比率并绘制观察风险与预测概率的比例图，对每十分之一的预测风险进行校准评估。有8003名儿童的数据可用。在所有阶段(妊娠早期、出生、~1岁和~2岁)，外部验证的AUC与发育阶段的AUC相当。体外验证的AUC在妊娠早期为0.64(95%可信区间0.62~0.66)，2年时为0.82(95%可信区间0.81~0.84)，而SLOPE模型开发时为0.66(95%可信区间0.65~0.67)和0.83(95%可信区间0.82~0.84)。模型后期(生命早期~1年和~2年)校正效果较好。为预测儿童超重和肥胖风险而开发的斜率模型在具有不同地理位置和种族组成的英国出生队列中进行了外部验证，表现良好。
Tackling the childhood obesity epidemic can potentially be facilitated by risk-stratifying families at an early-stage to receive prevention interventions and extra support. Using data from the Born in Bradford (BiB) cohort, this analysis aimed to externally validate prediction models for childhood overweight and obesity developed as part of the Studying Lifecourse Obesity PrEdictors (SLOPE) study in Hampshire. BiB is a longitudinal multi-ethnic birth cohort study which recruited women at around 28 weeks gestation between 2007 and 2010 in Bradford. The outcome was body mass index (BMI) ≥91st centile for overweight/obesity at 4–5 years. Discrimination was assessed using the area under the receiver operating curve (AUC). Calibration was assessed for each tenth of predicted risk by calculating the ratio of predicted to observed risk and plotting observed proportions versus predicted probabilities. Data were available for 8003 children. The AUC on external validation was comparable to that on development at all stages (early pregnancy, birth, ~1 year and ~2 years). The AUC on external validation ranged between 0.64 (95% confidence interval (CI) 0.62 to 0.66) at early pregnancy and 0.82 (95% CI 0.81 to 0.84) at ~2 years compared to 0.66 (95% CI 0.65 to 0.67) and 0.83 (95% CI 0.82 to 0.84) on model development in SLOPE. Calibration was better in the later model stages (early life ~1 year and ~2 years). The SLOPE models developed for predicting childhood overweight and obesity risk performed well on external validation in a UK birth cohort with a different geographical location and ethnic composition.