Antibiotic and acid-suppression medications during early childhood are associated with obesity
Antibiotic and acid-suppression medications during early childhood are associated with obesity
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DOI：
10.1136/gutjnl-2017-314971
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发表时间：
2019-01-01
期刊：
影响因子：
24.5
通讯作者：
Nylund, Cade M.
中科院分区：
文献类型：
--
作者：
Stark, Christopher M.;Susi, Apryl;Nylund, Cade M.
目的肠道菌群改变与肥胖相关。早期接触药物，包括抑酸剂和抗生素，会改变肠道生物群，并可能增加患肥胖症的可能性。我们调查了协会的抗生素，组胺-2受体拮抗剂（H2 RA）和质子泵抑制剂（PPI）的处方在儿童早期与obesity.Design的诊断，我们进行了一项队列研究，美国国防部TRICARE受益人出生于2006年10月至2013年9月。暴露定义为在生命的前2年内使用任何抗生素、H2 RA或PPI药物处方。结果333353名儿童符合纳入标准，其中241502名（72.4%）儿童使用抗生素，39488名（11.8%）儿童使用H2 RA，11089名（3.3%）儿童使用PPI。抗生素处方与肥胖相关（HR 1.26; 95% CI 1.23 - 1.28）。无论抗生素类别如何，这种关联都持续存在，并且随着处方的每一个额外类别的抗生素而加强。H2 RA和PPI处方也与肥胖有关，每30天的供应量处方的关联性更强。暴露于每一个额外的药物groupprescribed.Conclusions抗生素，抑酸剂和多种药物的组合，在第一个2年的生活与儿童肥胖症的诊断相关的HR increasingly。在儿童早期使用的改变微生物群的药物可能会影响体重增加。
Objective Gut microbiota alterations are associated with obesity. Early exposure to medications, including acid suppressants and antibiotics, can alter gut biota and may increase the likelihood of developing obesity. We investigated the association of antibiotic, histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) prescriptions during early childhood with a diagnosis of obesity.Design We performed a cohort study of US Department of Defense TRICARE beneficiaries born from October 2006 to September 2013. Exposures were defined as having any dispensed prescription for antibiotic, H2RA or PPI medications in the first 2 years of life. A single event analysis of obesity was performed using Cox proportional hazards regression.Results 333 353 children met inclusion criteria, with 241 502 (72.4%) children prescribed an antibiotic, 39 488 (11.8%) an H2RA and 11 089 (3.3%) a PPI. Antibiotic prescriptions were associated with obesity (HR 1.26; 95% CI 1.23 to 1.28). This association persisted regardless of antibiotic class and strengthened with each additional class of antibiotic prescribed. H2RA and PPI prescriptions were also associated with obesity, with a stronger association for each 30-day supply prescribed. The HR increased commensurately with exposure to each additional medication group prescribed.Conclusions A ntibiotics, acid suppressants and the combination of multiple medications in the first 2 years of life are associated with a diagnosis of childhood obesity. Microbiota-altering medications administered in early childhood may influence weight gain.