A Pooled Investigation of Prenatal Phthalate Exposure and Childhood Obesity

描述（由申请人提供）：在过去的20年里，我们目睹了儿童肥胖的惊人增长。2-5岁儿童的总体肥胖患病率（定义为年龄和性别特异性体重指数增长图表的第95百分位数）增加了5%，6-19岁儿童增加了13%。根据NHANES最近的人口调查，现在几乎每5个6岁及以上的美国儿童中就有1个符合肥胖的定义。虽然能量平衡是体重变化的关键决定因素，但最近的证据表明，众所周知的肥胖原因，包括不良饮食、缺乏体育锻炼和遗传易感性，可能并不能完全解释肥胖率的快速增长。新兴的实验室研究支持一种假设，即常见的环境化学物质可能会对脂质调节产生负面影响，从而有利于体重增加。然而，很少有关于肥胖的环境原因的流行病学研究。人类接触邻苯二甲酸盐是普遍存在的，许多证据表明邻苯二甲酸盐可能是致肥物质。从1998年开始，NIEHS和EPA联合资助了一个儿童环境健康和疾病预防研究中心网络，其任务是研究环境在儿童健康中的作用。西奈山、哥伦比亚和辛辛那提儿童中心分别招募了独立的前瞻性出生队列，收集了妊娠晚期的尿液样本，并对儿童的生长发育进行了随访。这些中心都已经在妊娠晚期测量了母体尿邻苯二甲酸酯代谢物。我们建议汇集这些数据，以便有效地检查母体邻苯二甲酸盐浓度与从出生到7岁的肥胖纵向测量之间的关系。据我们所知，这三个出生队列共同代表了美国目前仅有的关于邻苯二甲酸盐和7岁前生长数据的研究，并构成了丰富而独特的资源，可以有效地实现本研究的目标，同时为未来共同努力解决环境化学品对儿童健康的影响提供基础。

DESCRIPTION (provided by applicant): Over the last 20 years, we have witnessed a staggering increase in childhood obesity. The overall prevalence of obesity (defined as > 95th percentile of age- and sex-specific body mass index growth charts) has increased by 5% for children aged 2-5 and 13% for children aged 6-19. According to the most recent NHANES population-based survey, almost 1 out of 5 US children aged 6 and older now meets this definition of obese. While energy balance is a key determinant of weight change, recent evidence suggests that well-known causes of obesity, including poor diet, physical inactivity, and genetic predisposition, may not fully account for the rapid increase in obesity rates. Emerging laboratory research supports the hypothesis that common environmental chemicals may negatively impact lipid regulation in favor of weight gain. However, there have been very few epidemiological studies of environmental causes of obesity. Human exposure to phthalates is ubiquitous and a number of lines of evidence point to phthalates as possible obesogens. Starting in 1998, NIEHS and EPA jointly funded a network of Children's Environmental Health and Disease Prevention Research Centers, with the mission of addressing the role of environment in children's health. The Mount Sinai, Columbia, and Cincinnati Children's Centers each enrolled independent prospective birth cohorts, collected third trimester urine specimens, and followed children up for growth and development. Each of these Centers has already measured maternal urinary phthalate metabolites in the third trimester. We propose to pool these data in order to efficiently examine the association between maternal phthalate concentrations and longitudinal measures of adiposity from birth through age 7 years. To our knowledge, these three birth cohorts together represent the only US studies with currently available data on phthalates and growth through age 7, and constitute a rich and unique resource to efficiently address the aims of this study while providing the foundation for future pooling efforts to address the impact of environmental chemicals on children's health.