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症的惊人增长。2-5岁儿童的肥胖总患病率（定义为年龄和性别特定体重指数增长图表中>第95百分位数）增加了5%，6-19岁儿童增加了13%。根据最新的NHANES人口调查，几乎五分之一的美国6岁及以上儿童现在符合肥胖的定义。虽然能量平衡是体重变化的一个关键决定因素，但最近的证据表明，众所周知的肥胖原因，包括不良饮食，缺乏运动和遗传易感性，可能无法完全解释肥胖率的快速增加。新兴的实验室研究支持这一假设，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，关于肥胖的环境原因的流行病学研究很少。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胖剂。从1998年开始，NIEHS和EPA共同资助了一个儿童环境健康和疾病预防研究中心网络，其使命是探讨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各自招募了独立的前瞻性出生队列，收集了妊娠晚期尿液标本，并随访了儿童的生长和发育。这些中心都已经测量了孕晚期母体尿邻苯二甲酸酯代谢物。我们建议汇总这些数据，以有效地检查母体邻苯二甲酸酯浓度和从出生到7岁的肥胖纵向测量之间的关联。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酯和7岁以下儿童生长的数据的研究，并构成了丰富而独特的资源，可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.