Prospective investigation of long-term associations between childhood overweight, health-related determinants and health in young adults

超重可能发生在生命的各个阶段，也可能永久存在。不同受试者超重和营养相关疾病的发生时间不同。然而，超重的早期表现与晚期表现的重要性尚不清楚。到目前为止，儿童超重对年轻人健康的长期影响还没有得到系统的分析。此外，儿童超重的决定因素和成年后的疾病风险之间的关联还没有得到调查。为了解决这些问题，需要一种终生过程的方法。这项应用的目的是调查儿童超重及其决定因素对年轻人健康相关风险表现的影响。基尔肥胖预防研究(KOPS)的参与者1332名年龄在20岁到25岁之间的年轻人将被重新调查。在KOPS中，受试者已经在5或6个时间点(出生时，1、2、6、10和14岁)测量了身体成分(身高、体重、脂肪质量、腰围)和熟悉的、社交、产前和产后决定因素以及生活方式因素。建议重新调查的结果参数包括超重(患病率、发病率和持久性)、BMI、脂肪质量、代谢紊乱、炎症和营养相关疾病。疾病风险包括(I)功能障碍，如甘油三酯和胰岛素水平升高以及HOMA指数；(Ii)既有疾病，如高血压和CRP水平升高；以及(Ii)结构性障碍，如肝脏脂肪。在一项嵌套的病例对照研究中，将对200名超重受试者的肝脏脂肪进行磁共振成像(MRI)分析。受试者将按持续性超重(例如从小超重)和偶发超重(例如童年时正常体重和成年后超重)进行分层。持续正常体重的受试者将作为对照组，预期没有代谢紊乱。所有1332名参与者将填写一份关于生活方式(营养、体育活动、媒体消费)、环境、社会和熟悉变量的调查问卷。决定因素(以前在KOP中收集的以及新收集的)将按所谓的关键时间段分层。关键时期包括(I)生命的头两年，(Ii)5至8岁，(Iii)青春期(例如13至16岁)和(Iv)18至22岁。不同决定因素的影响以及它们从出生到25岁的交互作用将使用潜在的类别增长模型以及带有Boosting算法的相加分位数混合模型来估计。

Overweight can occur at all stages of life or remain permanently. The time of incidence of overweight and nutrition-related diseases differs between subjects. However, the importance of early versus late manifestation of overweight is unclear. Until now, the long-term effect of childhood overweight on health of young adults has not been systematically analyzed. In addition, the associations between determinants of childhood overweight and disease risks in adulthood have not been investigated. To address these questions a life course approach is required. The aim of this application is to investigate the impact of childhood overweight and its determinants on the manifestation of health-related risks in young adults. A cohort of 1332 young adults aged between 20 and 25 years who were participants of the Kiel Obesity Prevention Study (KOPS) will be re-investigated. Within KOPS the subjects were already measured at 5 or 6 time points (at birth, at ages 1, 2, 6, 10, and 14 years) regarding body composition (height, weight, fat mass, waist circumference) and familiar, social, pre- and postnatal determinants as well as lifestyle factors. Outcome parameters of the proposed re-investigation include overweight (prevalence, incidence and persistence), BMI, fat mass, metabolic disorders, inflammation, and nutrition-related diseases. Disease risks cover (i) functional disorders like elevated level of triglycerides and insulin as well as HOMA index, (ii) established diseases like hypertension and elevated levels of CRP and (ii) structural disorders like liver fat. Within a nested case-control study liver fat will be analyzed in 200 overweight subjects with magnetic resonance imaging (MRI). Subjects will be stratified by persistent (e.g. since childhood) and incident (e.g. normal weight during childhood and overweight as adults) overweight. Persistent normal weight subjects will serve as controls expecting no metabolic disorders. All 1332 participants will fill out a questionnaire to lifestyle (nutrition, physical activity, media consumption), environmental, social and familiar variables. The determinants (previously collected within KOPS as well as new collected) will be stratified by so called critical time periods. The critical time periods include (i) the first two years of life, (ii) age 5 to 8 years, (iii) puberty (e.g. age 13 to 16 years) and (iv) age 18 to 22 years. The impact of different determinants and their interactions from birth until age 25 years will be estimated using latent class growth models as well as additive quantile mixed models with boosting algorithm.