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儿童期肥胖延伸至成年期的生长轨迹模拟
Simulation of Growth Trajectories of Childhood Obesity into Adulthood


Zachary J. Ward ... 妇产科和儿科 • 2017.11.30
相关阅读
• 青少年肥胖:什么时候开始的 • 幼儿期BMI的加速增加和持续肥胖风险 • 儿童期重度肥胖预测成年期肥胖的高风险 • 儿童肥胖的诊断、治疗和预防指南 • 肥胖的机制、病理生理学和管理 • 美国儿童期肥胖的发病率 • 青春期BMI的变化以及糖尿病和冠心病发生风险的比较

摘要


背景

尽管当前儿童和成人肥胖流行问题已有据可查,但对于目前特定年龄和体重的儿童个体成人后肥胖的远期风险还知之甚少。我们通过建立模拟模型估计了美国当前儿童群体在35岁时的成人肥胖风险。

 

方法

我们汇总了包含41,567名儿童和成人,共176,720项观测值的5项具全国代表性的纵向研究的身高和体重数据。我们在校正时间趋势后模拟了整个生命过程的成长轨迹。我们建立了1,000个虚拟的、能代表2016年美国人群情况的100万19岁及以下儿童群体,并预测其至35岁的身高和体重轨迹。重度肥胖在成人中定义为体质指数(BMI,体重[kg]除以身高[m]的平方)≥35kg/m2,在儿童中定义为BMI≥第95百分位数的120%。

 

结果

在当前儿童肥胖水平下,模型预测现在肥胖的儿童中大多数(57.3%;95%不确定性区间[UI],55.2~60)在35岁时仍然肥胖,并且预测的肥胖患病病例约一半会在儿童期出现。我们的模拟结果显示成人后肥胖的相对危险度随着儿童年龄和BMI增加而升高,2岁超重儿童中为1.17(95% UI,1.09~1.29),而在19岁重度肥胖儿童中为3.10(95% UI,2.43~3.65)。对于重度肥胖儿童,35岁时不出现肥胖的概率从2岁儿童的21.0%(95% UI,1.09~1.29)下降至19岁儿童的6.1%(95% UI,2.1~9.9)。

 

结论

基于我们的模拟模型,儿童肥胖和体重超重仍将是美国面临的重大健康问题。生命早期出现的肥胖能预测成人期肥胖,对于重度肥胖儿童尤其如此(由JPB基金会等资助)。





作者信息

Zachary J. Ward, M.P.H., Michael W. Long, Sc.D., Stephen C. Resch, Ph.D., Catherine M. Giles, M.P.H., Angie L. Cradock, Sc.D., and Steven L. Gortmaker, Ph.D.
From the Center for Health Decision Science (Z.J.W., S.C.R.) and the Department of Social and Behavioral Sciences (C.M.G., A.L.C., S.L.G.), Harvard T.H. Chan School of Public Health, Boston; and the Department of Prevention and Community Health, Milken Institute School of Public Health, George Washington University, Washington, DC (M.W.L.). Address reprint requests to Mr. Ward at the Center for Health Decision Science, Harvard T.H. Chan School of Public Health, 718 Huntington Ave., Boston, MA 02115, or at zward@hsph.harvard.edu.

 

参考文献

1. Ogden CL, Carroll MD, Lawman HG, et al. Trends in obesity prevalence among children and adolescents in the United States, 1988-1994 through 2013-2014. JAMA 2016;315:2292-2299

2. Flegal KM, Kruszon-Moran D, Carroll MD, Fryar CD, Ogden CL. Trends in obesity among adults in the United States, 2005 to 2014. JAMA 2016;315:2284-2291

3. Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med 2014;370:403-411

4. Gordon-Larsen P, Adair LS, Nelson MC, Popkin BM. Five-year obesity incidence in the transition period between adolescence and adulthood: the National Longitudinal Study of Adolescent Health. Am J Clin Nutr 2004;80:569-575

5. Janssen I, Katzmarzyk PT, Srinivasan SR, et al. Utility of childhood BMI in the prediction of adulthood disease: comparison of national and international references. Obes Res 2005;13:1106-1115

6. Nader PR, O’Brien M, Houts R, et al. Identifying risk for obesity in early childhood. Pediatrics 2006;118:e594-e601

7. Stovitz SD, Hannan PJ, Lytle LA, Demerath EW, Pereira MA, Himes JH. Child height and the risk of young-adult obesity. Am J Prev Med 2010;38:74-77

8. Thompson DR, Obarzanek E, Franko DL, et al. Childhood overweight and cardiovascular disease risk factors: the National Heart, Lung, and Blood Institute Growth and Health Study. J Pediatr 2007;150:18-25

9. Tran MK, Krueger PM, McCormick E, Davidson A, Main DS. Body mass transitions through childhood and early adolescence: a multistate life table approach. Am J Epidemiol 2016;183:643-649

10. Wang LY, Chyen D, Lee S, Lowry R. The association between body mass index in adolescence and obesity in adulthood. J Adolesc Health 2008;42:512-518

11. Evensen E, Wilsgaard T, Furberg AS, Skeie G. Tracking of overweight and obesity from early childhood to adolescence in a population-based cohort — the Tromsø Study, Fit Futures. BMC Pediatr 2016;16:64-64

12. Kim KR, Kim MK, Shin YJ, Choi BY. Relationship between the change in overweight status from childhood to adolescence and metabolic syndrome phenotypes: a 9-year retrospective study. Eur J Clin Nutr 2008;62:748-753

13. Venn AJ, Thomson RJ, Schmidt MD, et al. Overweight and obesity from childhood to adulthood: a follow-up of participants in the 1985 Australian Schools Health and Fitness Survey. Med J Aust 2007;186:458-460

14. Deshmukh-Taskar P, Nicklas TA, Morales M, Yang SJ, Zakeri I, Berenson GS. Tracking of overweight status from childhood to young adulthood: the Bogalusa Heart Study. Eur J Clin Nutr 2006;60:48-57

15. Magarey AM, Daniels LA, Boulton TJ, Cockington RA. Predicting obesity in early adulthood from childhood and parental obesity. Int J Obes Relat Metab Disord 2003;27:505-513

16. Juhola J, Magnussen CG, Viikari JSA, et al. Tracking of serum lipid levels, blood pressure, and body mass index from childhood to adulthood: the Cardiovascular Risk in Young Finns Study. J Pediatr 2011;159:584-590

17. Ekelund U, Ong K, Linné Y, et al. Upward weight percentile crossing in infancy and early childhood independently predicts fat mass in young adults: the Stockholm Weight Development Study (SWEDES). Am J Clin Nutr 2006;83:324-330

18. Li L, Hardy R, Kuh D, Lo Conte R, Power C. Child-to-adult body mass index and height trajectories: a comparison of 2 British birth cohorts. Am J Epidemiol 2008;168:1008-1015

19. Dietz WH. Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics 1998;101:518-525

20. Rao G. Diagnosis, epidemiology, and management of hypertension in children. Pediatrics 2016;138:e20153616-e20153616

21. Temple JL, Cordero P, Li J, Nguyen V, Oben JA. A guide to non-alcoholic fatty liver disease in childhood and adolescence. Int J Mol Sci 2016;17:E947-E947

22. Thompson N, Mansfield B, Stringer M, Stewart B, Potter J, Fernengel K. An evidence-based resource for the management of comorbidities associated with childhood overweight and obesity. J Am Assoc Nurse Pract 2016;28:559-570

23. GBD 2013 Risk Factors Collaborators, Forouzanfar MH, Alexander L, et al. Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;386:2287-2323

24. Global BMI Mortality Collaboration, Di Angelantonio E, Bhupathiraju SN, et al. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016;388:776-786

25. Cheung PC, Cunningham SA, Narayan KM, Kramer MR. Childhood obesity incidence in the United States: a systematic review. Child Obes 2016;12:1-11

26. Goldhaber-Fiebert JD, Rubinfeld RE, Bhattacharya J, Robinson TN, Wise PH. The utility of childhood and adolescent obesity assessment in relation to adult health. Med Decis Making 2013;33:163-175

27. Trasande L. How much should we invest in preventing childhood obesity? Health Aff (Millwood) 2010;29:372-378

28. Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet 2011;378:804-814

29. Institute of Medicine. Accelerating progress in obesity prevention: solving the weight of the nation. Washington, DC: National Academies Press, 2012.

30. Wang YC, Colditz GA, Kuntz KM. Forecasting the obesity epidemic in the aging U.S. population. Obesity (Silver Spring) 2007;15:2855-2865

31. Wang Y, Beydoun MA, Liang L, Caballero B, Kumanyika SK. Will all Americans become overweight or obese? Estimating the progression and cost of the US obesity epidemic. Obesity (Silver Spring) 2008;16:2323-2330

32. Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet 2011;378:815-825

33. Finkelstein EA, Khavjou OA, Thompson H, et al. Obesity and severe obesity forecasts through 2030. Am J Prev Med 2012;42:563-570

34. Wang YC, Orleans CT, Gortmaker SL. Reaching the Healthy People goals for reducing childhood obesity: closing the energy gap. Am J Prev Med 2012;42:437-444

35. Ward ZJ, Long MW, Resch SC, et al. Redrawing the US obesity landscape: bias-corrected estimates of state-specific adult obesity prevalence. PLoS One 2016;11:e0150735-e0150735

36. Long MW, Ward ZJ, Resch SC, et al. State-level estimates of childhood obesity prevalence in the United States corrected for report bias. Int J Obes (Lond) 2016;40:1523-1528

37. Briggs AH, Weinstein MC, Fenwick EA, Karnon J, Sculpher MJ, Paltiel AD. Model parameter estimation and uncertainty analysis: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force Working Group-6. Med Decis Making 2012;32:722-732

38. Eddy DM, Hollingworth W, Caro JJ, Tsevat J, McDonald KM, Wong JB. Model transparency and validation: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force-7. Med Decis Making 2012;32:733-743

39. Efron B, Gong G. A leisurely look at the Bootstrap, the Jackknife, and cross-validation. Am Stat 1983;37:36-48

40. Gortmaker SL, Wang YC, Long MW, et al. Three interventions that reduce childhood obesity are projected to save more than they cost to implement. Health Aff (Millwood) 2015;34:1932-1939

41. Cradock AL, Barrett JL, Kenney EL, et al. Using cost-effectiveness analysis to prioritize policy and programmatic approaches to physical activity promotion and obesity prevention in childhood. Prev Med 2017;95:Suppl:S17-S27

42. Wang YC, Pamplin J, Long MW, Ward ZJ, Gortmaker SL, Andreyeva T. Severe obesity in adults cost state Medicaid programs nearly $8 billion in 2013. Health Aff (Millwood) 2015;34:1923-1931

43. Claire Wang Y, Gortmaker SL, Taveras EM. Trends and racial/ethnic disparities in severe obesity among US children and adolescents, 1976-2006. Int J Pediatr Obes 2011;6:12-20

44. Freedman DS, Mei Z, Srinivasan SR, Berenson GS, Dietz WH. Cardiovascular risk factors and excess adiposity among overweight children and adolescents: the Bogalusa Heart Study. J Pediatr 2007;150:12-17.e2

45. Taveras EM, Gillman MW, Kleinman KP, Rich-Edwards JW, Rifas-Shiman SL. Reducing racial/ethnic disparities in childhood obesity: the role of early life risk factors. JAMA Pediatr 2013;167:731-738

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