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幼儿期BMI的加速增加和持续肥胖风险
Acceleration of BMI in Early Childhood and Risk of Sustained Obesity


Mandy Geserick ... 妇产科和儿科 • 2018.10.04
相关阅读
• 青少年肥胖:什么时候开始的 • 儿童期肥胖延伸至成年期的生长轨迹模拟 • 儿童期重度肥胖预测成年期肥胖的高风险

婴幼儿期体重管理在肥胖防控中的潜在作用

 

潘雄飞

华中科技大学同济医学院公共卫生学院流行病系

 

肥胖问题早已成为全球面临的共同挑战。来自全球200多个国家和地区的数据显示,男性成人肥胖年龄标化患病率由1975年的3.2%上升到2014年的10.8%,而女性由6.4%上升到14.9%,其中2.3%的男性和5.0%的女性存在严重肥胖(体质指数[BMI]≥35 kg/m21。尽管既往超重/肥胖主要在发达国家流行,过去20年间随着发展中国家社会经济条件改善,高能、高脂膳食和静坐生活方式逐渐盛行,肥胖患病率已上升近200% 2,肥胖俨然不再是富裕国家的“专利”。

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摘要


背景

儿童从出生至青春期的体质指数(BMI)动态变化尚不清楚,而确定对持续肥胖的易感性是否发生于儿童的特定年龄有重要意义。

 

方法

为了评估肥胖的发病年龄,我们在由51,505名儿童组成的一个基于人群的样本中,对随着时间推移的BMI变化过程进行了前瞻性和回顾性分析,这些儿童有儿童期(0~14岁)和青春期(15~18岁)的连续人体测量数据。此外,我们在34,196名儿童中评估了儿童期每年BMI增量的动态变化(定义为每年BMI标准差评分的变化)。

 

结果

在回顾性分析中,我们发现,大部分体重正常的青少年在整个儿童期始终体重正常。约一半(53%)的肥胖青少年从5岁起超重或出现肥胖,并且随着年龄增长,BMI标准差评分进一步增加。在前瞻性分析中,我们发现,3岁时肥胖的儿童有近90%在青春期超重或肥胖。在肥胖的青少年中,每年BMI增量在2~6岁增加得最快,此后BMI百分位数进一步升高。在学龄前阶段(而非学龄阶段),每年BMI增量的快速增加与青春期的超重或肥胖风险相关,风险高达BMI稳定儿童的1.4倍。出生时大于胎龄儿在青春期超重或肥胖的比例(43.7%)高于适于胎龄儿(28.4%)或小于胎龄儿(27.2%),大于胎龄儿在青春期肥胖的风险高达其他人群的1.55倍。

 

结论

在肥胖青少年中,体重增长最快的时期是2~6岁;这一年龄段肥胖的儿童大部分在青春期也会肥胖(由德国“肥胖机制”临床研究中心研究委员会[German Research Council for the Clinical Research Center “Obesity Mechanisms”]等资助;在ClinicalTrials.gov注册号为NCT03072537)。





作者信息

Mandy Geserick, M.Sc., Mandy Vogel, Ph.D., Ruth Gausche, M.B.A., Tobias Lipek, M.D., Ulrike Spielau, M.Sc., Eberhard Keller, M.D., Roland Pfäffle, M.D., Wieland Kiess, M.D., and Antje Körner, M.D.
From the Center for Pediatric Research, University Hospital for Children and Adolescents (M.G., T.L., U.S., R.P., W.K., A.K.), Leipzig Research Center for Civilization Diseases (LIFE Child) (M.G., M.V., W.K., A.K.), CrescNet, Medical Faculty (R.G., E.K., R.P.), and Integrated Research and Treatment Center (IFB), Adiposity Diseases, University Medical Center (T.L., U.S., A.K.), University of Leipzig, Leipzig, Germany. Address reprint requests to Dr. Körner at the Center for Pediatric Research, University Hospital for Children and Adolescents, University of Leipzig, Liebigstr. 20a 04103 Leipzig, Germany, or at antje.koerner@medizin.uni-leipzig.de.

 

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