摘要
目的探讨脂肪重积聚(adiposity rebound,AR)提前与5岁儿童肥胖和代谢各指标的关联。方法研究基于已经建立的"马鞍山市优生优育(MABC)",在2013年10月至2015年4月出生的单胎活产儿,连续追踪随访至5岁时的儿童,截至2019年8月份共获得有连续性儿童测量数据≥8次及代谢指标的有720例。采用体格检查以及实验室检测的方法,获得儿童出生情况、身长/身高、体重、腰围、人体成分、代谢指标等信息。使用χ2检验、F检验、t检验、非参数检验、一般线性模型和Logistic回归模型进行分析。结果已有43.47%学龄前儿童界定为AR提前(AR≤4岁)。控制性别后,AR提前组5岁儿童超重/肥胖(OR=2.71,95%CI:1.81~4.05)、腰围超标(OR=1.88,95%CI:1.25~2.82)、体脂肪百分比≥P90(OR=2.09,95%CI:1.26~3.48)的发生风险均上升,差异均有统计学意义(P<0.05);AR提前组5岁儿童胰岛素抵抗和代谢风险因子得分虽高于未提前组,但是差异无统计学意义。5岁儿童肥胖和超重的发生率分别为6.0%和12.8%,且超重肥胖儿童、腰围超标、腰高比超标和体脂百分比≥P90者,胰岛素抵抗和代谢风险因子得分均较高,差异均有统计学意义(P<0.001)。结论 AR提前能增加5岁超重/肥胖、腰围超标和体脂肪百分比超标的风险,且5岁儿童肥胖各指标超标与胰岛素抵抗和代谢风险因子密切相关。
Objective To assess the association between timing of adiposity rebound(AR)and indices of obesity and metabolic risk in 5-year-old children.Methods Based on Ma’anshan Birth Cohort Study(MABC),the singleton children were born in Ma’anshan of Anhui province from October 2013 to April 2015,will be followed up for 5 years consecutively.As of August 2019,720 children with continuous measurements(≥8 times)and metabolic indicators were obtained.Physical examination and laboratory tests were used to obtain information on the birth status,length/height,weight,waist circumference,body composition and metabolic indicators of children.We used chi-square,analysis of variance,t-test and nonparametric test to compare the general characteristics(continuous and categorical variables).General linear models and Logistic regression were used.Results We found that 43.47%of the children had AR≤4 years.After controlling for gender,earlier AR was associated with overweight/obesity(OR=2.71,95%CI:1.81~4.05),larger waist circumference(OR=1.88,95%CI:1.25~2.82),body fat percentage≥90th percentile(OR=2.09,95%CI:1.26~3.48);in earlier AR group,the insulin resistance and metabolic score were higher,but the difference was not statistically significant.At age 5 years,the prevalence of obesity and overweight was 6.0%and 12.8%,children with overweight/obesity,larger waist circumference,higher waist-to-weight ratio and body fat percentage≥90th percentile were associated with higher insulin resistance and metabolic score,the differences were much more obvious(all P<0.001).Conclusion Earlier AR increases the risk of overweight/obesity,larger waist circumference,body fat percentage≥90th percentile at 5 years;each of the commonly used measures of childhood obesity closely related with insulin resistance and metabolic score at 5 years.
作者
曹慧
严双琴
谢亮亮
蔡智玲
高国朋
尹小刚
吕先发
汪素美
朱海琴
伍晓艳
黄锟
陶芳标
CAO Hui;YAN Shuangqin;XIE Liangliang;CAI Zhiling;GAO Guopeng;YIN Xiaogang;LYU Xianfa;WANG Sumei;ZHU Haiqin;WUXiaoyan;HUANG Kun;TAO Fangbiao(Maternal and Child Health Care Center of Maanshan,Maanshan 243000,China;Department of Maternal,Child,and Adolescent Health,School of Public Health,Anhui Medical University,Hefei 230032;Key Laboratory of Population Health Across Life Cycle(Anhui Medical University),Ministry of Education of the People’s Republic of China/Anhui Provincial Key Laboratory of Population Health and Aristogenics,Hefei 230032)
出处
《公共卫生与预防医学》
2020年第1期38-43,共6页
Journal of Public Health and Preventive Medicine
基金
国家自然科学基金青年科学基金项目(81602872)
中国疾病预防控制中心妇幼保健中心母婴营养与健康研究项目资助(2019FYH024)。
关键词
脂肪重积聚
超重/肥胖
体质量指数
代谢因子
儿童
Adiposity rebound
Overweight/obesity
Body mass index(BMI)
Metabolic factors
Children
