出生体重与儿童期肥胖关联性的系统评价

doi:10.11852/zgetbjzz2018-0964

摘要/Abstract

摘要： 目的分析出生体重(BW)与儿童肥胖的关联性,为儿童肥胖预防提供依据。方法通过数据库(PubMed,Elsevier和中国知网)检索BW与儿童肥胖发病相关的文献,用Meta分析方法评价BW与儿童肥胖发生风险的剂量反应关系。结果本研究纳入32篇研究,共包括548 348名研究对象。与BW参照组(2 500~4 000 g)相比,高出生体重(≥4 000 g)是儿童肥胖的危险因素(OR＝1.77, 95%CI:1.66~1.89)。剂量反应Meta分析结果显示:随着BW的增加,儿童肥胖的发生风险也逐渐增加,且BW每增加100 g,儿童肥胖的发生风险大约增加1.1%。当BW达到3 575 g时,与儿童发生肥胖风险的剂量反应关系有统计学意义(P=0.046,OR＝1.08,95%CI:1.00~1.17)。且当BW＞3 575 g时,儿童肥胖的发生风险明显增加。结论 BW与儿童肥胖发生风险存在明显的J型剂量反应关系,且当儿童BW超过3 575 g时,儿童肥胖的风险明显增加。

关键词: 出生体重, 儿童肥胖, 剂量反应关系, 一般线性模型

Abstract: Objective To explore the relationship between birth weight (BW) and the risk of childhood obesity, in order to provide evidence for the prevention of childhood obesity. Method Studies on birth weight and childhood obesity were identified by searching major electronic databases (PubMed, Elsevier and Web of Science) by the medical subject headings and key words, and a Meta-analysis was conducted to assess the dose-response relationship between childhood obesity and birth weight. Results A total of 32 studies including 548 348 subjects were enrolled in this study.Compared with reference birth weight (2 500-4 000 g), high birth weight(≥4 000 g) was risk factor for childhood obesity (OR=1.77, 95%CI:1.66-1.89).There was significant dose-response relationship between birth weight and the risk of childhood obesity, which suggested that the risk of childhood obesity increased 1.1% with the birth weight increasing every 100 g.When the birth weight increased to 3 575 g, the risk of obesity in children was statistically significant (OR=1.08, 95%CI:1.00-1.17, P=0.046).And the risk of obesity increased obviously when birth weight was higher than 3 575 g. Conclusions There is a significant J-dose-response relationship between birth weight and childhood obesity risk.When children′s birth weight exceeds 3 575 g, the risk of childhood obesity significantly increased.

Key words: birth weight, childhood obesity, dose-response, generalized linear model

中图分类号:

R723.14

常锐霞, 梁芳, 芦永斌. 出生体重与儿童期肥胖关联性的系统评价[J]. 中国儿童保健杂志, 2018, 26(12): 1340-1345.

CHANG Rui-xia, LIANG Fang, LU Yong-bin. Systematic review on the association between birth weight and childhood obesity[J]. journal1, 2018, 26(12): 1340-1345.

参考文献

[1] Ng M, Fleming T, Robinson M, et al.Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013:a systematic analysis for the Global Burden of Disease Study 2013[J].Lancet,2014,384(9945):766-781.
[2] De OM, Blössner M, Borghi E.Global prevalence and trends of obesity among preschool children[J].Am J Clin Nutr,2010,92(5):1257-1264.
[3] Kelly AS, Barlow SE, Rao G, et al.Severe obesity in children and adolescents:identification, associated health risks, and treatment approaches:a scientific statement from the American Heart Association[J].Circulation,2013,128(15):1689-1712.
[4] Freedman DS, Dietz WH, Srinivasan SR, et al.The relation of overweight to cardiovascular risk factors among children and adolescents:the Bogalusa heart study[J].Pediatrics,1999,25(1):1175-1182.
[5] Rinaudo PF, Lamb J, editors.Fetal origins of perinatal morbidity and/or adult disease[J].Semin Reprod Med,2008,26(5):436-445.
[6] Baidal JAW, Locks LM, Cheng ER, et al.Risk factors for childhood obesity in the first 1,000 days:a systematic review[J].Am J Prev Med,2016,50(6):761-779.
[7] 周婷, 王婉宜, 孙晓蒙, 等.中国7～18岁儿童青少年超重肥胖危险因素meta分析[J].中国公共卫生,2016,32(10):1444-1448.
[8] Orsini N, Bellocco R, Greenland S. Generalized least squares for trend estimation of summarized dose-response data[J].Stata J,2006,6(6):40-57.
[9] 张钰, 宋艾云, 范玉娟, 等.出生体重与5至8岁儿童超重和肥胖关联的队列研究[J].中国循证儿科杂志,2015,10(1):46-51.
[10] 戎芬, 武俊青, 李玉艳, 等.出生体重与儿童期超重肥胖的关系[J].中国儿童保健杂志,2011,19(11):989-991.
[11] 李辉, 于洋, 夏秀兰, 等.出生体重与儿童期肥胖[J].中国儿童保健杂志,2002,10(3):145-146.
[12] 王瑞静, 刘淑燕.学龄前儿童单纯性肥胖与出生体重关系研究[J].浙江体育科学,2009,31(2):94-6.
[13] 沈苓, 王丽, 曲文君.单纯性肥胖儿与出生体重的关系探讨[J].中国妇幼保健,2004,19(6):96-97.
[14] 秦秋兰, 梁远, 杨虹, 等.广西6～13岁儿童超重肥胖影响因素分析[J].中国热带医学,2014,14(8):935-938.
[15] 林蓉, 杜琳, 刘伟佳, 等.广州市城区儿童超重肥胖影响因素分析[J].中国儿童保健杂志,2011,19(5):409-411.
[16] Koirala M, Khatri RB, Khanal V, et al.Prevalence and factors associated with childhood overweight/obesity of private school children in Nepal[J].Obes Res Clin Pract,2015,9(3):220-227.
[17] Hirschler V, Bugna J, Roque M.Does low birth weight predict obesity/overweight and metabolic syndrome in elementary school children?[J].Arch Med Res,2008,39(8):796-802.
[18] Zhang X, Liu E, Tian Z, et al.High birth weight and overweight or obesity among Chinese children 3-6years old[J].Prev Med,2009,49(2):172-178.
[19] Yuan ZP, Yang M, Liang L, et al.Possible role of birth weight on general and central obesity in Chinese children and adolescents:a cross-sectional study[J].Ann Epidemiol,2015,25(10):748-752.
[20] Navti LK, Ferrari U, Tange E, et al.Contribution of socioeconomic status, stature and birth weight to obesity in Sub-Saharan Africa:cross-sectional data from primary school-age children in Cameroon[J].Bmc Public Health,2014,14(1):1-8.
[21] Hassanzadeh-Rostami Z, Kavosi E, Nasihatkon A.Overweight and obesity among preschool children from fars province of iran:prevalence and associated factors[J].J Res Health Sci,2016,16(1):26-30.
[22] De AMM, Coelho CP, Da SFH, et al.Prevalence and factors associated with overweight and obesity in children under five in Alagoas, Northeast of Brazil; a population-based study[J].Nutr Hosp,2014,29(6):1320-1326.
[23] Zong XN, Li H, Zhang YQ.Family-related risk factors of obesity among preschool children:results from a series of national epidemiological surveys in China[J].Bmc Public Health,2015,15(1):1-11.
[24] Zhang T, Cai L, Ma L, et al.The prevalence of obesity and influence of early life and behavioral factors on obesity in Chinese children inGuangzhou[J].Bmc Public Health,2016,16(1):954-961.
[25] Geremia R, Cimadon HM, de Souza WB, et al.Childhood overweight and obesity in a region of Italian immigration in Southern Brazil:a cross-sectional study[J].Ital J Pediatr,2015,41(1):1-8.
[26] Cnattingius S, Villamor E, Lagerros YT, et al.High birth weight and obesity--a vicious circle across generations[J].Int J Obes,2012,36(10):1320-1324.
[27] Zarrati M, Shidfar F, Moradof M, et al.Relationship between breast feeding and obesity in children with low birth weight[J].Iran Red Crescent Me,2013,15(8):676-682.
[28] Janjua NZ, Mahmood B, Islam MA, et al.Maternal and early childhood risk factors for overweight and obesity among low-income predominantly black children at age five years:a prospective cohort study[J].Intj J Obesity,2012,2012(2012):457173-457181.
[29] Li N, Liu E, Sun S, et al.Birth weight and overweight or obesity risk in children under 3 years in China[J].Am J Hum Biol,2014,26(3):331-336.
[30] Loaiza S, Coustasse A, Urrutiarojas X, et al.Birth weight and obesity risk at first grade in a cohort of Chilean children[J].Nutr Hosp,2011,26(1):214-219.
[31] Danielzik S, Czerwinski MMK, Dilba B, et al.Parental overweight, socioeconomic status and high birth weight are the major determinants of overweight and obesity in 5-7 y-old children:baseline data of the Kiel Obesity Prevention Study (KOPS)[J].Int J Obesity,2004,28(11):1494-1502.
[32] Tchoubi S, Sobngwi-Tambekou J, Noubiap JJ, et al.Prevalence and risk factors of overweight and obesity among children aged 6-59 months in Cameroon:a multistage, stratified cluster sampling nationwide survey[J].PLoS One,2015,10(12):e0143215.
[33] Dubois L, Girard M.Early determinants of overweight at 4.5 years in a population-based longitudinal study[J].Int J Obesity,2006,30(4):610-617.
[34] Rooney BL, Mathiason MA, Schauberger CW.Predictors of obesity in childhood, adolescence, and adulthood in a birth cohort[J].Matern Child Health,2011,15(8):1166-1175.
[35] Kuciene R, Dulskiene V, Medzioniene J.Associations between high birth weight, being large for gestational age, and high blood pressure among adolescents:a cross-sectional study[J].Eur J Nutr,2018,57:373-381.
[36] Kang M, Yoo JE, Kim K, et al.Associations between birth weight, obesity, fat mass and lean mass in Korean adolescents:the Fifth Korea National Health and Nutrition Examination Survey[J].Bmj Open,2018,8(2):e018039.
[37] Qiao Y, Zhang T, Liu H, et al.Joint association of birth weight and physical activity/sedentary behavior with obesity in children ages 9~11 years from 12 countries[J].Obesity,2017,25(6):1091-1097.
[38] 刘珏, 李钦, 承钰, 等.北京市东城区儿童出生体重与肥胖的相关性[J].中国学校卫生,2017,38(7):1039-1042.
[39] 李静, 曹娟, 韩百惠, 等.出生体重与学龄儿童青少年超重肥胖的关系[J].现代预防医学,2017,44(23):4267-4270,4275.
[40] 陈晓阳.杭州市学龄期超重肥胖儿童与出生体重的相关性研究[J].中外女性健康研究,2017,25(13):176-177.
[41] 黄婉平, 陈甘讷, 韦荣忠, 等.广州花都3373名学龄前儿童单纯性肥胖现状及影响因素分析[J].中国儿童保健杂志,2018,26(1):67-70.
[42] 廖兵荣.出生体重与儿童单纯性肥胖关系[J].中国公共卫生,2007,23(6):653-654.
[43] Fredriks A.Body index measurements in 1996-1997 compared with 1980[J].Arch Dis Child,2000,82:107-112.
[44] 张迎修, 王淑荣, 陈敏, 等.济南市7岁儿童BMI及体成分与血压水平的相关性分析[J].中国学校卫生,2010,31(10):1215-1217.