出生体重与5至8岁儿童超重和肥胖关联的队列研究  

Cohort study on the association of overweight and obesity among children aged 5 to 8 years with birth weight

作　　者：张钰[1] 宋艾云[1] 范玉娟[1] 李雪松[1] 范晓方[1] 任凤东[1] 郑徽[1] 沈春芳[1] 沈甲乙[1] 宋玉萍[1] 任国光[1] 张正球[1] 赵燕萍[2] 蒋良华[3] 张金伟[4] 储寄志 叶为民 马应忠[7] 姚红 杨玉明 曹永其 顾昊[11] 林建良 赵伟忠 朱洪其 李志勇 杨杰 程佳 杨架林[1] 

机构地区：[1]复旦大学附属闵行医院,上海201199 [2]上海市闵行区疾病预防控制中心,上海201199 [3]上海市闵行区江川社区卫生服务中心,上海200240 [4]上海市闵行区龙柏社区卫生服务中心,上海201103 [5]上海市闵行区古美社区卫生服务中心,上海201102 [6]上海市闵行区新虹社区卫生服务中心,上海201106 [7]上海市闵行区华漕社区卫生服务中心,上海201105 [8]上海市闵行区虹桥社区卫生服务中心,上海201103 [9]上海市闵行区七宝社区卫生服务中心,上海201101 [10]上海市闵行区梅陇社区卫生服务中心,上海201104 [11]上海市闵行区莘庄社区卫生服务中心,上海201199 [12]上海市闵行区颛桥社区卫生服务中心,上海201108 [13]上海市闵行区马桥社区卫生服务中心,上海201111 [14]上海市闵行区吴泾社区卫生服务中心,上海200241 [15]上海市闵行区浦江社区卫生服务中心,上海201112 [16]上海市闵行区卫生计生委员会,上海201199

出　　处：《中国循证儿科杂志》2015年第1期46-51,共6页Chinese Journal of Evidence Based Pediatrics

基　　金：上海市科委课题资助:114119b0400

摘　　要：目的以回顾性队列研究探讨出生体重与5～8岁儿童超重和肥胖的关系.方法利用上海市闵行区所辖的13家社区卫生服务中心3～12岁儿童的体格检查数据库,截取5～8岁儿童的身高和体重数据进行分析.体检时行问卷调查生育史、出生体重、妊娠情况和出生后喂养史.按照出生体重分为〈2500g（低出生体重儿）、～3000g、～3500g、～4000g和≥4000g组（巨大儿）.采用多元logistics分析评估出生体重与5～8岁儿童超重和肥胖的关系,并调整相关因素的影响.结果99897名5～8岁儿童进入分析,超重发生率为10.1%,肥胖发生率为5.0%.①1.4%的儿童为低出生体重,7.3%为巨大儿;出生体重〈2500g、～3000g、～3500g、～3500g、～4000g和≥4000g组超重检出率分别为8.4%、7.6%、9.2%、11.5%和14.5%;肥胖检出率分别为4.7%、3.9%、4.4%、5.9%和7.9%.②简单相关分析发现,～3500g、～4000g和≥4000g组出生体重与儿童体重呈正相关（P 〈0.0001）,在调整了性别、年龄、身高、分娩史、孕周、喂养史和身高后,仍具有显著相关性.③与出生体重～3500g组相比,～4000g组超重和肥胖的发生率增加31%和43%,～4500g组超重和肥胖的发生率增加76%和103%;～3000g组发生超重和肥胖的风险最低（RR=0.80,95%CI：0.73～0.88,P〈0.0001;RR=0.87,95%CI：0.77～0.98,P〈0.0001）,调整了年龄、性别、孕周和产式等因素后,仍具有相关性;5、6、7和8岁儿童～4000g和≥4000g组发生超重和肥胖的风险相近;〈2500g组肥胖的风险RR为1.07（95%CI：0.79～1.43）,P=0.27.结论出生体重对5～8岁儿童超重和肥胖的影响呈非线性关系.出生体重〉3500g儿童5～8岁超重和肥胖的风险显著增高.Objective Birth weight has effect not only on growth of infants but also on later life. Every year,children will be given routine examination by government at community health service centers in Minhang District in Shanghai,China. To observe the effect of birth weight on risk of overweight and obesity among children aged 5 to 8 years in China. M ethods A retrospective longitudinal study was performed. Birth weight,current height and weight,and other anthropometric data of children were obtained from the community health service centers. Results Among 99897 subjects,10. 1% of the children were overweighted and 5. 0% were obese. Of all the children,1. 4% had low birth weight( birth weight < 2 500 g) and 7. 3% had high birth weight( birth weight≥4 000 g). The percentages of overweight were 8. 4%,7. 6%,9. 2%,11. 5%,14. 5%,respectively,and the percentages of obesity were 4. 7%,3. 9%,4. 3%,5. 9%,7. 9% respectively,across the birth weight categories: < 2500 g,- 2500 g,- 3 000 g,- 3500 g,- 4000 g,≥4000 g. Comparing with the control group which was defined the birth weight as more than or equal to 3000 g and less than 3500 g,the risk ratio of the children with birth weight between 3500 and 4000 g for overweight increased 31% and for obesity increased 43%( RR = 1. 31,95% CI: 1. 24- 1. 38,P < 0. 0001; RR = 1. 43,95% CI:1. 32- 1. 54,P = 0. 0001,respectively) and the risk ratio of the children with birth weight equal to or more than 4000 g for overweight increased 76% and for obesity increased 103%( RR = 1. 76,95% CI: 1. 62- 1. 92,P < 0. 000 1; RR = 2. 03,95% CI:1. 81- 2. 23,P < 0. 0001,respectively). The association was persisted after adjustment of the confounders including age,sex,birth height,pregnant week,delivery models,current height and breast feeding. The RRs of overweight and obesity were close among children aged 5,6,7,8 years with birth weight of- 4000 g and ≥4000 g. The children with birth weight more than or equal to 2 500 g and less than 3000 g had no risk for overweight and obesity when they were 5 to 8

关 键 词：出生体重 超重 肥胖 儿童 

分 类 号：R723.14[医药卫生—儿科]