高出生体重与儿童期超重肥胖及代谢异常的关系

目的探讨高出生体重与儿童期超重肥胖及代谢异常的关系,为增强高出生体重儿成人期的健康水平提供参考依据。方法采用历史性队列研究的流行病学方法,随机抽取无锡地区1993-1995年出生的1 435对巨大儿和正常出生体重儿作为研究对象,每个巨大儿按出生日期±2个月及性别一致的原则匹配一个对照。测量身高、体重和血压,并从中抽取300名儿童采血,检测相关生化指标。结果巨大儿组超重与肥胖检出率(13.10%,2.86%)均高于对照组(9.69%,1.61%)(P<0.01);巨大儿组与对照组相比,发生超重和肥胖的RR值分别为1.35和1.78,AR值分别为3.41%和1.26%;两组儿童的收缩压、舒张压及偏高血压检出率的差异均无统计学意义(P值均>0.05);两组之间各生化指标、胰岛素和C肽异常的检出率及胰岛素抵抗差异均无统计学意义(P值均>0.05)。结论高出生体重与儿童期超重和肥胖有关,对高出生体重儿童未来生长情况的变化应给予持续关注。

Relationship between high birth weight and overweight,obesity,metabolic anomalies in childhood

Objective To learn the relationship between high birth weight and overweight,obesity,metabolic anomalies in childhood,and to provide evidence for improving high birth weight child.Methods By a historical cohort study,subjects were randomly selected from a birth cohort including 1 435 couples of high and normal birth weight babies in Wuxi.Their height,weight and blood pressure were measured.The 300 blood samples from the children were collected and the relevant biochemical indicators were detected.Results The incidence rates of overweight and obesity were 13.10% and 2.86% respectively in the group of high birth weight.They were 9.69% and 1.61% respectively in the control group.The incidence rates of overweight and obesity in the group of high birth weight were much higher than those of the control group(P<0.01).Compared with the control group,the relative risks of overweight and obesity were 1.35 and 1.78 respectively in the group of high birth weight.The attributable risks of those were 3.41% and 1.26% respectively.There were no statistical differences of systolic blood pressures,diastolic blood pressure and the incidence of high blood pressure between the two groups.The biochemical indicators,the incidence rates of insulin and C-P abnormalities,index of insulin resistance were also no significant statistical differences.Conclusion Overweight and obesity in childhood could be affected by high birth weight.The changes of children with high birth weight in future growth should be paid sustained attention.