儿童期肥胖与出生体重的关系探讨

目的探讨儿童期肥胖症与出生体重的关系。方法采用整群抽样横断面调查与追踪调查的流行病学方法调查北京市部分健康学生,调查学龄儿童(7岁～12岁)与9年后同一观察对象(15岁～20岁)共193名(386人次),对每位学生在其儿童期(7岁～12岁)及青少年期(15岁～20岁)测量身高、体重、血压,并将出生体重、儿童饮食习惯等内容的问卷表发给家长填写。根据儿童期及青少年期体重指数(BMI)分为体重正常、超重和肥胖,比较同一观察对象儿童期、青少年期肥胖与出生体重的关系。结果儿童期与青少年期男孩的超重和肥胖的发生率均明显高于女孩,儿童期的肥胖率要高于青少年期,青少年期的超重率高于儿童期。正常出生体重组与高出生体重组超重-肥胖发生率有统计学意义(P0.05),低出生体重组与高出生体重组之间无统计学意义(P0.05)。结论出生体重与儿童期肥胖及青少年期有关。     

儿童青少年体质指数、腰围预测代谢综合征的意义

目的 研究儿童青少年腰围（WC）、体质指数（BMI）预测胰岛素抵抗（IR）或代谢综合征（MS）的意义。方法 对超重33例、肥胖106例、正常对照（NC）儿童青少年140例进行身高、体重、腰围、Tanner分期、血压及OGTT、血脂、胰岛素的测定。结果 总体人群中，BMI、WC与MS组分存在单因素相关关系（P〈0．01），其中与HOMA-IR相关性最好（r=0.717，0.709）。多元线性回归分析显示，正常对照组WC（β coefficient=2．169）和TG（βcoefficient=0.429）可预测HOMA-IR，而超重肥胖组BMI（βcoefficient=0.356）和TG（βcoefficient=0.886）可预测HOMA—IR。结论 超重、肥胖儿童青少年的BMI可能是确定MS高危人群的指标。     

新诊断2型糖尿病患者体重指数与胰岛素抵抗、血脂的关系

根据体重指数（BMI）将128例新诊断2型糖尿病（T2DM）患者分为肥胖组、超重组、正常组三组,测定其血糖、血脂及胰岛素抵抗指数（HOMA-IR）。结果显示,肥胖组、超重组HOMA-IR明显高于正常组（P〈0.01）;肥胖组高密度脂蛋白低于其他两组;且随甘油三酯、BMI升高,血压有增高趋势。认为新诊断肥胖及超重T2DM患者与胰岛素抵抗、血脂异常、高血压相关。     

肥胖、超重、正常体重儿童心脏结构和功能比较

目的比较肥胖、超重及正常体重儿童心脏的结构和功能。方法随机选择单纯性肥胖儿童38名（肥胖组）、超重儿童60名（超重组）和正常体重儿童50名（对照组）。彩超检查室间隔舒张末期厚度（IVST）、左室舒张末期内径（LVDd）、左室后壁舒张末期厚度（LVPWT）、二尖瓣舒张早期峰值流速（E峰）、舒张晚期峰值流速（A峰）和射血分数（EF）。结果①IVST、LVDd、LVPWT和左室质量（LVW）依次是肥胖组〉超重组〉正常组，P〈0．05，P〈0．01。②肥胖组和超重组E峰低于正常组，而A峰高于正常组；前两组间差异亦有统计学意义。③体重指数（BMI）与IVST（r=0．798）、LVDd（r=0．627）、LVPwr（r=0．554）、LVW（r=0．693）及A峰（r=0．458）呈正相关，与E峰（r=-0．449）呈负相关。结论心脏结构及功能与儿童肥胖程度密切相关，单纯肥胖和超重儿童已有亚临床心脏形态及舒张功能改变，开展儿童早期肥胖的预防势在必行。     

温州地区汉族人群G蛋白β3亚基C825T基因多态性与肥胖的相关性研究

目的研究温州地区汉族人群G蛋白β3亚基（GNB3）C825T等位基因多态性与超重及单纯性肥胖的相关性。方法超重及单纯性肥胖组为肥胖专科门诊中随机选取161例超重或单纯性肥胖患者，并于温州市中心血站随机选取313名体重正常健康献血者为对照组，PCR-RFLP检测基因型。结果（1）温州地区汉族人群GNB3 825T等位基因频率为0．428，与其他人种的基因频率显著不同。（2）超重及单纯性肥胖组的TT基因型携带者显著增加（P〈0．01），TT／CT导致肥胖的比数比（OR值）为2．9（95％可信区间1．8-4．7，P〈0．01）；TT／CC致肥胖的OR值为2．7（95％CI 1．5—4．7，P〈0．01）；TT基因型分布按体重指数（BMI，kg／m^2）分组后，正常体重（18≤BMI〈23）、超重（23≤BMI〈25）、Ⅰ度肥胖（25≤BMI〈30）和Ⅱ度肥胖（BMI≥30）4组均显著高于低体重（BMI〈18组，P〈0．05或P〈0．01）；Ⅰ度肥胖、Ⅱ度肥胖组高于正常体重组（均P〈0．05）；Ⅱ度肥胖组高于超重组（P〈0．01）。（3）同组男女间比较GNB3 C825T基因型和T等位基因频率分布差别无统计学意义。结论GNB3 C825T等位基因频率分布存在种族差异，温州地区汉族人群GNB3 825T等位基因频率为0．428，GNB3 825T等位基因与超重及单纯性肥胖呈正相关。GNB3 825T基因型可作为早期预测单纯性肥胖的遗传学指标之一。     

超重肥胖青少年空腹血糖受损的特点及其相关影响因素分析

目的 研究儿童青少年空腹血糖受损（IFG）的特点及其相关影响因素。方法 超重肥胖组（0b）459例，体重正常对照组（NC）221名，测量身高体重、FPG、Fins、瘦素及血脂，计算HO—MA—IR、HOMA-β、QUICKI，分析FPG的分布及相关因素。结果 （1）Ob组的Fins、瘦素、血脂、HOMA—IR、HOMA-β显著高于NC组（P〈0．05）。QUICKI显著低于NC组（P〈0．05）。（2）在正常血糖组和IFG组，NC组的Fins显著低于Ob组（P〈0．05）。（3）Ob组的IFG（17．21％）比例显著高于NC组（2．26％），NC组的IFG患者其FPG主要介于5．6～6．0mmol／L。FPG与年龄、性别、BMI、Fins、瘦素、TG、TC和HOMA—IR均显著相关。结论 本组Ob患者IFG的发生率显著高于NC组，FPG与其他代谢综合征（MS）组分显著相关，进一步研究儿童青少年FPG和IFG变化规律，将有助于儿童青少年T2DM及相关MS的防治。     

北京农村老年人体重指数与血压、血糖、血脂关系分析

目的 了解北京大兴农村地区老年超重和肥胖与血压、血糖、血脂等的关系及临床意义.方法 对长子营地区3036名60岁以上老年人(包括超重1328人、肥胖747人、正常体重961人)通过问卷调查获得高血压、糖尿病和吸烟等情况,通过体格检查和实验室检查获得体重指数、血压、血糖、血脂、血尿酸等数据.结果 60岁以上老年女性超重和肥胖者明显多于男性.正常体重组、超重组和肥胖组血压、空腹血糖、TG、LDL-C、尿酸水平依次升高,而HDL-C水平逐渐降低,三组之间差异有统计学意义(P＜0.01).超重和肥胖组的高血压、糖尿病、血脂异常和高尿酸血症发病率明显高于正常体重组.结论 超重和肥胖与高血压、糖尿病、血脂异常和高尿酸血症密切相关,可能是导致老年心脑血管疾病的共同危险因素.     

体重指数、腰围与血糖、血压的关系

目的 探讨体重指数、腰围与血糖、血压的关系.方法 2000年对克拉玛依市12个单位取样调查4830人测身高,体重,腰围（WC）,测血糖,血压,计算体重指数（BMI）.BMI、 WC按中国肥胖标准分组,男女按BMI各分为三组：（1）正常组BMI＜24 kg/m^2,（2）超重组BMI≥24～＜28 kg/m^2,（3）肥胖组BMI≥28 kg/m^2;男女按WC各分两组：男性正常组WC≤85 cm,腹型肥胖组WC＞85 cm;女性正常组WC≤80 cm,腹型肥胖组WC＞80 cm.男女各组间血糖,收缩压,舒张压进行统计学分析.结果 （1）男女各组间血糖、收缩压、舒张压均有显著性差异（P＜0.01）;（2）多元回归分析示男女血糖、收缩压、男性舒张压与BMI、 WC正相关（P＜0.01）,女性舒张压与BMI、WC无相关性（P＞0.05）.结论 为了防治糖尿病及高血压病,控制肥胖及腹型肥胖甚为重要,控制体重指数,腰围为基本的措施之一.     

慢性阻塞性肺疾病患者体质量指数与肺功能及HRCT气道重塑参数的相关性研究

目的探讨低体质量指数（bodymassindex,BMI）cOPD患者肺功能受损程度、临床及影像学特征。方法选取COPD急性加重期患者62例,根据BMI分为4组：低体重组（BMI％18．5kg／m2）、正常体重组（BMI18．5～23．9kg／m2）、超重组（BMI24．0H27．9kg／m2）、肥胖组（BMI≥28kg／m2）。所有患者进行慢性阻塞性肺疾病自我评估测试（COPDassessmenttest,CAT）问卷、肺功能检测及高分辨CT（highresolutionCT,HRcT）检查,并同时应用HRCT相关软件测定肺气肿评分、气道壁厚度及管腔面积等气道重塑指标。观察各组上述指标的变化,并研究其与BMI的相关性。结果①所有患者中低体重组患者12例,正常体重组患者30例,超重组患者7例,肥胖组患者13例,各组患者的年龄、性别、吸烟指数差异无统计学意义;②与正常体重、超重及肥胖患者比较,低体重患者FEV。％pred、MVV、Dt．co／VA％pred、FEV,／FVC均下降（P〈0．05）,而RV／TLc增高（P〈0．05）;③与正常体重、肥胖患者比较,低体重患者CAT评分增高（Pd0．05）;④与正常体重、超重及肥胖组患者比较,低体重组患者肺气肿评分高（Pd0．05）;⑤低体重患者管壁面积百分比（WA％pred）、壁厚与外径比率（TDR％pred）与各组间差异无统计学意义（P〉0．05）;⑥BMI与CAT评分、肺气肿评分、RV／TLC均呈负相关（r=-0．351,P〈0．05;r=-0．628,P〈0．05;r=-0．256,P〈0．05）,而与WA％pred、TDR％pred无相关性（P〉0．05）;BMI与FEV1／FVC、DLCO／VA％pred呈正相关（r=0．387,P〈0．05;r=0．549,P〈0．05）。结论低BMI的COPD患者肺气肿程度严重,通气及弥散功能明显下降,这对临床综合评估COPD病情的严重程度有一定帮助。     

北京地区儿童青少年胰岛素抵抗分布及其与瘦素／脂联素比值的关系

目的研究北京儿童青少年胰岛素抵抗指数的分布,探讨血液瘦素／月旨联素比值（LEP／APN）对儿童胰岛素抵抗状态的诊断价值。方法选取北京地区6—18岁儿童青少年代谢综合征研究队列的3506名儿童青少年,以中国肥胖问题工作组2004年制定的中国学龄儿童青少年超重、肥胖筛查体质指数（BMI）分类标准将研究对象分为正常体重人群（1628人）、超重人群（659人）和肥胖人群（1219人）,进行体量指标和青春发育程度的评价以及测定空腹血糖、血脂、真胰岛素、LEP和APN等。以稳态模型胰岛素抵抗指数（HOMA—IR）评价胰岛素抵抗状态。在健康儿童青少年中,按HOMA—IR百分位分布确定评价儿童青少年胰岛素抵抗界值。采用相关和回归分析评价LEP／APN与HOMA—IR的相关性,受试者工作特征曲线（ROC曲线）探讨LEP／APN对儿童胰岛素抵抗状态的诊断价值。结果尝试建立北京地区健康儿童青少年胰岛素抵抗界值：青春发育前期HOMA—IR≥2．6;青春发育期HOMA—IR≥3．4。超重和肥胖儿童胰岛素抵抗检出率分别为22．2％和42．9％。相关分析显示LEP／APN与HOMA—IR相关（相关系数为0．51,偏相关系数为0．40,P〈0．01）。多元线性回归分析提示LEP／APN独立于其他因素对HOMA—IR的影响最大（偏回归系数0．273,标准化偏回归系数为0．467,P〈0．01）。ROC曲线分析显示LEP／APN对胰岛素抵抗预测能力高于LEP、APN和评价肥胖的体量指标（如腰围、BMI和体脂率）。结论评价儿童青少年胰岛素抵抗需考虑青春发育状况,超重和肥胖儿童存在明显胰岛素抵抗。LEP／APN可作为一项反映儿童青少年胰岛素抵抗的新指标,对肥胖相关代谢紊乱的预测具有参考价值。     

儿童和青少年期肥胖症与血脂的关系

目的探讨儿童和青少年期肥胖症与m脂的关系。方法采用整群抽样横断面调查与追踪调查的流行病学方法观察北京市193名(386人次)学生,每一观察对象在儿童期(7～12岁)和9年后其青少年期(16～21岁)测量身高、体质量,检测血清总胆固醇(TC)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)和三酰甘油(TG)水平。结果儿童和青少年期男孩的超重和肥胖发牛率均明显高于女孩(儿童期:16.3%比11.9%,15.2%比10.9%;青少年期:23.9%比7.9%,8.7%比3.0%,均为P0.05),儿童期总的肥胖率高于青少年期(12.9%比5.7%,P0.05),青少年期的超重率略高于儿童期(15.5%比14.0%,P0.05)。儿童期肥胖组的平均TG水平较体质量正常组高[(1.22±0.84)mmol/L比(0.82±0.54)mmol/L,P0.01];青少年期肥胖组平均TC和LDL-C水平均高于体质量正常组(均为P0.05);儿童期肥胖组在青少年期时平均TC和LDL-C水平高于体质量正常组(均为P0.01)。结论儿童和青少年期肥胖症是影响血脂的重要因素。     

Association of childhood obesity phenotypes with early adulthood Carotid Intima-Media Thickness (CIMT): Tehran lipid and glucose study

Background and aimsOver the past few years, obesity and metabolic syndrome prevalence among children and adolescence have an increasing trend. This study aims to investigate the association of obesity phenotypes during childhood and adolescence with early adulthood carotid intima-media thickness (CIMT).Methods and resultsParticipants were divided into four obesity phenotypes: Metabolically healthy normal weight (MHNW), metabolically unhealthy normal weight (MUNW), metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO). Participants were followed for 18 years. Multivariate-adjusted Risk Ratios (RRs) were calculated for high CIMT (≥95% percentile) incidence.In this cohort study 1220 children and adolescents with the average age of 10.9 ± 4.0 years were included. CIMT values had a significantly increasing trend from MHNW to MUO group (p for trend<0.001). Individuals with normal weight status, even with an unhealthy metabolic profile did not have higher risk of high CIMT. Similarly, Children with obesity but healthy metabolic status was not at higher risk. On the other hand, MUO phenotype during childhood was associated with increased risk of high CIMT in early adulthood (RR = 2.13, 95%CI (1.02–4.48)). This association became insignificant for all obesity phenotypes after adjusting for adulthood BMI.ConclusionAdulthood CIMT has an increasing trend based on childhood and adolescence obesity phenotypes from MHNW to MUO. Children with MUO phenotype was the only ones that had an increased risk of high CIMT incidence in early adulthood.     

Birth weight and blood pressure in childhood: results from the Health Survey for England

Findings of previous reports relating low birth weight with raised blood pressure in childhood and adolescence have been inconsistent. The present study uses cross-sectional data from a series of nationally representative annual surveys--the Health Survey for England--between 1995 and 2002, totaling a sample of 15 629 children aged 5 to 15. A significant negative relationship between birth weight, in quartiles or dichotomized as low (<2.5 kg) and normal (> or =2.5 kg) and systolic blood pressure was apparent. Linear regression analyses confirmed these findings. When current weight was included in the model, the strength of the relationship increased. An interaction term between birth weight and current weight was not significant. A life-course plot for those aged 13 to 15 (n=3900), converting the weight measurements at birth and as a teenager to standard deviation scores to make the regression coefficients comparable, showed the importance of weight gain on blood pressure (1 standard deviation increase in weight from birth to age 13 to 15 was associated with an increase in systolic blood pressure of 0.8 mm Hg). Separating those with low and normal birth weight demonstrated that the increase in weight from birth to adolescence had an effect on blood pressure in both those with low and normal birth weight. Postnatal changes in size have a more important effect on blood pressure in childhood and adolescence than birth weight. Reducing the prevalence of overweight among children may reduce their systolic blood pressure importantly and, particularly among children with lower birth weight, the prevalence of hypertension later in life.     

Impaired glucose tolerance and elevated blood pressure in low birth weight, nonobese, young south african adults: early programming of cortisol axis

Low birth weight is associated with increased cardiovascular and metabolic disorders in adult life, although the mechanisms of this effect remain uncertain. There is one report of increased morning plasma cortisol levels in an elderly low birth weight cohort, but whether this is primary or secondary to other aspects of the phenotype is unclear. We investigated the association between low birth weight and glucose intolerance, blood pressure, and dyslipidemia in young, nonobese adults from a community undergoing the health transition with a high prevalence of both noncommunicable diseases and low birth weight. Additionally, we investigated whether altered basal and stimulated cortisol levels as a marker of hypothalamic-pituitary-adrenal responsiveness or cortisol metabolism were associated with low birth weight in these young adults. Twenty-year-old, historically disadvantaged, urbanized South Africans (n = 137) with birth weights either below the 10th percentile [underweight for age (UFA)] or between the 25th and 75th percentiles [appropriate for gestational age (AFA)] had anthropometry, blood pressure, lipid levels, and glucose tolerance measured. In a subset (n = 62), 0900 h plasma cortisol concentrations, cortisol responses to 1 microg ACTH, and urinary glucocorticoid metabolites were measured. The mothers of UFA infants were themselves lighter and had a lower body mass index (P: = 0. 0016). At age 20 yr, although the UFA group was still smaller and lighter, with a lower body mass index, they had higher fasting plasma glucose levels (P: = 0.047), and a greater proportion demonstrated glucose intolerance (11.9% vs. 0%; P: < 0.01). The UFA group also had higher systolic [UFA, 126.0 +/- 13.3 (+/-SD); AFA, 122.0 +/- 11.7 mm Hg; P: = 0.007] and diastolic (72.3 +/- 8.4 vs. 69. 5 +/- 8.7 mm Hg; P: = 0.02) blood pressures, after covarying for current weight and gender. Plasma cortisol levels determined at 0900 h were higher in the UFA group (484.9 +/- 166.3 vs. 418.6 +/- 160.6 nmol/L) and showed a greater plasma cortisol response to low dose ACTH stimulation (area under the curve for cortisol: UFA, 77,238 +/- 19,511; AFA, 66,597 +/- 16,064 nmol/L.min; P: = 0.04). In conclusion, the link between low birth weight and adult glucose intolerance and blood pressure elevation occurs in young adults in a high risk, disadvantaged population despite a lack of full catch-up growth. Moreover, cortisol axis activation is an early feature in the process linking low birth weight with adult cardiovascular and metabolic disease and is not dependent upon adult obesity or full catch-up growth, at least in this population undergoing the health transition.     

Weight and length at birth and their relationship to diabetes incidence and all-cause mortality--a 32-year follow-up of the population study of women in Gothenburg, Sweden

OBJECTIVE: The purpose of the study was to explore the relationship of weight and length at birth to diabetes in adult life and to all-cause mortality. Special attention was taken to potential confounding factors as age, family history, education, socio-economic group, physical inactivity, smoking, blood pressure, serum lipids and obesity. RESEARCH DESIGN AND METHODS: A longitudinal population study consisting of a representative sample of 1381 women aged 38-54 started in Gothenburg, Sweden, in 1968-1969 monitoring for diabetes mellitus and overall mortality over 32 years. Original delivery records were retrieved for 61.2% of the women. Death certificates were obtained for 99.3% the women who died during the 32-year follow-up period. RESULTS: We observed an inverse statistically significant relationship between birth weight and 32-year diabetes incidence independent of age, the highest incidence 16.3% in the lowest quartile of birth weight compared to 9.2% in the highest quartile. The relationship remained when controlling for the following covariates: education, socio-economic group, physical activity, smoking, systolic blood pressure, adult body mass index (BMI), waist-hip ratio, serum triglycerides and cholesterol. When overweight women (BMI> or =25) were excluded from the statistical analyses birth weight was even stronger related to the incidence of diabetes, 12.8% in lowest quartile and 5.7% in the highest quartile of birth weight independent of birth length, education, socio-economic group, physical activity, smoking, systolic blood pressure, body mass index, waist-hip ratio, blood glucose, serum triglycerides and cholesterol. Length at birth was a predictor for diabetes independent of age plus adult body mass index (BMI) and smoking but not independent of age only. No significant associations were observed between birth factors as birth weight and birth length and overall mortality during the 32-year of follow-up. CONCLUSIONS: A low birth weight seems to be a risk factor for diabetes in adult women independent of age and most of the established risk factors for diabetes.     

初始血压水平对青少年远期血压变化及高血压发生的影响

目的 探索初始血压水平对青少年远期血压变化及高血压发生的影响.方法 1987年在陕西汉中农村4623名6～15岁在校学生进行血压等相关因素调查的基础上,根据初始3次血压测量,收缩压持续稳定在该年龄、性别血压百分位数75以上者为血压偏高组,3次血压测量收缩压持续稳定在该年龄、性别血压百分位数50以下者为血压正常对照组.共有292名儿童进入队列(其中血压偏高组152名,血压正常对照组140名).2005年对该队列组样本进行随访.结果 总随访率70.2%,其中血压偏高组随访率70.4%,对照组随访率70.0%;基线血压偏高组,18年后随访不仅收缩压、舒张压仍显著高于基线血压对照组,而且前者发生高血压(≥140/90 mm Hg,1 mm Hg=0.133 kPa)的概率是后者的6.88倍(28.0%对4.1%,P＜0.01).结论 初始血压百分位偏高儿童,远期高血压发生率显著增加,是青年高血压发病重要易患因素.     

海门地区体检人群脂肪肝检出及危险因素分析

目的了解海门地区体检人群脂肪肝的检出率及其危险因素。方法对海门市5112例健康体检者测量其身高、体重、血压,检测其血脂、乙型肝炎病毒血清指标、血糖,并随机抽样100例检测其血清瘦素、胰岛素,计算胰岛素抵抗。结果脂肪肝组肥胖、高血脂、高血压、HBV感染、高胰岛素、高瘦素的患病率明显高于非脂肪肝组(P<0.01)。结论有效合理地控制人群中肥胖、高血脂、高血压、HBV感染、高胰岛素、高瘦素等危险因素,将有效降低脂肪肝的发病率。     

Early socioeconomic position and blood pressure in childhood and adulthood: the Cardiovascular Risk in Young Finns Study

Studies have found an association between low socioeconomic position in childhood and high adult blood pressure. It is unclear whether this association is explained by a pathway directly linking disadvantage to elevated blood pressure in childhood and adolescence, which then tracks into adulthood. We assessed parental socioeconomic position and systolic blood pressure in 1807 children and adolescents ages 3 to 18 years at baseline. Adult systolic blood pressure was measured 21 years later at ages 24 to 39 years. There was strong tracking of blood pressure from childhood to adulthood. Lower parental socioeconomic position was associated with higher blood pressure in childhood, adolescence (P<0.01), and adulthood (P<0.0001), with the mean age- and sex-adjusted systolic pressure differences between the highest and lowest socioeconomic groups varying between 2.9 and 4.3 mm Hg. With adjustment for blood pressure in childhood and adolescence, the regression coefficient between parental socioeconomic position and adult blood pressure attenuated by 32%. A similar level of attenuation (28%) occurred with adjustment for adult body mass index (BMI). With adjustment for both preadult blood pressure and adult BMI, the association between parental socioeconomic position and adult blood pressure was attenuated by 45%. Other factors, including birth weight and BMI in childhood and adolescence, had little impact on the association between parental socioeconomic position and adult blood pressure. These data suggest that early socioeconomic disadvantage influences later blood pressure in part through an effect on blood pressure in early life, which tracks into adulthood, and in part through an effect on BMI.     

Birth size, early childhood growth, and adolescent obesity in a Brazilian birth cohort

DESIGN: Cross-sectional visit to a subsample of a population-based birth cohort. SAMPLE: A total of 1076 adolescents aged 14-16 y; 51% males. MEASUREMENTS: Weight, height, subscapular and triceps skinfolds were used for assessing overweight and obesity in adolescence, using WHO-recommended criteria. Anthropometric status in early life was measured through birthweight and through weight and length/height at average ages of 20 and 43 months. RESULTS: All analyses were adjusted for socioeconomic and maternal confounding factors. Birthweight and attained size (Z-scores of weight-for-age, height-for-age and weight-for-height) at 20 and 43 months were associated linearly and positively with overweight and obesity in adolescence. Four in each five obese adolescents were not overweight in childhood. Rapid weight gain, both between birth and 20 months, and between 20 and 43 months, was also associated with adolescent overweight and with obesity. Rapid height gain between 20 and 43 months was associated with overweight only. Most associations were stronger for boys. CONCLUSIONS: Birth size, attained size in childhood and particularly growth velocity in early life were associated with increased prevalence of obesity and overweight in Brazilian adolescents. On the other hand, the vast majority of overweight or obese adolescents were not overweight children. Early interventions are undoubtedly important, but population-based strategies aimed at improving diets and physical activity appear to have greater long-term potential than measures targeted at overweight children.