生命早期营养不良对成年后超重和肥胖患病危险影响的研究

目的 研究生命早期食物短缺及营养不良对成年后超重和肥胖患病危险的影响，对成年人慢性病的原因溯源，为国家制订妇女儿童营养改善政策提供科学依据。方法 应用2002年中国居民营养与健康状况调查资料，将三年自然灾害（1959—1961年）出生的研究对象作为受灾害影响人群，将灾害之后（1964年）出生的人群作为未受灾害影响人群（对照组），比较两组人群平均体重指数（BMI）及超重和肥胖患病率，并计算受灾害影响组人群患超重和肥胖的相对危险度（OR）。结果1959—1961年出生女性的BMI均值显著高于未受灾害影响的1964年出生的女性（P〈0．01），调整地区等因素后，1959—1961年出生女性的超重患病率均显著高于1964年出生的对照组女性（P〈0．05）；1959、1960年出生女性的肥胖患病率显著高于1964年出生的对照组女性（P〈0．05）。与1964年出生女性比较，生命早期受灾害影响的1959—1961年出生女性患超重的危险性分别增加28．9％（OR值95％CI为1．063～1．565）、37．2％（OR值95％CI为1．136～1．658）、35．2％（OR值95％CI为1．103～1．657），1959、1960年出生女性患肥胖的危险性分别增加46．5％（OR值95％CI为1．088～1．972）、39．6％（OR值95％CI为1．039～1．876）。而男性四组之间的平均BMI水平、超重和肥胖患病率的差异均无统计学意义（P〉0．05）。结论 生命早期遭受食物供应不足及营养不良可能会使成年后患超重和肥胖的危险性增加，制订适合国情的妇女、儿童营养改善政策，特别是控制新生儿低体重的有效措施对预防成年后慢性病的发生具有重要意义。

Effect of nutritional status during infancy and childhood on the risk of overweight and obesity in adulthood

Objective To examine the association between fetal nutritional status and overweight and obesity in their adulthood and to provide evidence for formulation of the strategy on preventing low birth weight. Methods Using data from 2002 Nationwide Nutrition and Health Survey to set up a case control method in order to compare body mass index(BMI), prevalence of overweight and obesity as well as to calculate odds ratio of overweight and obesity of case group compared with control group. Three case groups were selected from those who were born in 1959, 1960, 1961 respectively, and the controls were those who were born in 1964. Results The health consequence of being famines on adulthood was evident in women. Means of BMI in women were significantly higher in three case groups than that in control group(P<0. 01). After adjustment on geographic regions, the prevalence of overweight in women was significantly higher in three case groups than that in control group(P< 0.01). The prevalence rates of obesity were significantly higher in 1959, 1960 groups than 1964 group( P< 0.05). The odds ratios of overweight of women in three case groups were 28. 9% (95% CI :1.063-1. 565), 37. 2% (95% CI: 1.136-1.658) and 35.2% (95% CI:1. 103-1.657) respectively, all higher than that in the control group. The odds ratios of obesity of women born in 1959, 1960 groups were 46.5% (95% CI: 1.088-1.972) and 39.6% (95% CI: 1.039-1.876) respectively, higher than that in the 1964 group. However, such differences were not found in men. Conclusion Higher risks of overweight and obesity in women were caused by malnutrition during their fetal lives. A strategy on preventing low birth weight should be formulated by the government to prevent the chronic disease in adulthood.