出生体重与儿童期肥胖关联性的系统评价

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。

Systematic review on the association between birth weight and childhood obesity

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.