出生体重与青少年期单纯性肥胖及血脂、血糖、血压相关关系的队列研究

目的 探讨出生体重与青少年期单纯性肥胖及血脂、血糖、血压的相关关系。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,对北京市193名健康学龄儿童（7～11岁）与9年后同一观察对象（16～20岁）进行出生情况调查、体格检查及实验室检测。结果 出生体重与儿童、青少年期体质指数呈U型相关,低出生体重组（5．6％）及高出生体重组（6．1％）青少年期超重-肥胖发生率较正常出生体重组（2．8％）有增高趋势,但差异无统计学意义（P〉0．05）。高出生及低出生体重组体质指数均显著大于正常出生体重组（P值分别为0．002和0．009）,高出生体重组（33．3％）及低出生体重组（38．9％）青少年期超重-肥胖发生率均显著高于正常出生体重组（16．2％,P值分别为0．025和0．020）。不同出生体重婴儿至儿童及青少年期血糖、血脂及血压水平未发现显著差异。结论 胎儿宫内生长与青少年期体格生长密切相关,加强孕期营养指导有利于预防青少年期单纯性肥胖的发生。

A cohort study on the correlation between birth weight, simple obesity, blood lipids, blood glucose and blood pressure from childhood to adolescence

OBJECTIVE: To determine the correlation between birth weight and simple obesity, blood lipids, blood glucose and blood pressure from childhood to adolescence. METHODS: A vertical sectional survey on 193 children aged 7 - 11 years was performed in 1996. A questionnaire consisting of items on environmental factors and lifestyle, physical examination and biochemical assessment was conducted at baseline and the 9th year of follow-up. RESULTS: The incidence of obesity and over-weight in childhood in high (6.1%) and low birth-weight group (5.6%) was higher than that in normal birth-weight group (2.8%), but did not reach statistic significance; The levels of body mass index in adolescence in high and low birth-weight group were significantly higher than that in normal birth-weight group (P = 0.002 and 0.009, respectively), and the incidence of obesity and over-weight in adolescence was significantly higher in high (33.3%) and low birth-weight group (38.9%) than that in normal birth-weight group (16.2%, P = 0.025 and 0.020, respectively). There were no significant differences in the levels of blood glucose, blood lipids and blood pressure between different birth weight groups (all, P > 0.05). CONCLUSIONS: Intrauterine growth is linked to physical growth during childhood and adolescence. Nutritional guidance in pregnant phase may help to control the increased prevalence of overweight and obesity in children and adolescent.