儿童青少年出生体质量与体质量指数关系系统评价

Relationship between birth weight and body mass index of children and adolescents:a systematic review of research in China

目的探讨出生体质量(birth weight,BW)与我国儿童青少年体质量指数(body mass index,BMI)的关系。方法利用中国生物医学文献(CBMdisc)、中国知网(CNKI)、万方、PubMed等数据库检索相关报道。以合并相对危险度(relative ratio,RR)及其95%置信区间(confidence interval,CI)评估BW与儿童青少年超重或肥胖的关联。结果本研究共纳入19篇合格文献,包含研究对象208095人,其中正常出生体质量(normalbirthweight,NBW)176930人、高出生体质量(lowbirthweight,LBW)27909人以及低出生体质量(high birth weight,HBW)3256人。Meta分析结果显示,与NBW相比,LBW儿童青少年时期发生超重或肥胖的危险性降低(RR=0.84,95%CI:0.77~0.92),而HBW可增加儿童青少年发生超重或肥胖的危险性(RR=1.54,95%CI:1.47~1.60);进一步性别亚组分析结果表明,LBW可降低女性儿童青少年发生超重或肥胖的危险性(RR=0.46,95%CI:0.25~0.84),而HBW可增加男性(RR=1.41,95%CI:1.28~1.56)和女性(RR=1.48,95%CI:1.21~1.82)超重或肥胖的危险性,差异有统计学意义(P<0.05)。结论HBW可增加我国儿童青少年超重或肥胖发生的危险性,LBW可降低女性超重或肥胖的危险性,其是否可降低男性超重或肥胖的危险仍有待增加大样本、多中心研究的系统评价进行确认。

Objective To explore the relationship between birth weight(BW)and body mass index(BMI)of children and adolescents in China.Methods Relevant reports were retrieved from CBMdisc,Chinese National Knowledge Infrastructure(CNKI),Wanfang and PubMed databases.The association between BW and overweight or obesity in children and adolescents was evaluated by pooled relative ratio(RR)and its 95%confidence interval(CI).Results A total of 19 qualified papers were included in this study,involving 208095 participants,including 176930 with normal birth weight(NBW),27909 with high birth weight(HBW)and 3256 with low birth weight(LBW).Meta-analysis showed that compared with NBW,LBW reduced the risk of overweight or obesity in children and adolescents(RR=0.84,95%CI:0.77-0.92),while HBW increased the risk of overweight or obesity in children and adolescents(RR=1.54,95%CI:1.47-1.60).Subgroup analysis by gender showed that LBW could significantly reduce the risk of overweight or obesity in girls(RR=0.46,95%CI:0.25-0.84),while HBW could significantly increase the risk of overweight or obesity in both boys(RR=1.41,95%CI:1.28-1.56)and girls(RR=1.48,95%CI:1.21-1.82),all with statistically significant differences(P<0.05).Conclusions HBW may significantly increase the risk of overweight or obesity in children and adolescents in China.LBW may reduce the risk of overweight or obesity in girls.Whether it can reduce the risk of overweight or obesity in boys remains to be confirmed by systematic evaluation of large samples and multi center studies.