| Objective:This study intends to explore the situation and related risk factors about overweight and obesity of a birth cohort including low birth weight(LBW)and normal birth weight(NBW)in childhood;To analyze the early life of LBW,life behavior factors and their interactions on the influence of childhood overweight and obesity.In addition,we try to explain and understand the mechanisms behind overweight and obesity in children and provide a scientific basis for improving prevention.Methods:We studied the LBW birth cohort in shenyang,China.In the birth cohort,subjects with BW < 2500 g were selected as exposure group.For each exposed subject,3 non-exposed subjects were selected,with a BW value of 2500-3999 g,matching type of institute,gender,and year of birth.We excluded those who had died before the age of 12 and had severe congenital malformations.The follow-up period is from September 2016 to February 2017.The follow-up consisted of three parts: physical examination,questionnaire survey,and biochemical markers related to metabolism.All data is entered by the software EpiData.SPSS 21.0 was used for all analyses.Results: 1.Characteristics of the subjects In this study,281 children aged 7-9 years were eligible to visit in childhood,and 121 were female,accounting for 43.1%.The number of male students was 160,accounting for 56.9%.Gestational age,birth rate,caesarean section and multiple births were all risk factors for low birth weight.Exposure group(low birth weight)were 77,204 nonexposure group(normal birth weight).2.Associations between LBW and childhood overweight/obesity,abdominal obesity,body fat,blood pressure and biochemical markers The incidence of overweight and obesity was 28.9% and 23.4% in childhood exposure group and non-exposure group,and there was no statistical difference in the incidence of overweight and obesity in the two groups(P>0.05).The mean waist circumference,waistto-hip ratio and waist height ratio of the exposed group were 62.96,0.89 and 0.47 respectively,and the non-exposure group was 60.56,0.82 and 0.45 respectively,and there was a statistical difference between the two groups(P<0.05).The mean of hip circumference was 70.38 and 70.27,respectively.No statistical significance was found between the two groups.Exposure group and non exposed group midterm centrality obesity incidence in children were 49.4% and 30.0% respectively,the incidence statistical differences between the two groups(P < 0.05),the incidence of exposure group of central obesity exposed group was 2.27 times(95% CI = 1.32,1.32).The mean values of the exposed group were 9.43 mm,10.67 mm and 9.25 mm respectively in the subscapular,biceps and umbilicus.The non-exposure group was 9.56 mm,11.08 mm and 8.70 mm respectively,and the difference was not statistically significant(P >0.05).Exposed group in childhood fat rate,body fat,in addition to fat weight,muscle mass and basal metabolic rate of average were 19.17,6.72,24.08,22.92,1121.00,non exposed group were 13.79,4.56,24.29,23.10,24.29;The difference between fat rate,fat content and basal metabolic rate was statistically significant(P <0.05).The mean value of the exposure group was 105.69 and 62.52 respectively in childhood systolic and diastolic blood pressure.The non-exposure group was 102.56 and 61.69 respectively,and the results were not statistically significant(P >0.05).Exposure in childhood triglyceride,total cholesterol,high-density lipoprotein cholesterol,low density lipoprotein cholesterol and apolipoprotein A1,apolipoprotein B,and the average fasting glucose were 0.70,4.27,1.63,2.43,1.57,1.01,1.57,non exposed group were 0.77,4.30,1.58,2.44,1.46,1.01,1.46,fasting blood glucose between two groups have statistical difference(P < 0.001).3.Birth weight and life behavior factors influencing central obesity Low birth weight(0R=4.89),TV in children's room(0R=3.65),excessive TV time(0R=1.91),severe hyperactivity disorder(0R=2.47),father and children often eat Fried food(0R=7.22).0R = 1.96),often in food(0R = 2.47),the be fond of food(0R = 2.11),easy to emotional overeating(0R = 2.10)and mother overweight obesity children(0R = 2.91)occurred in the mind have a higher risk of obesity,and the outdoors for a long time(0R = 0.24),easily seen full response(0R = 0.43)and emotional diet reduce(0R = 0.45)is a protective factor of reducing the risk of central obesity.Low birth weight and father eating Fried food,the number of take-out times in the home have positive multiplication interaction.Conclusion: 1.Low birth weight has direct effect on childhood overweight and obesity.The primary prevention of overweight and obesity would start from fetus.The children with low birth weight would be intervened as high risk group by changing their unhealthy life styles to decrease the risk of overweight and obesity.2.In view of the factors that affect children's interim central and their interactions,from different aspects to obtain,to exert the leading role of government,to promote multisectoral linkage.Based on the family,build a family-school-community of overweight obesity prevention and control system.Therefore,family factors should be paid attention to intervention of obesity in children. |
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