Birth outcomes and early growth patterns associated with age at adiposity rebound: the Ma'anshan birth cohort (MABC) study

出生结局和早期生长模式与肥胖反弹年龄相关：马鞍山优生优育队列

Authors: Zhou J, Teng Y, Zhang S, Yang M, Yan S, Tao F, Huang K.

Source: BMC Public Health. 2023 Dec 4;23(1):2405.

DOI: 10.1186/s12889-023-17236-9.

Abstract

Light at night (LAN) is a significant but underappreciated risk factor contributing to cardiometabolic disease (CMD). We therefore conducted the review examining the relationship of LAN exposure with CMD in order to investigate the effects of LAN exposure on CMD. We searched PubMed, Web of Science, Embase, and Scopus for eligible studies published from database inception to August 17, 2023. The pooled effect size was calculated using random-effects models. Heterogeneity among the studies was quantified by Cochran's Q test and I2 statistic. A total of 1,019,739 participants from 14 studies (5 cohort studies and 9 cross-sectional) were included. Among the 14 eligible studies, 9 on obesity, 4 on diabetes, 2 on hypertension, 1 on dyslipidemia, and 1 on coronary heart disease. Exposure to higher levels of LAN were associated with 21% higher risk of CMD (Summary risk ratio, SRR: 1.21, 95% CI = 1.16-1.27), accompanied by substantial heterogeneity (I2 = 61%; tau2 = 0.004; Cochran's Q = 41.02). Specifically, individuals in the highest category of LAN exposure exhibited 23% higher risk of obesity (SRR: 1.23, 95% CI = 1.14-1.32), 46% higher risk of diabetes (SRR: 1.46, 95% CI = 1.05-2.03) and 21% higher risk of other CMDs (SRR: 1.21, 95% CI = 1.10-1.34). Subgroup analyses revealed that the pooled-effect size of LAN and CMD was higher for indoor LAN than outdoor LAN (indoor LAN: SRR = 1.36; outdoor LAN: SRR = 1.17, P = 0.03). The overall quality was rated as moderate using GRADE guideline. Our study strengthens the evidence on the increase in CMD risk due to LAN exposure. Findings from this study have important implications for identifying modifiable risk factor of CMD, future prevention strategy development, and resource allocation for high-risk group.

Keywords: Cardiometabolic disease; Diabetes; Light at night; Obesity.

背景：脂肪重集聚提前被认为是肥胖风险的早期指标。我们研究目的是探讨不良出生结局和早期体格生长模式与儿童脂肪重集聚提前的关联。

方法：研究对象（n = 2705）来自马鞍山优生优育队列（the Ma’anshan birth cohort，MABC）。研究人员重复收集儿童早期体重指数（BMI）、头围、腰围和体脂数据。体重快速增长（RWG）是值出生后头两年体重标准Z分数的变化。以群组轨迹模型（GBTM）用于拟合儿童的体格生长轨迹，使用分数多项式函数模型拟合脂肪重集聚时相。

结果： 72 个月前BMI轨迹非常高（RR = 2.83；95% CI 2.33 - 1.40）、BMI轨迹上升（RR = 3.15；95% CI 2.66 - 3.72）、腰围轨迹高（RR = 4.17；95% CI 3.43 - 5.06）和体脂轨迹高（RR = 3.01；95% CI 2.62 - 3.46）的儿童发生AR提前的风险更大。低出生体重（LBW）（RR = 1.86；95% CI 1.28 - 2.51）、早产（PTB）（RR = 1.50；95% CI 1.17 - 1.93）和小于胎龄儿（SGA）（RR = 1.37；95% CI 1.14 - 1.64）与 AR提前风险增加有关。此外，出生后头两年经历RWG（RR = 1.59；95% CI 1.40 - 1.83）、低BMI数轨迹（RR = 1.27；95% CI 1.06 - 1.53）和BMI轨迹上升（RR = 1.50；95% CI 1.22 - 1.84）的婴儿随后发生AR提前的风险更高。与AR未提前的儿童相比，AR提前的儿童BMI呈现出先低（从出生到6月龄）后高的趋势（从18月龄到72月龄）。

结论：儿童在72月龄前高BMI轨迹、高腰围轨迹和高体脂肪轨迹的儿童更有可能经历AR提前，但BMI轨迹低、BMI轨迹上升和出生后头两年经历RWG的婴儿同样会增加早期AR的风险。这些结果有助于了解导致代谢风险的早期因素和过程。。

关键词：脂肪重集聚、出生结局、体重快速增长、BMI轨迹、儿童