美国儿童和青年肥胖症发病率：一项汇总分析。
Obesity Incidence in U.S. Children and Young Adults: A Pooled Analysis.
机构信息
Survey Methodology Program, University of Michigan, Ann Arbor, Michigan.
Survey Methodology Program, University of Michigan, Ann Arbor, Michigan; Department of Biostatistics, University of Michigan, Ann Arbor, Michigan.
出版信息
Am J Prev Med. 2022 Jul;63(1):51-59. doi: 10.1016/j.amepre.2021.12.021. Epub 2022 Mar 4.
INTRODUCTION
Obesity prevalence among children and adolescents has risen sharply, yet there is a limited understanding of the age-specific dynamics of obesity as there is no single nationally representative cohort following children into young adulthood. Investigators constructed a pooled data set of 5 nationally representative panels and modeled age-specific obesity incidence from childhood into young adulthood.
METHODS
This longitudinal prospective follow-up used 718,560 person-years of observation in a pooled data set of 5 high-quality nationally representative panels-National Longitudinal Survey of Youth 1979 and 1997, National Longitudinal Study of Adolescent Health, and Early Childhood Longitudinal Study-Kindergarten cohorts of 1998 and 2011-constructed by the authors, covering 1980-2016. Differences in obesity incidence across birth cohorts and disparities in obesity incidence by sex and race/ethnicity (non-Hispanic Black, Hispanic, and non-Hispanic White) were tested in multivariate models. Data were analyzed from September 2018 to October 2021.
RESULTS
Obesity incidence increased by approximately 6% for each 1 year of age (hazard ratio=1.06, 95% CI=1.05, 1.07); however, incidence was nonlinear, exhibiting an inverted "U"-shaped pattern before 15 years of age and then rising from adolescence through 30 years. Obesity incidence more than doubled between the cohorts born in 1957-1965 and those born in 1974-1985 during adolescence. There was no significant change among those born in 1991-1994 and 2003-2006 up to age 15 years. Compared with non-Hispanic White children, non-Hispanic Black and Hispanic children had higher obesity incidence in all study cohorts. The magnitude of these disparities on the relative scale remained stable throughout the study period.
CONCLUSIONS
Although many children become obese before the age of 10, obesity incidence rises from about 15 years into early adulthood, suggesting that interventions are required at multiple developmental stages.
简介
儿童和青少年的肥胖患病率急剧上升，但由于没有单一的全国代表性队列跟踪儿童进入成年早期，因此对肥胖的特定年龄动态的了解有限。研究人员构建了一个由 5 个具有全国代表性的面板组成的合并数据集，并对从儿童期到成年早期的特定年龄肥胖发病率进行建模。
方法
这是一项使用作者构建的由 5 个高质量全国代表性面板（1979 年和 1997 年全国青年纵向调查、青少年健康纵向研究以及 1998 年和 2011 年早期儿童纵向研究-幼儿园队列）的合并数据集中的 718560 人年观察结果进行的纵向前瞻性随访，涵盖了 1980 年至 2016 年。多变量模型检验了不同出生队列的肥胖发病率差异以及肥胖发病率的性别和种族/民族差异（非西班牙裔黑人、西班牙裔和非西班牙裔白人）。数据分析于 2018 年 9 月至 2021 年 10 月进行。
结果
肥胖发病率随年龄增加约 6%（风险比=1.06，95%置信区间=1.05，1.07）；然而，发病率是非线性的，在 15 岁之前呈现出倒“U”形模式，然后从青春期上升到 30 岁。在青春期，出生于 1957-1965 年的队列与出生于 1974-1985 年的队列相比，肥胖发病率增加了一倍以上。在 15 岁之前，出生于 1991-1994 年和 2003-2006 年的队列之间没有明显变化。与非西班牙裔白人儿童相比，非西班牙裔黑人和西班牙裔儿童在所有研究队列中肥胖发病率更高。在整个研究期间，这些差异的相对规模保持稳定。
结论
尽管许多儿童在 10 岁之前就已经肥胖，但肥胖发病率从大约 15 岁开始上升到成年早期，这表明需要在多个发育阶段进行干预。
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