青少年期身體質量指數對成年期肥胖的相關性研究

Abstract

背景： 肥胖已成為世界嚴重的公衛問題，已有研究證實兒童及青少年時期的肥胖，與成年期的肥胖、心血管疾病甚至是死亡率都有正相關性，然而兒童及青少年正處於身體生長發育時間，如何適當的在生長發育及肥胖控制上達到平衡點，是目前各國及研究者所共同關注，國內雖已做過多次橫斷面的肥胖盛行率調查研究，始終缺乏從青少年至成年長期體位追蹤的研究。 方法： 本研究利用社區已建檔之青少年期身體檢查之資料，探討青少年期肥胖對成年期肥胖的影響。主要利用北台灣某鄉鎮唯一一所國中於1995年入學，進行國一(約13歲)、國三(約15歲)及成年時(約27歲)的三次體位測量，以身體質量指數做為過重或肥胖的定義，使用logistic regression 統計方法，對青少年肥胖與成年肥胖做相關性的統計分析。 結果： 1995年入學共有384位新生(男生178人，女生206人)，而有完整至成年追蹤體位的共有112位受試者(男生61人，女生51人)。以國一時過重或肥胖與否對成年過重或肥胖進行分析，在男生部分可得到勝算比達14.3 (95%信賴區間: 2.70 – 75.2)，而女生部分則為57.3 (4.78 – 687.6)，而在國三部分，男生則為13.6 (3.17 – 58.1)，女生則為8.36 (1.18 – 59.4)。以國一至國三間身高、體重或身體質量指數之變化對成年過重或肥胖進行統計分析，可得在不分男女的族群分析上，體重變化為三者中唯一達到統計意義，其勝算比為1.11 (1.02 – 1.21)，而在男性女性分開的分析中，僅有男性的身高變化有統計顯著的負相關，其勝算比為0.83 (0.72 – 0.97)。 結論： 兒童或青少年時期的肥胖，在成人時繼續保持肥胖的情形較體重正常者為高，政府的公共衛生政策應將兒童或青少年時期適當的身體組成包括身高、體重及身體質量指數訂出，並提出相關防治或治療建議。

Background: The worldwide epidemic of obesity had become serious health problem. The relationship between childhood obesity and adult obesity had been demonstrated. Moreover, there are reports showed childhood obesity lnks to adult cardiovascular disease mortality. However, there are few longitudinal follow up studies aimed at the change of body indices from childhood to adulthood in Taiwan. Materials and Methods: The study population was all the freshman entering one junior high school in Northern part of Taiwan in 1985. The measurements of body height, body weight, and body mass index were performed longitudinally for three times at the first year of junior high school (about 13 years old), the third year of junior high school (about 15 years old), and adulthood (about 27 years old). Based on BMI levels, participants were classified into overweight or not, obese or not, and overweight and obese or not. Logistic regression analysis was used as the statistical method for the association analysis of adolescent obesity with young adulthood obesity. Results: A total of 384 participants (male: 178, female: 206) were included in 1985, and the complete follow up data for three measurements were available in 112 participants (male: 61, female: 51). Using logistic regression analysis with adulthood obesity as the outcome variable, odds ratio (OR) of adulthood overweight and obesity of participants with overweight and obesity at the first year of junior high school survey versus without was 14.3 (95% confidence interval: 2.70 – 75.2) in male and 57.3 (4.78 – 687.6) in female. The OR of adulthood overweight and obesity of participants with overweight and obesity at the third year of junior high school survey versus without was 13.6 (3.17 – 58.1) in male and 8.36 (1.18 – 59.4) in female. The change of body height, body weight, and body mass index between the investigations at the first year and the third year were also used as the indepent variables for analysis. The results showed that the change of body weight (OR = 1.11, 1.02 – 1.21) was positively associated with adulthood obesity among all participants, and the change of body height (OR = 0.83, 0.72 – 0.97) were negatively associated with adulthood obesity in males. Conclusion: The results demonstrated that obese adolescents are tended to become obese adults in our country even our obesity cut-off points are different from other races. Also, the change of body weight and body height is important in obesity prevention program. The government should provide proper children and adolescents growth standards including body height, body weight, and body mass index among different ages our children and adolescents, and build effective obesity control programs.