期刊
PEDIATRICS
卷 137, 期 5, 页码 -出版社
AMER ACAD PEDIATRICS
DOI: 10.1542/peds.2015-3492
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资金
- NIDDK [2T32DK063688-11A1, 5K12DK094723-02, 1K23DK102659-01]
- Endocrine Society's Endocrine Scholars Award in Growth Hormone Research
- Children's Hospital of Philadelphia Research Institute
- NICHD [R01 HD056465]
- NHLBI [K01HL123612]
- National Institutes of Health (NIH)
BACKGROUND: Weight-for-length (WFL) is currently used to assess adiposity under 2 years. We assessed WFL-versus BMI-based estimates of adiposity in healthy infants in determining risk for early obesity. METHODS: Anthropometrics were extracted from electronic medical records for well-child visits for 73 949 full-term infants from a large pediatric network. World Health Organization WFL and BMI z scores (WFL-z and BMI-z, respectively) were calculated up to age 24 months. Correlation analyses assessed the agreement between WFL-z and BMI-z and within-subject tracking over time. Logistic regression determined odds of obesity at 2 years on the basis of adiposity classification at 2 months. RESULTS: Agreement between WFL-z and BMI-z increased from birth to 6 months and remained high thereafter. BMI-z at 2 months was more consistent with measurements at older ages than WFL-z at 2 months. Infants with high BMI (>= 85th percentile) and reference WFL (5th-85th percentiles) at 2 months had greater odds of obesity at 2 years than those with high WFL (>= 85th percentile) and reference BMI (5th-85th percentiles; odds ratio, 5.49 vs 1.40; P<.001). At 2 months, BMI had a higher positive predictive value than WFL for obesity at 2 years using cut-points of either the 85th percentile (31% vs 23%) or 97.7th percentile (47% vs 29%). CONCLUSIONS: High BMI in early infancy is more strongly associated with early childhood obesity than high WFL. Forty-seven percent of infants with BMI >= 97.7th percentile at 2 months (versus 29% of infants with WFL >= 97.7th percentile at 2 months) were obese at 2 years. Epidemiologic studies focused on assessing childhood obesity risk should consider using BMI in early infancy.
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