目的 分析出生体重与抑郁-肥胖共病风险的关联,为针对不同风险人群开展精准共病干预提供科学依据。方法 基于中国家庭追踪调查,纳入2012年(本研究基线调查)和2016—2022年(随访调查)有抑郁肥胖数据、出生体重数据完整者,共纳入2 628名10~19岁的儿童青少年。抑郁症状定义为流调中心用抑郁量表评分≥17分。儿童青少年肥胖根据BMI Z评分标准判断;成年人肥胖根据BMI≥28.0kg/m2判定。抑郁症状和肥胖共病定义为有抑郁症状且肥胖。非共病进一步分为健康(无抑郁症状且不肥胖)、仅有抑郁症状(有抑郁症状但不肥胖)以及仅肥胖(肥胖但无抑郁症状)。采用多分类logistic回归模型分别分析出生体重作为连续变量和分类变量时与抑郁症状和肥胖共病风险的关联。根据年龄和性别进行分层分析。结果 在出生体重<3kg的人群中,随着出生体重增加,仅有抑郁症状的风险降低(OR＝0.561, 95%CI: 0.356~0.885)。相比于正常出生体重,低出生体重人群仅有抑郁症状的风险增加(OR＝1.489, 95%CI: 1.068~2.075),巨大儿人群仅肥胖的风险增加(OR＝1.823, 95%CI: 1.122~2.963)。结论 异常出生体重可能与儿童青少年抑郁、肥胖或抑郁-肥胖共病风险增加相关,提示将生命早期因素纳入共病风险干预有一定意义。
Abstract
Objective To analyze the association between birth weight and the comorbidity of depressive symptoms and obesity, so as to provide scientific evidence for future personalized interventions targeting different risk groups. Methods Based on the China Family Panel Studies, 2 628 children and adolescents aged 10 - 17 years with complete data on depressive symptom, obesity, and birth weight in both the baseline survey (2012) and follow-up surveys (2016-2022) were included.Depressive symptoms were defined as a score of ≥17 on the Center for Epidemiological Studies Depression Scale.Obesity in children and adolescents was determined by BMI Z-score criteria, while adult obesity was defined as BMI ≥ 28.0 kg/m2.Comorbid depressive symptoms and obesity were defined as the presence of both depressive symptoms and obesity.Non-comorbid cases were further categorized into healthy (no depressive symptoms and not obese), depressive symptoms dominant (had depressive symptoms but not obese), and obesity dominant (obese but no depressive symptoms).Multinomial logistic regression models were used to analyze the associations between birth weight (both as a continuous and categorical variable) and the risk of comorbid depressive symptoms and obesity.Stratified analysis were conducted by age and gender. Results Among individuals with birth weight <3 kg, each 1-kg increase in birth weight was associated with a decreased risk of depressive symptoms dominant (OR＝0.561, 95%CI: 0.356 - 0.885).Compared with individuals with normal birth weight, individuals with low birth weight had an increased risk of depressive symptoms dominant (OR＝1.489, 95%CI: 1.068 - 2.075), while those with macrosomia had an increased risk of obesity dominant (OR＝1.823, 95%CI: 1.122 - 2.963). Conclusion Abnormal birth weight may be associated with an increased risk of depressive symptoms, obesity, or comorbid depressive symptoms and obesity in children and adolescents, highlighting the potential significance of incorporating early-life factors into future interventions for comorbidity risk.
关键词
出生体重 /
抑郁症状 /
肥胖 /
共病 /
关联
Key words
birth weight /
depressive symptoms /
obesity /
comorbidity /
association
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基金
北京市教育科学“十四五”规划课题(BECA23111)
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