High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood
Objective To characterize growth trajectories of children who develop severe obesity by age 6 years and identify clinical thresholds for detection of high-risk children before the onset of obesity. Study design Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th...
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| Veröffentlicht in: | The Journal of pediatrics 2017-04, Vol.183, p.87-93.e1 |
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| container_title | The Journal of pediatrics |
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| creator | Smego, Allison, MD Woo, Jessica G., PhD Klein, Jillian, MD Suh, Christina, MD, MPH Bansal, Danesh, MD Bliss, Sherri, MS Daniels, Stephen R., MD Bolling, Christopher, MD Crimmins, Nancy A., MD |
| description | Objective To characterize growth trajectories of children who develop severe obesity by age 6 years and identify clinical thresholds for detection of high-risk children before the onset of obesity. Study design Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th percentile) groups were selected from populations treated at pediatric referral and primary care clinics. A population-based cohort was used to validate the utility of identified risk thresholds. Repeated-measures mixed modeling and logistic regression were used for analysis. Results A total of 783 participants of normal weight and 480 participants with severe obesity were included in the initial study. BMI differed significantly between the severely obese and normal-weight cohorts by age 4 months ( P |
| doi_str_mv | 10.1016/j.jpeds.2016.11.020 |
| format | Article |
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Study design Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th percentile) groups were selected from populations treated at pediatric referral and primary care clinics. A population-based cohort was used to validate the utility of identified risk thresholds. Repeated-measures mixed modeling and logistic regression were used for analysis. Results A total of 783 participants of normal weight and 480 participants with severe obesity were included in the initial study. BMI differed significantly between the severely obese and normal-weight cohorts by age 4 months ( P < .001), at 1 year before the median age at onset of obesity. A cutoff of the World Health Organization (WHO) 85th percentile for BMI at 6, 12, and 18 months was a strong predictor of severe obesity by age 6 years (sensitivity, 51%-95%; specificity, 95%). This BMI threshold was validated in a second independent cohort (n = 2649), with a sensitivity of 33%-77% and a specificity of 74%-87%. A BMI ≥85th percentile in infancy increases the risk of severe obesity by age 6 years by 2.5-fold and the risk of clinical obesity by age 6 years by 3-fold. Conclusions BMI trajectories in children who develop severe obesity by age 6 years differ from those in children who remain at normal weight by age 4-6 months, before the onset of obesity. Infants with a WHO BMI ≥85th percentile are at increased risk for developing severe obesity by age 6 years.</description><identifier>ISSN: 0022-3476</identifier><identifier>EISSN: 1097-6833</identifier><identifier>DOI: 10.1016/j.jpeds.2016.11.020</identifier><identifier>PMID: 27916426</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Factors ; BMI percentile ; Body Mass Index ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Humans ; Incidence ; Infant ; infant growth ; Infant, Newborn ; Logistic Models ; Male ; obese ; Obesity - diagnosis ; Obesity - epidemiology ; Obesity, Morbid - diagnosis ; Obesity, Morbid - epidemiology ; Pediatrics ; Predictive Value of Tests ; Reference Values ; Reproducibility of Results ; Risk Assessment ; Sex Factors ; weight for length ; Weight Gain</subject><ispartof>The Journal of pediatrics, 2017-04, Vol.183, p.87-93.e1</ispartof><rights>Elsevier Inc.</rights><rights>2016 Elsevier Inc.</rights><rights>Copyright © 2016 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c514t-f823320c75c0834004e5d89f444a6b58d802f2a97cd84818c3251bc121d052433</citedby><cites>FETCH-LOGICAL-c514t-f823320c75c0834004e5d89f444a6b58d802f2a97cd84818c3251bc121d052433</cites><orcidid>0000-0002-2852-8427 ; 0000-0003-3644-8432</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpeds.2016.11.020$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>230,315,781,785,886,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27916426$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smego, Allison, MD</creatorcontrib><creatorcontrib>Woo, Jessica G., PhD</creatorcontrib><creatorcontrib>Klein, Jillian, MD</creatorcontrib><creatorcontrib>Suh, Christina, MD, MPH</creatorcontrib><creatorcontrib>Bansal, Danesh, MD</creatorcontrib><creatorcontrib>Bliss, Sherri, MS</creatorcontrib><creatorcontrib>Daniels, Stephen R., MD</creatorcontrib><creatorcontrib>Bolling, Christopher, MD</creatorcontrib><creatorcontrib>Crimmins, Nancy A., MD</creatorcontrib><title>High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood</title><title>The Journal of pediatrics</title><addtitle>J Pediatr</addtitle><description>Objective To characterize growth trajectories of children who develop severe obesity by age 6 years and identify clinical thresholds for detection of high-risk children before the onset of obesity. Study design Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th percentile) groups were selected from populations treated at pediatric referral and primary care clinics. A population-based cohort was used to validate the utility of identified risk thresholds. Repeated-measures mixed modeling and logistic regression were used for analysis. Results A total of 783 participants of normal weight and 480 participants with severe obesity were included in the initial study. BMI differed significantly between the severely obese and normal-weight cohorts by age 4 months ( P < .001), at 1 year before the median age at onset of obesity. A cutoff of the World Health Organization (WHO) 85th percentile for BMI at 6, 12, and 18 months was a strong predictor of severe obesity by age 6 years (sensitivity, 51%-95%; specificity, 95%). This BMI threshold was validated in a second independent cohort (n = 2649), with a sensitivity of 33%-77% and a specificity of 74%-87%. A BMI ≥85th percentile in infancy increases the risk of severe obesity by age 6 years by 2.5-fold and the risk of clinical obesity by age 6 years by 3-fold. Conclusions BMI trajectories in children who develop severe obesity by age 6 years differ from those in children who remain at normal weight by age 4-6 months, before the onset of obesity. Infants with a WHO BMI ≥85th percentile are at increased risk for developing severe obesity by age 6 years.</description><subject>Age Factors</subject><subject>BMI percentile</subject><subject>Body Mass Index</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Humans</subject><subject>Incidence</subject><subject>Infant</subject><subject>infant growth</subject><subject>Infant, Newborn</subject><subject>Logistic Models</subject><subject>Male</subject><subject>obese</subject><subject>Obesity - diagnosis</subject><subject>Obesity - epidemiology</subject><subject>Obesity, Morbid - diagnosis</subject><subject>Obesity, Morbid - epidemiology</subject><subject>Pediatrics</subject><subject>Predictive Value of Tests</subject><subject>Reference Values</subject><subject>Reproducibility of Results</subject><subject>Risk Assessment</subject><subject>Sex Factors</subject><subject>weight for length</subject><subject>Weight Gain</subject><issn>0022-3476</issn><issn>1097-6833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFUk1v1DAQtRCILoVfgIRy5JLgsR2vc6ASXRVaqVWRCmfLa0-6Dtl4sbMr8u9x2FIBF062x-9jNG8IeQ20AgryXVd1O3SpYvlRAVSU0SdkAbRZllJx_pQsKGWs5GIpT8iLlDpKaSMofU5O2LIBKZhckJtLf78pzoObihuTUnE1OPxR-CFfWjPYuToVnyM6b8fiDg8YsbhdY_LjNKMuTOynYrXxvduE4F6SZ63pE756OE_J148XX1aX5fXtp6vVh-vS1iDGslWMc0btsrZU8dySwNqpphVCGLmulVOUtcw0S-uUUKAsZzWsLTBwtGaC81NydtTd7ddbdBaHMZpe76LfmjjpYLz--2fwG30fDlpmYw6zwNsHgRi-7zGNeuuTxb43A4Z90qCEpEwyJTKUH6E2hpQito82QPUchO70ryD0HIQG0DmIzHrzZ4ePnN-Tz4D3RwDmOR08Rp2sx8HmSUe0o3bB_8fg7B--7f3grem_4YSpC_s45Ag06MQ01XfzLsyrAJIDE03NfwL1q63J</recordid><startdate>20170401</startdate><enddate>20170401</enddate><creator>Smego, Allison, MD</creator><creator>Woo, Jessica G., PhD</creator><creator>Klein, Jillian, MD</creator><creator>Suh, Christina, MD, MPH</creator><creator>Bansal, Danesh, MD</creator><creator>Bliss, Sherri, MS</creator><creator>Daniels, Stephen R., MD</creator><creator>Bolling, Christopher, MD</creator><creator>Crimmins, Nancy A., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-2852-8427</orcidid><orcidid>https://orcid.org/0000-0003-3644-8432</orcidid></search><sort><creationdate>20170401</creationdate><title>High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood</title><author>Smego, Allison, MD ; Woo, Jessica G., PhD ; Klein, Jillian, MD ; Suh, Christina, MD, MPH ; Bansal, Danesh, MD ; Bliss, Sherri, MS ; Daniels, Stephen R., MD ; Bolling, Christopher, MD ; Crimmins, Nancy A., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c514t-f823320c75c0834004e5d89f444a6b58d802f2a97cd84818c3251bc121d052433</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Age Factors</topic><topic>BMI percentile</topic><topic>Body Mass Index</topic><topic>Case-Control Studies</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Humans</topic><topic>Incidence</topic><topic>Infant</topic><topic>infant growth</topic><topic>Infant, Newborn</topic><topic>Logistic Models</topic><topic>Male</topic><topic>obese</topic><topic>Obesity - diagnosis</topic><topic>Obesity - epidemiology</topic><topic>Obesity, Morbid - diagnosis</topic><topic>Obesity, Morbid - epidemiology</topic><topic>Pediatrics</topic><topic>Predictive Value of Tests</topic><topic>Reference Values</topic><topic>Reproducibility of Results</topic><topic>Risk Assessment</topic><topic>Sex Factors</topic><topic>weight for length</topic><topic>Weight Gain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smego, Allison, MD</creatorcontrib><creatorcontrib>Woo, Jessica G., PhD</creatorcontrib><creatorcontrib>Klein, Jillian, MD</creatorcontrib><creatorcontrib>Suh, Christina, MD, MPH</creatorcontrib><creatorcontrib>Bansal, Danesh, MD</creatorcontrib><creatorcontrib>Bliss, Sherri, MS</creatorcontrib><creatorcontrib>Daniels, Stephen R., MD</creatorcontrib><creatorcontrib>Bolling, Christopher, MD</creatorcontrib><creatorcontrib>Crimmins, Nancy A., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>The Journal of pediatrics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smego, Allison, MD</au><au>Woo, Jessica G., PhD</au><au>Klein, Jillian, MD</au><au>Suh, Christina, MD, MPH</au><au>Bansal, Danesh, MD</au><au>Bliss, Sherri, MS</au><au>Daniels, Stephen R., MD</au><au>Bolling, Christopher, MD</au><au>Crimmins, Nancy A., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood</atitle><jtitle>The Journal of pediatrics</jtitle><addtitle>J Pediatr</addtitle><date>2017-04-01</date><risdate>2017</risdate><volume>183</volume><spage>87</spage><epage>93.e1</epage><pages>87-93.e1</pages><issn>0022-3476</issn><eissn>1097-6833</eissn><abstract>Objective To characterize growth trajectories of children who develop severe obesity by age 6 years and identify clinical thresholds for detection of high-risk children before the onset of obesity. Study design Two lean (body mass index [BMI] 5th to ≤75th percentile) and 2 severely obese (BMI ≥99th percentile) groups were selected from populations treated at pediatric referral and primary care clinics. A population-based cohort was used to validate the utility of identified risk thresholds. Repeated-measures mixed modeling and logistic regression were used for analysis. Results A total of 783 participants of normal weight and 480 participants with severe obesity were included in the initial study. BMI differed significantly between the severely obese and normal-weight cohorts by age 4 months ( P < .001), at 1 year before the median age at onset of obesity. A cutoff of the World Health Organization (WHO) 85th percentile for BMI at 6, 12, and 18 months was a strong predictor of severe obesity by age 6 years (sensitivity, 51%-95%; specificity, 95%). This BMI threshold was validated in a second independent cohort (n = 2649), with a sensitivity of 33%-77% and a specificity of 74%-87%. A BMI ≥85th percentile in infancy increases the risk of severe obesity by age 6 years by 2.5-fold and the risk of clinical obesity by age 6 years by 3-fold. Conclusions BMI trajectories in children who develop severe obesity by age 6 years differ from those in children who remain at normal weight by age 4-6 months, before the onset of obesity. Infants with a WHO BMI ≥85th percentile are at increased risk for developing severe obesity by age 6 years.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27916426</pmid><doi>10.1016/j.jpeds.2016.11.020</doi><orcidid>https://orcid.org/0000-0002-2852-8427</orcidid><orcidid>https://orcid.org/0000-0003-3644-8432</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Age Factors BMI percentile Body Mass Index Case-Control Studies Child Child, Preschool Female Humans Incidence Infant infant growth Infant, Newborn Logistic Models Male obese Obesity - diagnosis Obesity - epidemiology Obesity, Morbid - diagnosis Obesity, Morbid - epidemiology Pediatrics Predictive Value of Tests Reference Values Reproducibility of Results Risk Assessment Sex Factors weight for length Weight Gain |
| title | High Body Mass Index in Infancy May Predict Severe Obesity in Early Childhood |
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