父親與母親的身體質量指數對小孩體重過重的影響

The Association of Paternal and Maternal Body Mass Index on Childhood Overweight

目的：肥胖常常出現在同一個家族，而父母親是否肥胖已被證實為小孩體重過重的危險因子，本研究目的是探討父親與母親的身體質量指數對於小孩體重過重是否有不同的影響。材料與方法：我們在91年針對花蓮市國中學生進行肥胖調查，總共有1,418名年齡在12到13歲的學生參加，我們測量學生的身高、體重、腰圍與臀圍，然後以身體質量指數在85百分位作為體重過重的標準，至於父母親的身高、體重的相關資料則是經由問卷向父母親收集。統計方法是用史匹曼相關係數（Spearman’s correlation analysis），與邏輯斯迴歸分析（logistic regression analysis）。結果：孩童的身體質量指數與雙親的身體質量指數關聯性最強，其次為孩童的腰圍，至於孩童的腰臀圍和雙親的身體質量指數關聯性最差。在雙親──子女的相關係數分析中，以母親──女兒的相關性最強。若將男學童依照父親的身體質量指數分為四組，則最低組與最高組男學童體重過重的盛行率分別為9.2%與21.3%，若依照母親的身體質量指數分為四組，則最低組與最高組男學童體重過重的盛行率分別為10.6%與24.1%；在女學童方面，依父親及母親的身體質量指數分成四組，則女學童體重過重的盛行率在最高組也明顯高於其他三組。多變項迴歸分析結果顯示，男學童是否肥胖與母親的身體質量指數有關（p<0.001），但是和父親的身體質量指數關聯性較差（p=0.055）；至於女學童是否肥胖與母親及父親的身體質量指數都有關（分別為p<0.001與p=0.001）。結論：母親的身體質量指數為男學童或女學童是否肥胖的獨立危險因子，而父親的身體質量指數和女學童是否肥胖有關。

Purpose: Obesity often aggregates within families and parental obesity has been identified as a risk factor. To examine the different effects of maternal and paternal body mass index on the prevalence rate and risk of overweight in children. Materials and Methods: A total of 1418 students, aged 12 or 13 years, were recruited for analysis. Children’s body height, weight and waist and hip circumferences were obtained. Self-reported body height and weight of their parents were collected. The 85th percentile of body mass index (BMI) was used as cutoff points to identify the children being overweight. Spearman’s correlation and logistic regression analysis were used to examine the parent-offspring BMI relationship. Paternal and maternal BMI were classified into four groups using the quartile categories to examine their different effects on the prevalence rate and risk of children overweight. Results: The association of children’s BMI with parents’ BMI was the strongest, closely followed by children’s waist circumference whereas waist-hip ratio barely had any association. The Spearman’s correlation coefficient of the mother-daughter association was the highest among all the parent-offspring association. Among the boys, the prevalence rate for being overweight increased significantly from 9.2% in the lowest quartile to 21.3% in the highest quartile of paternal BMI (p trend<0.005). The effect of maternal BMI on the prevalence rate for being overweight was also noted (p trend<0.0001). Among the girls, an increasing rate of being overweight for the increasing quartile of paternal and maternal BMI was also noted (p trend<0.0001). Multiple logistic regression analysis revealed that maternal BMI was significantly associated with boys’ overweight with the odds ratios increased from 1.0 in the lowest quartile to 2.33 in the highest quartile of maternal BMI (p<0.001). However, the association between paternal BMI and boys’ overweight was marginally significant (p=0.055). Among the girls, both maternal and paternal BMI were significantly associated with girls’ overweight (p<0.001 and p=0.001, respectively). Conclusion: Maternal BMI was an independent risk factor of overweight in both boys and girls. Paternal BMI was also associated with girls’ overweight.