The Effect of Antibiotic Use Within the First Year of Life On 3-Year Childhood Obesity

Abstract

Objectives: The aim of the present study was to research the effect of antibiotic use within first year of life on 3-year obesity or overweight condition in consideration of maternal obesity, birth weight, gender, the weight gained during pregnancy.
Materials and Methods: This retrospective cohort study was conducted on 182 healthy children who were born in Rize (Turkey) province and followed regularly until 3 years of age. The antibiotics used by the children within first 12 months of their life were determined through electronic health cards and the association between antibiotic use and 3-year obesity or overweight status was detected.
Results: We used logistic regression to adjust for potential confounders. In the crude analysis, risk of being overweighted and obesity was evaluated in the children who were exposed to antibiotic use within first 12 months of life in comparison within those who have not used. (odds ratio: 1.40; 95% CI: [ 1.23–1.57]). After multivariate adjustment, the increased risk remained (adjusted odds ratio: 1.22; 95% CI: [1.04-1.40]).
Conclusion: The results obtained indicated that risk of obesity is significantly higher in the 3- year old children who were exposed to antibiotics within first 12 months of life. Further studies may focus on prevention of obesity in the children due to antibiotic use.

Keywords

• Antibiotic,childhood obesity,overweight

Yaşamın İlk Yılındaki Antibiyotik Kullanımının 3 Yaş Çocukluk Çağı Obezitesi Üzerine Etkisi

Abstract

Amaç: Bu çalışmanın amacı, maternal obezite, doğum ağırlığı, cinsiyet, gebelikte kazanılan kilo dikkate alındığında, yaşamın ilk yılında antibiyotik kullanımının 3 yıllık obezite veya fazla kilo durumu üzerindeki etkisini araştırmaktır.
Materyal ve Metot: Bu retrospektif kohort çalışması, Rize (Türkiye) ilinde doğan ve 3 yaşına kadar düzenli olarak takip edilen 182 sağlıklı çocuğa uygulandı. Çocukların yaşamlarının ilk 12 ayı içerisinde kullandıkları antibiyotikler elektronik sağlık kartları ile belirlendi ve antibiyotik kullanımı ile 3 yıllık obezite veya fazla kilo durumu arasındaki ilişki tespit edildi.
Bulgular: Potansiyel karışıklıkları ayarlamak için lojistik regresyon analizi kullanıldı. Ham analizde, yaşamdan sonraki ilk 12 ay içerisinde antibiyotik kullanımına maruz kalan çocuklarda kullanılmamış olanlara kıyasla aşırı kilo alma ve şişmanlık riski değerlendirildi. (oran oranı((OR)): 1.40;% 95 CI: [1.23-1.57]). Çok değişkenli ayarlama sonrasında, artan risk kaldı (düzeltilmiş oran oranı((AOR)): 1.22;% 95 CI: [1.04-1.40]).

Sonuç: Elde edilen sonuçlar, obezite riskinin, yaşamın ilk 12 ayında antibiyotik uygulanan 3 yaşındaki çocuklarda anlamlı derecede yüksek olduğunu göstermiştir. Gelecekteki çalışmalar, antibiyotik kullanımı nedeniyle çocuklarda obezitenin önlenmesine odaklanabilir.

Keywords

• Antibiyotik,çocukluk çağı obezitesi,fazla kiloluluk

References

1. Ng M, Fleming T, Robinson M, Thomson B, Graetz N, Margono C, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2014; 384(9945):766–81.
2. Cunningham SA, Kramer MR, Narayan KM. Incidence of childhood obesity in the United States. N Engl J Med 2014;370(5):403–11.
3. World Health Organization: Childhood Overweight and Obesity. www.who.int/dietphysicalactivity/childhood; 2015, Erişim tarihi: 01.04.2019.
4. Simmonds M, Llewellyn A, Owen CG, Woolacott N. Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev 2016;17(2):95–107.
5. Llewellyn A, Simmonds M, Owen CG, Woolacott N. Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev 2016;17(1):56–67.
6. Ajslev TA, Andersen CS, Gamborg M, Sørensen, T. I. A., Jess, T. Childhood overweight after establishment of the gut microbiota: the role of delivery mode, pre-pregnancy weight and early administration of antibiotics. Int J Obes 2011;35:522–9.
7. . Trasande L, Blustein J, Liu M, Corwin E, Cox LM, Blaser MJ. Infant antibiotic exposures and early-life body mass. Int J Obes (Lond) 2013;37:16–23.
8. Cox LM, Yamanishi S, Sohn J, Alekseyenko AV, Leung JM, Cho I,et al. Altering the intestinal microbiota during a critical developmental window has lasting metabolic consequences. Cell 2014;158:705-21.

9. Lemas DJ, Yee S, Cacho N, Miller D, Cardel M, Gurka M, et al. Exploring the contribution of maternal antibiotics and breastfeeding to development of the infant microbiome and pediatric obesity. Semin Fetal Neonatal Med 2016;21:406–9.
10. Yallapragada SG, Nash CB, Robinson DT. Early-life exposure to antibiotics, alterations in the intestinal microbiome, and risk of metabolic disease in children and adults. Pediatr Ann 2015;44(11):e265–9.
11. Mikkelsen KH, Allin KH, Knop FK. Effect of antibiotics on gut microbiota, glucose metabolism and body weight regulation: a review of the literature. Diabetes Obes Metab 2016; 18(5):444–53.
12. Bailey LC, Forrest CB, Zhang P, Richards TM, Livshits A, DeRusso PA. Association of antibiotics in infancy with early childhood obesity. JAMA Pediatr 2014;168:1063–9.
13. Saari A, Virta LJ, Sankilampi U, Dunkel L, Saxen H. Antibiotic exposure in infancy and risk of being overweight in the fi rst 24 months of life. Pediatrics 2015;135:617–26.
14. Murphy R, Stewart AW, Braithwaite I, Beasley R, Hancox RJ, Mitchell EA. Antibiotic treatment during infancy and increased body mass index in boys: an international cross-sectional study. Int J Obes (Lond) 2014;38:1115–9.
15. Azad MB, Bridgman SL, Becker AB, Kozyrskyj AL. Infant antibiotic exposure and the development of childhood overweight and central adiposity. Int J Obes (Lond) 2014; 38:1290–8.
16. Orsi CM, Hale DE, Lynch JL. Pediatric obesity epidemiology. Curr Opin Endocrinol Diabetes Obes 2011;18:14–22.
17. Stamatakis E, Wardle J, Cole TJ. Childhood obesity and overweight prevalence trends in England: evidence for growing socioeconomic disparities. Int J Obes (Lond) 2010;34:41-7.
18. Guyenet SJ, Schwartz MW. Clinical review: regulation of food intake, energy balance, and body fat mass: implications for the pathogenesis and treatment of obesity. J Clin Endocrinol Metab 2012;97(3):745–55.
19. Ridaura VK, Faith JJ, Rey FE, Cheng J, Duncan AE, Kau AL, et al. Gut micro- biota from twins discordant for obesity modulate metabolism in mice. Science 2013; 341(6150):1241-9.
20. Winer DA, Luck H, Tsai S, Winer S. The intestinal immune system in obesity and insulin resistance. Cell Metab 2016;23(3):413–26.
21. Ussar S, Griffin NW, Bezy O, Fujisaka S, Vienberg S, Softic S, et al. Interactions between gut microbiota, host genetics and diet modulate the predisposition to obesity and metabolic syndrome. Cell Metab 2015;22(3):516–30.
22. Cho I, Yamanishi S, Cox L, Methe I, Barbcho, Ilseung A, et al. Antibiotics in early life alter the murine colonic microbiome and adiposity. Nature. 2012;488(7413):621–6.
23. Mahana D, Trent CM, Kurtz ZD, Bokulich NA, Battaglia T, Chung J, et al. Antibiotic perturbation of the murine gut microbiome enhances the adiposity, insulin resistance, and liver disease associated with high-fat diet. Genome Med 2016;8(1):48.
24. Ley RE, Backhed F, Turnbaugh P, Lozupone CA, Knight RD, Gordon JI. Obesity alters gut microbial ecology. Proc Natl Acad Sci U S A 2005;102:11070-5.
25. Gaskins HR, Collier CT, Anderson DB. Antibiotics as growth promotants: mode of action. Anim Biotechnol 2002;13:29-42.
26. Whitaker RC. Predicting preschooler obesity at birth: the role of maternal obesity in early pregnancy. Pediatrics 2004;114:e29–e36.
27. Leal, DB, Assis MAAD, Conde WL, Lobo AS, Bellisle F, Andrade DFD. Individual characteristics and public or private schools predict the body mass index of Brazilian children: a multilevel analysis. Cadernos de saude publica, 2018;34:e00053117.