Antibiotic Exposure in Early Life Increases Risk of Childhood Obesity: A Systematic Review and Meta-Analysis.

Xiaofei An,Ling Li,Jin-an Zhang,Qiuming Yao,Xiaolian Ding,Ronghua Song,Bin Wang,Xiaoqing Shao

doi:10.3389/fendo.2017.00170

Abstract

A number of studies have previously assessed the impact of antibiotic exposure in early life on the risk of childhood obesity, but no systematic assessment is currently available. A systematic review and meta-analysis was performed to comprehensively and quantitatively elucidate the risk of childhood obesity caused by antibiotic exposure in early life. Literature search was performed in PubMed, Embase, and Web of Science. Random-effect meta-analysis was used to pool the statistical estimates. Fifteen cohort studies involving 445,880 participants were finally included, and all those studies were performed in developed countries. Antibiotic exposure in early life significantly increased risk of childhood overweight [relative risk (RR) = 1.23, 95% confidence interval (CI) 1.13–1.35, P < 0.001] and childhood obesity (RR = 1.21, 95% CI 1.13–1.30, P < 0.001). Antibiotic exposure in early life also significantly increased the z-score of childhood body mass index (mean difference: 0.07, 95% CI 0.05–0.09, P < 0.00001). Importantly, there was an obvious dose–response relationship between antibiotic exposure in early life and childhood adiposity, with a 7% increment in the risk of overweight (RR = 1.07, 95% CI 1.01–1.15, P = 0.03) and a 6% increment in the risk of obesity (RR = 1.06, 95% CI 1.02–1.09, P < 0.001) for each additional course of antibiotic exposure. In conclusion, antibiotic exposure in early life significantly increases risk of childhood obesity. Moreover, current analyses are mainly taken from developed countries, and therefore the impact of antibiotic exposure on risk of childhood obesity in vulnerable populations or developing countries still needs to be evaluated in future studies.

Highlights

Obesity has increased significantly among children and adolescents over the past several decades, and childhood adiposity has become a major challenge to public health worldwide [1, 2]
The present study is the first systematic review comprehensively evaluating the impact of antibiotic exposure on childhood adiposity
The results suggested that antibiotic exposure during early life significantly increased risk of childhood overweight and obesity, and there was an obvious dose-dependent relationship

Summary

Introduction

Obesity has increased significantly among children and adolescents over the past several decades, and childhood adiposity has become a major challenge to public health worldwide [1, 2]. In the United States, the prevalence of obesity in children and adolescents is about 17.0% and it has increased substantially [3]. Excess adiposity during childhood is likely to persist into adulthood and further increases the predisposition to cardiovascular diseases, cancer, and early mortality [4, 5]. Childhood obesity increases risk of other diseases during childhood, such as hypertension and depression [6,7,8]. Some obese children have exhibited early signs of cardiovascular dysfunction [9]. The pathogenesis of obesity is complex and may involve many

Methods

Results

Conclusion