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Impact of early-life weight status on urinary tract infections in children: a nationwide population-based study in Korea
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Hyung Eun Yim, Kyung Do Han, Bongseong Kim, Kee Hwan Yoo
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Epidemiol Health. 2021;43:e2021005. Published online December 29, 2020
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DOI: https://doi.org/10.4178/epih.e2021005
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 Abstract
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Abstract
OBJECTIVES
We aimed to evaluate the association between early-life weight status and urinary tract infection (UTI) risk in children.
METHODS A nationwide study was conducted using Korean National Health Screening (NHS) data and National Health Insurance Service data. A sample cohort was selected using data from the 2014 and 2015 NHS for infants and children (4-71 months) and followed up until the end of 2017. Participants were divided into 4 groups (underweight, normal weight, overweight, and obese) based on the weight-for-age (< 2 years) or body mass index (≥ 2 years). Hazard ratios (HRs) with 95% confidence intervals (CIs) for developing UTIs, cystitis, and acute pyelonephritis (APN) were calculated using a Cox proportional hazard model.
RESULTS Of 1,653,106 enrolled children, 120,142 (7.3%) developed UTIs, cystitis, and APN during follow-up. The underweight, overweight, and obese groups had higher risks of UTIs than the reference group after adjusting for age, sex, birth weight, and preterm birth. Between 2 years and 6 years of age, boys with underweight had a high risk of UTI and APN, while girls with overweight and obesity revealed elevated risks of UTIs, cystitis, and APN. The HRs for APN in boys with underweight and in girls with obesity were 1.46 (95% CI, 1.03 to 2.07) and 1.41 (95% CI, 1.13 to 1.75), respectively, after adjusting for age, sex, birth weight, and preterm birth. The incidence of APN did not decrease with age in underweight and obese children aged 2-6 years.
CONCLUSIONS Children with underweight, overweight, and obesity may be at high risk for UTIs.
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Summary
Korean summary
1. 영유아 및 소아에서 과소체중, 과체중 및 비만은 요로감염 발생 증가와 관련이 있다.
2. 본 전국적인 인구 기반 연구에서 2-6세 남아에서 과소체중을 보인 경우 요로감염과 신우신염 발생빈도가 증가하였으며, 2-6세 여아에서 과체중 및 비만을 보이는 경우 요로감염, 방광염, 신우신염 발생이 증가하였다.
3. 소아에서 적정체중을 유지하는 것이 요로감염, 방광염, 신우신염의 발생을 예방함에 있어서 중요하다.
Key Message
1. Being underweight, overweight, or obese can be associated with an increased risk of urinary tract infection in infants and children.
2. The underweight boys aged 2–6 years had a high risk of urinary tract infection and acute pyelonephritis, while the overweight and obese girls aged 2–6 years revealed increased risks of urinary tract infection, cystitis, and acute pyelonephritis in our nationwide population-based study on urinary tract infections.
3. Body weight control would be significant for the primary prevention of urinary tract infections, cystitis, and acute pyelonephritis in children.
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Citations
Citations to this article as recorded by  - Risk factors for recurrent urinary tract infections in young infants under the age of 24 months
Min Hwa Son, Hyung Eun Yim
Childhood Kidney Diseases.2024; 28(1): 35. CrossRef - Childhood Body Mass Index (BMI) and the Risk of Infection: A Narrative Review
Houman Hashemian, Mohammad Ali Esfandiari, Setila Dalili
Journal of Comprehensive Pediatrics.2023;[Epub] CrossRef - Kidney Considerations in Pediatric Obesity
Alexandra Sawyer, Evan Zeitler, Howard Trachtman, Petter Bjornstad
Current Obesity Reports.2023; 12(3): 332. CrossRef - Association of body weight and urinary tract infections during infancy: a nationwide comparative matched cohort study
Peong Gang Park, Ji Hyun Kim, Yo Han Ahn, Hee Gyung Kang
Childhood Kidney Diseases.2023; 27(2): 111. CrossRef - Obesity and chronic kidney disease: prevalence, mechanism, and management
Hyung Eun Yim, Kee Hwan Yoo
Clinical and Experimental Pediatrics.2021; 64(10): 511. CrossRef
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