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Updated: Jun 6, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Antibiotic exposure and risk of overweight/obesity in children: a biomonitoring-based study from eastern Jiangsu,
Huamin Sun1, Jianping Huang1, Yijing Zhou2
1Nantong Center for Disease Control and Prevention, Nantong, Jiangsu, China.
Insights
Children show widespread antibiotic exposure. Exposure to specific veterinary antibiotics, potentially via food, is linked to a higher risk of childhood overweight and obesity.
Area of Science:
- Environmental Health
- Pediatric Health
- Pharmacology
Background:
- Antibiotic exposure in children is a growing concern.
- Understanding the link between antibiotic use and childhood obesity is crucial for public health.
Purpose of the Study:
- To quantify antibiotic exposure levels in children.
- To investigate the association between antibiotic exposure and the prevalence of overweight and obesity in children.
Main Methods:
- Urinary samples from 295 children (aged 3-8) in Nantong city were analyzed for 41 antibiotics using ultra-performance liquid chromatography and tandem mass spectrometry.
- Logistic regression models were employed to assess the relationship between creatinine-adjusted urinary antibiotic concentrations and overweight/obesity status.
Main Results:
- Antibiotics were detected in 98.31% of children, with 35 different types identified.
- Overweight/obesity was present in 24.75% of the study cohort.
- Significant associations were found between overweight/obesity and exposure to specific veterinary antibiotics (VAs) and preferred veterinary antibiotics (PVAs), including sulfamethoxazole, norfloxacin, and fluoroquinolones, particularly in boys.
Conclusions:
- Children exhibit extensive exposure to a wide range of antibiotics.
- Exposure to certain veterinary antibiotics, likely through dietary pathways, is associated with an increased risk of overweight and obesity in children.
Objective:
To describe antibiotic exposure in children and explore its association with overweight/obesity.
Methods:
In June 2022, 328 kindergarten and primary school children were selected from Nantong city in Jiangsu Province. Questionnaires were distributed, and morning urine samples were obtained. Total urinary concentrations of 41 antibiotics were measured using ultra-performance liquid chromatography and tandem mass spectrometry. The rates of antibiotic exposure were expressed as percentages (%), specific percentiles (P 95 and P 99), and the maximum values were used to describe the concentration of antibiotics. The association between urinary antibiotic creatinine-adjusted and overweight/obesity was analyzed using logistic regression.
Results:
A total of 328 children were initially recruited, of which 295 aged 3-8 years met the inclusion criteria and were finally included in the study. The biomonitoring results revealed that 35 antibiotics were detected, with a total detection frequency of 98.31%. Among the included children, 24.75% were classified as overweight/obesity. Multinomial logistic regression analyses revealed significant associations between overweight/obese and exposure to veterinary antibiotics (VAs) and preferred veterinary antibiotics (PVAs). After adjusting for various overweight/obesity-relevant variables, higher exposure to sulfamethoxazole [OR = 2.35, 95% confidence interval (CI):1.17-4.70], norfloxacin (OR = 2.66, 95% CI: 1.01-7.08), and fluoroquinolones (OR = 1.97, 95% CI: 1.02-3.78) were significantly associated with overweight/obesity (p < 0.05). In addition, after stratification by sex and adjustment for confounding variables, sex-specific differences were observed in the association between antibiotic exposure and overweight/obesity. Notably, these associations were predominantly observed among boys.
Conclusion:
Children were extensively exposed to antibiotics. Exposure to certain types of veterinary antibiotics and preferred veterinary antibiotic exposure, mainly through food or drinking water, are associated with an increased risk of overweight/obesity in children.
