Novel lifecourse childhood adiposity trajectories and the prediction of adolescent cardiovascular risk factors
Objectives: In the light of the obesity epidemic we aimed to characterise novel childhood adiposity trajectories and to determine their relation to adolescent cardiovascular risk.
Research design and methods: 2868 Australian children were studied serially from birth to age 14 years. Semi-parametric mixture modelling was applied to anthropometric data over 8 time points to generate adiposity trajectories of z-scores (weight-for-height and body mass index (BMI)). Cardiovascular and related metabolic risk factors assessed in 1106 children at age 14 were compared between adiposity trajectories.
Results: Seven adiposity trajectories were identified. Three (2 rising and 1 chronic high adiposity) comprised 29% of the population and were associated with higher fasting insulin, homeostasis model of insulin resistance (HOMA) and prevalence of the metabolic risk cluster (all p-value ≤ 0.003 in males) compared to a reference trajectory group (with longitudinal adiposity z-scores of approximately zero). In boys, trajectories with rising slopes had greater HOMA, insulin and metabolic syndrome cluster compared with a falling or stable trajectory reaching the same final adiposity. Birth weight was not an independent predictor of HOMA, insulin or metabolic syndrome.
Conclusion: A rising trajectory with accelerated adiposity gain had a greater influence than birth weight on cardiovascular/metabolic risk factors. With world-wide increases in maternal obesity and infant birth weight we speculate that “rising” and “stable high” adiposity trajectories will become more common, resulting in a positive relationship between birth weight and cardiovascular risk. Public health should urgently target excessive weight gain in early childhood across all birth weights.
Huang, R. C., de Klerk, N., Smith, A., Kendall, G., Mori, T., Newnham, J., et al. (2010). Novel lifecourse childhood adiposity trajectories and the prediction of adolescent cardiovascular risk factors. Obesity Research and Clinical Practice, 4(S1), S75. doi: 10.1016/j.orcp.2010.09.146
Huang, R. C., de Klerk, N., Smith, A., Kendall, G., Mori, T., Newnham, J., et al. (2010). Novel lifecourse childhood adiposity trajectories and the prediction of adolescent cardiovascular risk factors. Paper presented at the Australian and New Zealand Obesity Society Annual Scientific meeting. Sydney, NSW, 21-23 October, 2010.