儿童 BMI 轨迹与成人糖尿病：博加卢萨心脏研究。
Trajectories of childhood BMI and adult diabetes: the Bogalusa Heart Study.
机构信息
Department of Biostatistics, School of Public Health, Shandong University, Jinan, China.
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
出版信息
Diabetologia. 2019 Jan;62(1):70-77. doi: 10.1007/s00125-018-4753-5. Epub 2018 Oct 20.
AIMS/HYPOTHESIS: The aim of this study was to characterise longitudinal profiles of BMI from childhood and to examine the impact of level-independent childhood BMI trajectories on adult type 2 diabetes.
METHODS
The longitudinal cohort consisted of 2449 adults (1613 white and 836 black) who had their BMI measured between four and 15 times from childhood (4-19 years) to adulthood (20-51 years) and fasting glucose measured in adulthood. Model-estimated levels and linear slopes of BMI at childhood age points were calculated in 1-year intervals using growth-curve parameters and their first derivatives, respectively.
RESULTS
BMI from childhood to adulthood fit cubic growth curves; linear and non-linear curve parameters differed significantly between race-sex groups. BMI showed race and sex differences from 15 years onwards. Individuals with hyperglycaemia had higher long-term BMI levels than those who were normoglycaemic in race-sex groups. Linear and non-linear slope parameters of BMI differed consistently and significantly between adult hyperglycaemia groups. The OR of childhood BMI levels for ages 4-19 years was 1.45-1.83 (p < 0.001 for all) for adult hyperglycaemia after adjustment for confounders. Level-adjusted linear slopes of BMI at ages 10-19 years showed significantly positive associations with adult hyperglycaemia (OR 1.17-1.50, p < 0.01 for all). The associations of childhood BMI linear slopes with adult hyperglycaemia were not significant during the age period 5-9 years. The trends in these associations were consistent across race-sex groups.
CONCLUSIONS/INTERPRETATION: These observations indicate that childhood BMI trajectories have a significant impact on adult diabetes, independent of BMI levels. The adolescence age period is a crucial window for the development of diabetes in later life, which has implications for early-life prevention.
DATA AVAILABILITY
All data and materials are publicly available at the National Heart, Lung, and Blood Institute (NHLBI) Biologic Specimen and Data Repository and can be accessed at https://biolincc.nhlbi.nih.gov/studies/bhs .
目的/假设：本研究的目的是描述儿童时期 BMI 的纵向变化，并探讨水平独立的儿童 BMI 轨迹对成人 2 型糖尿病的影响。
方法
该纵向队列包括 2449 名成年人（1613 名白人和 836 名黑人），他们在儿童期（4-19 岁）至成年期（20-51 岁）之间接受了 4 到 15 次 BMI 测量，并在成年期测量了空腹血糖。使用生长曲线参数及其一阶导数，分别在 1 年间隔内计算童年年龄点 BMI 的模型估计水平和线性斜率。
结果
儿童期至成年期的 BMI 符合三次生长曲线；种族-性别组之间的线性和非线性曲线参数存在显著差异。BMI 从 15 岁开始存在种族和性别差异。在种族-性别组中，血糖升高的个体的长期 BMI 水平高于血糖正常的个体。BMI 的线性和非线性斜率参数在成人高血糖组之间始终存在显著差异。调整混杂因素后，儿童时期 BMI 水平在 4-19 岁时与成年高血糖的比值为 1.45-1.83（所有 p 值均<0.001）。10-19 岁时 BMI 的水平调整线性斜率与成年高血糖显著正相关（OR 1.17-1.50，所有 p 值均<0.01）。在 5-9 岁期间，儿童 BMI 线性斜率与成年高血糖的相关性不显著。这些关联的趋势在种族-性别组中是一致的。
结论/解释：这些观察结果表明，儿童时期 BMI 轨迹对成人糖尿病有显著影响，与 BMI 水平无关。青春期是生命后期发生糖尿病的关键窗口期，这对生命早期预防具有重要意义。
数据可用性
所有数据和材料均可在国家心肺血液研究所（NHLBI）生物样本和数据存储库中公开获取，可在 https://biolincc.nhlbi.nih.gov/studies/bhs 访问。
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