Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America.
Department of Health Management and Policy, School of Public Health, University of Michigan, Ann Arbor, Michigan, United States of America.
PLoS One. 2020 Oct 22;15(10):e0240904. doi: 10.1371/journal.pone.0240904. eCollection 2020.
Little is known about body size over the life-course and non-communicable disease risk in low- and middle-income country populations. Our study explored the role of body mass index (BMI) trajectories from infancy through mid-adulthood on cardio-metabolic disease (CMD) risk factors in a prospective cohort of Guatemalan adults. Study participants were born in Guatemala from 1962-77 and have been followed prospectively since participating in a nutrition supplementation trial as children. Sex-specific BMI latent class trajectories were derived using latent class growth modeling from up to 22 possible BMI values from age 1 month to 42 years measured between 1969 and 2004. CMD risk factors were assessed in 2015-17 (at age 37-54 years) using anthropometry, blood glucose and lipids, and blood pressure. We used logistic regression to assess the role of BMI trajectory on CMD risk factors in 510 women and 346 men (N = 856). We identified two BMI latent classes for women (low [n = 287, 56.3%] and high [n = 223, 43.7%]) and three classes for men (low [n = 141, 40.8%], medium [n = 160, 46.2%], and high [n = 45, 13.0%]). Given the small percentage of men in the high BMI latent class, we collapsed the medium and high BMI latent classes for men (n = 205, 59.1%). Among the most prevalent CMD risk factors at ages 37-54 years were abdominal obesity defined by waist-height ratio (99.6% of women and 87.3% of men), obesity defined by percent body fat (96.6% of women and 75.9% of men), low HDL-c (87.5% of women and 74.5% of men), and elevated triglycerides (78.3% of women and 73.6% of men). Except for obesity defined by BMI, we found no associations between BMI latent class and CMD risk factors in women. Among men, BMI latent class was not associated with CMD risk factors after controlling for current BMI. For the CMD risk factors we analyzed, the role of early life BMI on adult CMD appeared to be mediated by adult BMI among men-highlighting the need to establish and maintain healthy body weight over the life course.
关于低中收入国家人群一生中的体型和非传染性疾病风险，人们知之甚少。我们的研究探讨了从婴儿期到成年中期的体重指数 (BMI) 轨迹对危地马拉成年人前瞻性队列中心血管代谢疾病 (CMD) 危险因素的影响。研究参与者于 1962-77 年在危地马拉出生，自作为儿童参加营养补充试验以来，一直进行前瞻性随访。使用潜在类别增长建模从 1969 年至 2004 年期间测量的多达 22 个可能的 BMI 值中得出了性别特异性 BMI 潜在类别轨迹。在 2015-17 年（37-54 岁）使用人体测量法、血糖和血脂以及血压评估 CMD 危险因素。我们使用逻辑回归评估了 BMI 轨迹对 510 名女性和 346 名男性（856 名）CMD 危险因素的作用。我们确定了女性的两种 BMI 潜在类别（低 [n = 287，56.3%] 和高 [n = 223，43.7%]）和男性的三种类别（低 [n = 141，40.8%]、中 [n = 160，46.2%] 和高 [n = 45，13.0%]）。鉴于高 BMI 潜在类别中男性的比例较小，我们将男性的中高 BMI 潜在类别合并（n = 205，59.1%）。在 37-54 岁时最常见的 CMD 危险因素中，有腰围身高比定义的腹型肥胖（99.6%的女性和 87.3%的男性）、体脂百分比定义的肥胖（96.6%的女性和 75.9%的男性）、低高密度脂蛋白胆固醇（87.5%的女性和 74.5%的男性）和甘油三酯升高（78.3%的女性和 73.6%的男性）。除了 BMI 定义的肥胖外，我们没有发现女性 BMI 潜在类别与 CMD 危险因素之间存在关联。在男性中，控制当前 BMI 后，BMI 潜在类别与 CMD 危险因素之间没有关联。对于我们分析的 CMD 危险因素，男性中，成人 BMI 似乎介导了生命早期 BMI 对成年 CMD 的影响，这突显了在整个生命周期中建立和维持健康体重的必要性。
