Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark.
Steno Diabetes Center Copenhagen, Gentofte, Denmark.
Atherosclerosis. 2020 Dec;314:10-17. doi: 10.1016/j.atherosclerosis.2020.10.011. Epub 2020 Oct 9.
Children with a growth trajectory of overweight have higher levels of cardiovascular disease (CVD) risk factors than children with a normal-weight trajectory. However, less is known about how trajectories of body mass index (BMI) across the rest of the BMI spectrum relate to CVD risk factors and whether adult BMI affects these associations. Our aim was to examine associations between childhood BMI trajectories and adult CVD risk factors.
We included 2466 individuals with childhood weights and heights (ages 6-14) from the Copenhagen School Health Records Register and adult CVD risk factors (ages 20-81) from the Copenhagen City Heart Study. Associations between childhood BMI trajectories identified by latent class modelling and CVD risk factors were examined using generalized linear regression analyses with and without adjustment for adult BMI. Normal-weight and overweight were defined by growth references from the Centers for Disease Control and Prevention.
We identified four childhood trajectories within the normal-weight spectrum and one trajectory of overweight. Compared to the trajectory with the lowest BMI level, several higher BMI trajectories were associated with worse circumference, HDL and glucose homeostasis in adulthood. The highest trajectory was additionally associated with higher total cholesterol and triglycerides. When adjusting for adult BMI, the higher BMI trajectories had lower waist circumference, blood pressure and triglycerides.
Trajectories of BMI within the normal-weight range and in the overweight range are associated with a worse CVD risk profile than in the lowest BMI trajectory, and these associations are modifiable by growth after childhood.
与体重正常增长轨迹的儿童相比，超重增长轨迹的儿童具有更高水平的心血管疾病（CVD）风险因素。然而，对于整个 BMI 谱中 BMI 轨迹如何与 CVD 风险因素相关，以及成人 BMI 是否会影响这些关联，了解较少。我们的目的是研究儿童 BMI 轨迹与成人 CVD 风险因素之间的关系。
我们纳入了来自哥本哈根学校健康记录登记处的 2466 名儿童（6-14 岁）的体重和身高以及来自哥本哈根城市心脏研究的成人 CVD 风险因素（20-81 岁）。使用广义线性回归分析，在不调整和调整成人 BMI 的情况下，检验潜在类别模型确定的儿童 BMI 轨迹与 CVD 风险因素之间的关联。正常体重和超重根据疾病控制和预防中心的生长参考标准定义。
我们在正常体重范围内确定了四个儿童 BMI 轨迹和一个超重轨迹。与 BMI 水平最低的轨迹相比，几个较高的 BMI 轨迹与成年后更大的腰围、更低的高密度脂蛋白和葡萄糖稳态有关。最高的轨迹还与更高的总胆固醇和甘油三酯有关。当调整成人 BMI 时，较高的 BMI 轨迹具有更低的腰围、血压和甘油三酯。
与最低 BMI 轨迹相比，正常体重范围内和超重范围内的 BMI 轨迹与更差的 CVD 风险状况相关，这些关联可以通过儿童期后的生长来改变。
