儿童早期体重指数轨迹与 10 岁时身体成分和心血管代谢标志物的关系：埃塞俄比亚婴幼儿人体测量和身体成分（iABC）出生队列研究。

Associations of early childhood body mass index trajectories with body composition and cardiometabolic markers at age 10 years: the Ethiopian infant anthropometry and body composition (iABC) birth cohort study.

机构信息

Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark.

Clinical Research, Steno Diabetes Center Copenhagen, Herlev, Denmark.

出版信息

Am J Clin Nutr. 2024 May;119(5):1248-1258. doi: 10.1016/j.ajcnut.2024.03.004. Epub 2024 Mar 7.

DOI:10.1016/j.ajcnut.2024.03.004

PMID:38458400

Abstract

BACKGROUND

Variability in body mass index (BMI) (kg/m) trajectories is associated with body composition and cardiometabolic markers in early childhood, but it is unknown how these associations track to later childhood.

OBJECTIVES

We aimed to assess associations of BMI trajectories from 0 to 5 y with body composition and cardiometabolic markers at 10 y.

METHODS

In the Ethiopian infant anthropometry and body composition (iABC) birth cohort, we previously identified 4 distinct BMI trajectories from 0 to 5 y: stable low BMI (19.2%), normal BMI (48.8%), rapid growth to high BMI (17.9%), and slow growth to high BMI (14.1%). At 10 y, we obtained data from 320 children on anthropometry, body composition, abdominal subcutaneous and visceral fat, and cardiometabolic markers. Associations of BMI trajectories and 10-y outcomes were analyzed using multiple linear regression.

RESULTS

Compared with children with the normal BMI trajectory, those with rapid growth to high BMI had 1.7 cm (95% CI: 0.1, 3.3) larger waist circumference and those with slow growth to high had 0.63 kg/m (95% CI: 0.09, 1.17) greater fat mass index and 0.19 cm (95% CI: 0.02, 0.37) greater abdominal subcutaneous fat, whereas those with stable low BMI had -0.28 kg/m (95% CI: -0.59, 0.03) lower fat-free mass at 10 y. Although the confidence bands were wide and included the null value, children with rapid growth to high BMI trajectory had 48.6% (95% CI: -1.4, 123.8) higher C-peptide concentration and those with slow growth to high BMI had 29.8% (95% CI: -0.8, 69.8) higher insulin and 30.3% (95% CI: -1.1, 71.6) higher homeostasis model assessment of insulin resistance, whereas those with rapid growth to high BMI had -0.23 mmol/L (95% CI: -0.47, 0.02) lower total cholesterol concentration. The trajectories were not associated with abdominal visceral fat, blood pressure, glucose, and other lipids at 10 y.

CONCLUSIONS

Children with rapid and slow growth to high BMI trajectories before 5 y tend to show higher measures of adiposity and higher concentrations of markers related to glucose metabolism at 10 y.

CLINICAL TRIAL REGISTRY

ISRCTN46718296 (https://www.isrctn.com/ISRCTN46718296).

摘要

背景

体重指数 (BMI)（kg/m）轨迹的变化与儿童早期的身体成分和心血管代谢标志物有关，但尚不清楚这些关联如何追踪到儿童后期。

目的

我们旨在评估 0 至 5 岁时 BMI 轨迹与 10 岁时身体成分和心血管代谢标志物的相关性。

方法

在埃塞俄比亚婴儿人体测量和身体成分 (iABC) 队列研究中，我们之前从 0 到 5 岁确定了 4 种不同的 BMI 轨迹：稳定的低 BMI（19.2%）、正常 BMI（48.8%）、快速增长到高 BMI（17.9%）和缓慢增长到高 BMI（14.1%）。在 10 岁时，我们获得了 320 名儿童的人体测量、身体成分、腹部皮下和内脏脂肪以及心血管代谢标志物的数据。使用多元线性回归分析 BMI 轨迹与 10 岁时的结果之间的相关性。

结果

与具有正常 BMI 轨迹的儿童相比，快速增长到高 BMI 的儿童腰围大 1.7 厘米（95%CI：0.1，3.3），缓慢增长到高 BMI 的儿童脂肪质量指数大 0.63kg/m（95%CI：0.09，1.17），腹部皮下脂肪大 0.19cm（95%CI：0.02，0.37），而稳定的低 BMI 儿童 10 岁时的去脂体重低 0.28kg/m（95%CI：-0.59，0.03）。尽管置信区间较宽，包括零值，但快速增长到高 BMI 轨迹的儿童 C 肽浓度高 48.6%（95%CI：-1.4，123.8），缓慢增长到高 BMI 轨迹的儿童胰岛素浓度高 29.8%（95%CI：-0.8，69.8），胰岛素抵抗的稳态模型评估值高 30.3%（95%CI：-1.1，71.6），而快速增长到高 BMI 轨迹的儿童总胆固醇浓度低 0.23mmol/L（95%CI：-0.47，0.02）。在 10 岁时，这些轨迹与腹部内脏脂肪、血压、葡萄糖和其他脂质没有关联。