Jin Xuli, Zhao Min, Sun Jiahong, Xi Bo
Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
Front Nutr. 2024 Dec 18;11:1506191. doi: 10.3389/fnut.2024.1506191. eCollection 2024.
Previous studies have shown positive associations of waist circumference (WC) and waist-to-height ratio (WHtR) with left ventricular hypertrophy (LVH) among children and adolescents. However, most of these studies were cross-sectional or limited to only two time points. We aim to estimate the association of trajectories in WC and WHtR with LVH during childhood.
Data were from the prospective "Huantai Childhood Cardiovascular Health Cohort Study" conducted from 2017 to 2023 in Huantai County, Zibo City, Shandong Province. Group-based trajectory modeling was used to categorize WC into three groups: low-increasing, moderate-increasing, and high-increasing trajectories. Similarly, WHtR was categorized into three groups: stabilizing, decreasing, and increasing trajectories. Linear and log-binomial regression analyses were used to examine the associations of WC and WHtR trajectories with increased left ventricular mass index (LVMI) and LVH.
A total of 946 children were included, with 51.9% being boys and an average age of 8 years at baseline. After adjustment for potential covariates, children in the high-increasing WC group and the increasing WHtR trajectory group had increased LVMI ( = 5.16 g/m, 95% confidence interval (CI): 4.37, 5.95 and = 4.91 g/m, 95% CI: 4.15, 5.68) and a higher risk of LVH [risk ratio (RR) = 5.84, 95% CI: 3.39, 10.05 and RR = 7.38, 95% CI: 4.14, 13.14] compared to the low-increasing WC group and stabilizing WHtR group, respectively. Interestingly, the moderate-increasing WC and decreasing WHtR trajectory groups still have an increased LVMI ( = 2.83 g/m, 95% CI: 2.05, 3.61 and = 2.25 g/m, 95% CI: 1.50, 3.01) and a higher risk of LVH (RR = 2.04, 95% CI: 1.00, 4.15 and RR = 2.23, 95% CI: 1.06, 4.71) compared to the low-increasing WC group and stabilizing WHtR group, respectively. Similar results were found when stratified by sex.
We found the risk of LVH was not fully eliminated among children with a decreasing WHtR trajectory. These findings underscore the need for early prevention and continuous monitoring of WC and WHtR to help prevent future sub-clinical cardiovascular damage in childhood.
既往研究表明，儿童和青少年的腰围（WC）及腰高比（WHtR）与左心室肥厚（LVH）呈正相关。然而，这些研究大多为横断面研究或仅限于两个时间点。我们旨在评估儿童期WC和WHtR轨迹与LVH的关联。
数据来自于2017年至2023年在山东省淄博市桓台县进行的前瞻性“桓台儿童心血管健康队列研究”。基于群组的轨迹模型用于将WC分为三组：低增长、中度增长和高增长轨迹。同样，WHtR被分为三组：稳定、下降和上升轨迹。线性和对数二项回归分析用于检验WC和WHtR轨迹与左心室质量指数（LVMI）增加及LVH的关联。
共纳入946名儿童，其中51.9%为男孩，基线时平均年龄为8岁。在对潜在协变量进行调整后，WC高增长组和WHtR上升轨迹组的儿童LVMI增加（分别为=5.16 g/m，95%置信区间（CI）：4.37，5.95和=4.91 g/m，95% CI：4.15，5.68），且LVH风险更高[风险比（RR）=5.84，95% CI：3.39，10.05和RR =7.38，95% CI：4.14，13.14]，分别与WC低增长组和WHtR稳定组相比。有趣的是，WC中度增长组和WHtR下降轨迹组的LVMI仍增加（分别为=2.83 g/m，95% CI：2.05，3.61和=2.25 g/m，95% CI：1.50，3.01），且LVH风险更高（RR =2.04，95% CI：1.00，4.15和RR =2.23，95% CI：1.06，4.71），分别与WC低增长组和WHtR稳定组相比。按性别分层时发现了类似结果。
我们发现WHtR轨迹下降的儿童中LVH风险并未完全消除。这些发现强调了早期预防以及持续监测WC和WHtR以帮助预防儿童未来亚临床心血管损害的必要性。
