Zhang Jie, Andersen Christina, Olsen Anja, Halkjær Jytte, Petersen Kristina Elin, Schaarup Jonas Frey Rosborg, Antoniussen Christian S, Witte Daniel R, Dahm Christina C
Department of Public Health, Aarhus University, Aarhus, Denmark.
Steno Diabetes Center Aarhus, Aarhus, Denmark.
Int J Obes (Lond). 2025 Aug 22. doi: 10.1038/s41366-025-01882-7.
BACKGROUND/OBJECTIVES: Higher body mass index (BMI) is strongly associated with cardiovascular metabolic diseases, however, BMI changes across the lifespan may be complex and non-linear. Furthermore, heterogeneous BMI trajectories may exhibit different cardiometabolic traits. We aimed to identify BMI trajectories over up to 50 years and examine their associations with cardiometabolic biomarkers.
SUBJECTS/METHODS: In total, 30,581 participants from the Danish Diet, Cancer and Health - Next Generations cohort were included in the study. Participants recalled their weight history for each decade through questionnaires. Weight and height were measured, and blood samples were collected during a clinic visit. Cardiometabolic biomarkers (Hemoglobin A1c, total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, C-reactive Protein, and creatinine) were determined. Latent class growth models were applied to model BMI trajectories from age 20 until the current age. The optimal number of groups was selected according to Bayesian Information Criteria, the integrated completed likelihood, and the mean posterior probability of each group. Linear and logistic regression models were used to examine the association between distinct BMI trajectories and cardiovascular biomarkers, with adjustment for age, sex, and smoking status.
Four distinct BMI trajectories were identified: "Stable low BMI" group (32%, n = 9753), "Gradual BMI increase" (45%, n = 13,780), "Early high BMI" group (3%, n = 771), and "Steeper BMI increase" group (21%, n = 6277). Compared to the "Stable low BMI" group, all other trajectory groups showed significant associations with adverse cardiometabolic biomarkers. For instance, the "Steeper BMI increase" group was associated with elevated triglycerides (β = 0.36 mmol/L, 95% CI: 0.34, 0.38), followed by the "Early high BMI" group (β = 0.30 mmol/L, 95% CI: 0.26, 0.34) and the "Gradual BMI increase" group (β = 0.12 mmol/L, 95% CI: 0.11, 0.13).
Both those with constant high BMI and steeply increased BMI trajectories from age 20 had more unfavorable cardiometabolic profiles compared to those maintaining lower BMI throughout adulthood.
背景/目的：较高的体重指数（BMI）与心血管代谢疾病密切相关，然而，BMI在整个生命周期中的变化可能是复杂且非线性的。此外，不同的BMI轨迹可能表现出不同的心脏代谢特征。我们旨在确定长达50年的BMI轨迹，并研究它们与心脏代谢生物标志物的关联。
受试者/方法：丹麦饮食、癌症与健康——下一代队列中的30581名参与者被纳入本研究。参与者通过问卷调查回忆了他们每十年的体重史。在门诊就诊期间测量体重和身高，并采集血样。测定心脏代谢生物标志物（糖化血红蛋白、总胆固醇、甘油三酯、高密度脂蛋白、低密度脂蛋白、C反应蛋白和肌酐）。应用潜在类别增长模型对从20岁到当前年龄的BMI轨迹进行建模。根据贝叶斯信息准则、综合完成似然度和每组的平均后验概率选择最佳组数。使用线性和逻辑回归模型来检验不同BMI轨迹与心血管生物标志物之间的关联，并对年龄、性别和吸烟状况进行了调整。
确定了四种不同的BMI轨迹：“稳定低BMI”组（32%，n = 9753）、“BMI逐渐增加”组（45%，n = 13780）、“早期高BMI”组（3%，n = 771）和“BMI急剧增加”组（21%，n = 6277）。与“稳定低BMI”组相比，所有其他轨迹组均与不良心脏代谢生物标志物存在显著关联。例如，“BMI急剧增加”组与甘油三酯升高相关（β = 0.36 mmol/L，95%CI：0.34，0.38），其次是“早期高BMI”组（β = 0.30 mmol/L，95%CI：0.26，0.34）和“BMI逐渐增加”组（β = 0.12 mmol/L，95%CI：0.11，0.13）。
与成年期始终保持较低BMI的人相比，20岁起BMI持续较高以及BMI轨迹急剧增加的人具有更不利的心脏代谢特征。
