Original Article | Published:

Epidemiology and Population Health

Trajectories of total and central adiposity throughout adolescence and cardiometabolic factors in early adulthood

International Journal of Obesity volume 40, pages 18991905 (2016) | Download Citation

Abstract

Background/Objectives:

Our aim was to identify trajectories of total and central adiposity from 13 to 21 years, and to investigate how adiposity changes at different phases of adolescence relate to adulthood cardiovascular risk factors.

Subjects/Methods:

This study included participants from a population-based cohort (EPITeen), Portugal. Body mass index (BMI) and waist circumference (WC) were measured at 13, 17 and 21 years, and sex- and age-specific z-scores were calculated. Adiposity trajectories were identified using mixture growth models (BMI, n=2901; WC, n=2898). Cardiovascular risk factors were evaluated at 21 years (n=1763): systolic (SBP) and diastolic blood pressure (DBP), insulin resistance (HOMA-IR), triglycerides and cholesterol. Association of trajectory, and changes in adiposity z-scores with each cardiovascular risk factor was estimated by linear regression models.

Results:

‘Normal’, ‘high, declining’ and ‘high, increasing’ trajectories were identified in both sexes. ‘High, increasing’ BMI trajectory was associated with less favorable cardiovascular risk profile at 21 years in both sexes, whereas ‘high, declining’ presented a more favorable profile, similar to ‘normal’ trajectory in females. In addition, BMI increases between 13–17 years and 17–21 years were associated with increases in systolic and diastolic blood pressure, and insulin resistance, but more strongly for the later period. For every standard deviation (s.d.) increase in BMI between 17–21 years, mean SBP increased by 1.99 mmHg (95% confidence interval (CI): 1.01; 2.97) for females and 3.83 mmHg (2.67; 4.98) for males; the respective increase was 1.56 mmHg (0.72; 2.40) and 2.80 mmHg (1.97; 3.64) for DBP and 0.27 (0.21; 0.32) and 0.30 (0.24; 0.36) for HOMA-IR (log-transformed). Similar results were found for WC.

Conclusions:

Increases in adiposity, particularly from late adolescence-to-young adulthood, were associated with unfavorable cardiovascular profile in early adulthood. A benefit on the cardiovascular risk profile for participants in the declining adiposity trajectory was observed.

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Acknowledgements

This study was supported by national funding from the Portuguese Foundation for Science and Technology—FCT (Portuguese Ministry of Education and Science) within the Epidemiology Research Unit—Institute of Public Health, University of Porto (UID/DTP/047507/2013). The Population, Policy and Practice Programme was formed in 2014, incorporating the activities of the Centre for Paediatric Epidemiology and Biostatistics, which was supported in part by the Medical Research Council in its capacity as the MRC Centre of Epidemiology for Child Health (award G0400546). Research at the GOSH/UCL Institute of Child Health is supported in part by the Department of Health’s NIHR Biomedical Research Centres. An individual grant to JA (SFRH/BD/78153/2011) by the Portuguese Foundation for Science and Technology—FCT is gratefully acknowledged.

Author information

Affiliations

  1. EPIUnit—Institute of Public Health, University of Porto, Porto, Portugal

    • J Araújo
    • , H Barros
    •  & E Ramos
  2. Population, Policy and Practice Programme, Institute of Child Health, University College London, London, UK

    • J Araújo
    •  & L Li
  3. Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, Porto, Portugal

    • H Barros
    •  & E Ramos

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Competing interests

The authors declare no conflict of interest.

Corresponding author

Correspondence to J Araújo.

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DOI

https://doi.org/10.1038/ijo.2016.170

Supplementary Information accompanies this paper on International Journal of Obesity website (http://www.nature.com/ijo)