Abstract
Background/Objectives:
The effect of adiposity dynamics throughout adolescence on adult cardiometabolic outcomes is not well known. We aimed to assess the effect of duration and degree of adiposity from adolescence to early adulthood on blood pressure and insulin resistance at 24 years.
Subjects/Methods:
We used data from 2253 participants evaluated at 13, 17, 21 and 24 years of age in the EPITeen cohort, Porto, Portugal. The area under the curve of body mass index (BMIAUC) was computed to summarize duration and degree of BMI for the 11-year period. Outcomes were systolic blood pressure (SBP) and insulin resistance at 24 years. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an indicator of insulin resistance and the variable was log-transformed. Associations between BMIAUC and each outcome were estimated by linear regression models.
Results:
The median BMIAUC was 243.1 (223.9–268.6) kg m−2 in 11 years, corresponding to 22.1 kg m−2 on average per year. In crude analyses, both BMIAUC and BMI at 24 years were positively associated with SBP (β=0.096 mm Hg, 95% confidence interval (CI) 0.077; 0.115 for BMIAUC; β=4.616 mm Hg, 95% CI 3.082; 6.151 for BMI at 24 years) and ln HOMA-IR (β=0.004, 95% CI 0.003; 0.005 for BMIAUC; β=0.047, 95% CI 0.036; 0.057 for BMI at 24 years). After adjustment for confounders and for BMI at 24 years, the magnitude of the association of BMIAUC attenuated for both outcomes, mostly for SBP, but the association remained statistically significant. Results using standardized variables confirmed that both outcomes were more strongly associated with BMI at 24 years than with BMIAUC.
Conclusions:
In addition to the effect of adult attained BMI, cumulative exposure to higher BMI throughout adolescence, taking into account duration and degree, was also relevant for adult cardiovascular risk factors, mainly for insulin resistance.
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References
Llewellyn A, Simmonds M, Owen CG, Woolacott N . Childhood obesity as a predictor of morbidity in adulthood: a systematic review and meta-analysis. Obes Rev 2016; 17: 56–67.
Lloyd LJ, Langley-Evans SC, McMullen S . Childhood obesity and adult cardiovascular disease risk: a systematic review. Int J Obes (Lond) 2010; 34: 18–28.
Simmonds M, Llewellyn A, Owen CG, Woolacott N . Predicting adult obesity from childhood obesity: a systematic review and meta-analysis. Obes Rev 2016; 17: 95–107.
Singh AS, Mulder C, Twisk JW, van Mechelen W, Chinapaw MJ . Tracking of childhood overweight into adulthood: a systematic review of the literature. Obes Rev 2008; 9: 474–488.
Power C, Thomas C . Changes in BMI, duration of overweight and obesity, and glucose metabolism: 45 years of follow-up of a birth cohort. Diabetes Care 2011; 34: 1986–1991.
Law CM, Shiell AW, Newsome CA, Syddall HE, Shinebourne EA, Fayers PM et al. Fetal, infant, and childhood growth and adult blood pressure: a longitudinal study from birth to 22 years of age. Circulation 2002; 105: 1088–1092.
Tirosh A, Shai I, Afek A, Dubnov-Raz G, Ayalon N, Gordon B et al. Adolescent BMI trajectory and risk of diabetes versus coronary disease. N Engl J Med 2011; 364: 1315–1325.
Lawlor DA, Leon DA . Association of body mass index and obesity measured in early childhood with risk of coronary heart disease and stroke in middle age: findings from the aberdeen children of the 1950s prospective cohort study. Circulation 2005; 111: 1891–1896.
Suglia SF, Clark CJ, Gary-Webb TL . Adolescent obesity, change in weight status, and hypertension: racial/ethnic variations. Hypertension 2013; 61: 290–295.
Lawlor DA, Benfield L, Logue J, Tilling K, Howe LD, Fraser A et al. Association between general and central adiposity in childhood, and change in these, with cardiovascular risk factors in adolescence: prospective cohort study. BMJ 2010; 341: c6224.
Maximova K, O'Loughlin J, Paradis G, Hanley JA, Lynch J . Changes in anthropometric characteristics and blood pressure during adolescence. Epidemiology 2010; 21: 324–331.
Parker ED, Sinaiko AR, Kharbanda EO, Margolis KL, Daley MF, Trower NK et al. Change in weight status and development of hypertension. Pediatrics 2016; 137: e20151662.
Juonala M, Magnussen CG, Berenson GS, Venn A, Burns TL, Sabin MA et al. Childhood adiposity, adult adiposity, and cardiovascular risk factors. N Engl J Med 2011; 365: 1876–1885.
Araujo J, Severo M, Barros H, Mishra GD, Guimaraes JT, Ramos E . Developmental trajectories of adiposity from birth until early adulthood and association with cardiometabolic risk factors. Int J Obes (Lond) 2015; 39: 1443–1449.
Attard SM, Herring AH, Howard AG, Gordon-Larsen P . Longitudinal trajectories of BMI and cardiovascular disease risk: the national longitudinal study of adolescent health. Obesity (Silver Spring) 2013; 21: 2180–2188.
Ventura AK, Loken E, Birch LL . Developmental trajectories of girls' BMI across childhood and adolescence. Obesity (Silver Spring) 2009; 17: 2067–2074.
Ziyab AH, Karmaus W, Kurukulaaratchy RJ, Zhang H, Arshad SH . Developmental trajectories of Body Mass Index from infancy to 18 years of age: prenatal determinants and health consequences. J Epidemiol Community Health 2014; 68: 934–941.
Abdullah A, Stoelwinder J, Shortreed S, Wolfe R, Stevenson C, Walls H et al. The duration of obesity and the risk of type 2 diabetes. Public Health Nutr 2011; 14: 119–126.
Hekimsoy Z, Oktem IK . Duration of obesity is not a risk factor for type 2 diabetes mellitus, arterial hypertension and hyperlipidemia. Diabetes Obes Metab 2003; 5: 432–437.
Pinto Pereira SM, Power C . Life course body mass index, birthweight and lipid levels in mid-adulthood: a nationwide birth cohort study. Eur Heart J 2013; 34: 1215–1224.
The NS, Richardson AS, Gordon-Larsen P . Timing and duration of obesity in relation to diabetes: findings from an ethnically diverse, nationally representative sample. Diabetes Care 2013; 36: 865–872.
Tanamas SK, Wong E, Backholer K, Abdullah A, Wolfe R, Barendregt J et al. Duration of obesity and incident hypertension in adults from the Framingham Heart Study. J Hypertens 2015; 33: 542–545.
Pontiroli AE, Galli L . Duration of obesity is a risk factor for non-insulin-dependent diabetes mellitus, not for arterial hypertension or for hyperlipidaemia. Acta Diabetol 1998; 35: 130–136.
Abdullah A, Wolfe R, Mannan H, Stoelwinder JU, Stevenson C, Peeters A . Epidemiologic merit of obese-years, the combination of degree and duration of obesity. Am J Epidemiol 2012; 176: 99–107.
Ramos E, Barros H . Family and school determinants of overweight in 13-year-old Portuguese adolescents. Acta Paediatr 2007; 96: 281–286.
Executive summary of the clinical guidelines on the identification, evaluation, and treatment of overweight and obesity in adults. Arch Intern Med 1998; 158: 1855–1867.
Ekstrom C . MESS: Miscellaneous Esoteric Statistical Scripts. R Package Version 0.3-2 2014. Available at: http://CRAN.R-project.org/package=MESS.
Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28: 412–419.
Weber MA, Schiffrin EL, White WB, Mann S, Lindholm LH, Kenerson JG et al. Clinical practice guidelines for the management of hypertension in the community a statement by the American Society of Hypertension and the International Society of Hypertension. J Hypertens 2014; 32: 3–15.
O’brien RM . A caution regarding rules of thumb for variance inflation factors. Qual Quant 2007; 41: 673–690.
van Buuren S, Groothuis-Oudshoorn K . mice: multivariate imputation by chained equations in R. J Stat Softw 2011; 45: 1–67.
Rubin DB . Multiple Imputation for Nonresponse in Surveys vol. 81. John Wiley & Sons: New Jersey, USA, 2004.
Twig G, Yaniv G, Levine H, Leiba A, Goldberger N, Derazne E et al. Body-mass index in 2.3 million adolescents and cardiovascular death in adulthood. N Engl J Med 2016; 374: 2430–2440.
Acknowledgements
This study was funded by FEDER through the Operational Programme Competitiveness and Internationalization and national funding from the Foundation for Science and Technology—FCT (Portuguese Ministry of Science, Technology and Higher Education) (POCI-01-0145-FEDER-016829), under the project ‘A longitudinal approach to metabolically healthy obesity: from inflammation to cardiovascular risk profile’ (Ref. FCT PTDC/DTP-EPI/6506/2014) and the Unidade de Investigação em Epidemiologia—Instituto de Saúde Pública da Universidade do Porto (EPIUnit) (POCI-01-0145-FEDER-006862; Ref. UID/DTP/04750/2013), and the PhD Grant SFRH/BD/78153/2011 (to JA), co-funded by the FCT and the POPH/FSE Program.
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Araújo, J., Severo, M., Barros, H. et al. Duration and degree of adiposity: effect on cardiovascular risk factors at early adulthood. Int J Obes 41, 1526–1530 (2017). https://doi.org/10.1038/ijo.2017.133
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DOI: https://doi.org/10.1038/ijo.2017.133