Postnatal height and adiposity gain, childhood blood pressure and prehypertension risk in an Asian birth cohort



There have been hypotheses that early life adiposity gain may influence blood pressure (BP) later in life. We examined associations between timing of height, body mass index (BMI) and adiposity gains in early life with BP at 48 months in an Asian pregnancy-birth cohort.


In 719 children, velocities for height, BMI and abdominal circumference (AC) were calculated at five intervals [0–3, 3–12, 12–24, 24–36 and 36–48 months]. Triceps (TS) and subscapular skinfold (SS) velocities were calculated between 0–18, 18–36 and 36–48 months. Systolic (SBP) and diastolic blood pressure (DBP) was measured at 48 months. Growth velocities at later periods were adjusted for growth velocities in preceding intervals, as well as measurements at birth.


After adjusting for confounders and child height at BP measurement, each unit z-score gain in BMI, AC, TS and SS velocities at 36–48 months were associated with 2.3 (95% CI:1.6, 3.1), 2.1 (1.3, 2.8), 1.4 (0.6, 2.2) and 1.8 (1, 2.6) mmHg higher SBP respectively, and 0.9 (0.4, 1.4), 0.9 (0.4, 1.3), 0.6 (0.1, 1.1) and 0.8 (0.3, 1.3) mmHg higher DBP respectively. BMI and adiposity velocities (AC, TS or SS) at various intervals in the first 36 months however, were not associated with BP. Faster BMI, AC, TS and SS velocities, but not height, at 36–48 months were associated with 0.22 (0.15, 0.29), 0.17 (0.10, 0.24), 0.11 (0.04, 0.19) and 0.15 (0.08, 0.23) units higher SBP z-score respectively, and OR=1.46 (95% CI: 1.13–1.90), 1.49 (1.17–1.92), 1.45 (1.09–1.92) and 1.43 (1.09, 1.88) times higher risk of prehypertension/hypertension respectively at 48 months.


Our results indicated that faster BMI and adiposity (AC, TS or SS) velocities only at the preceding interval before 48 months (36–48 months), but not at earlier intervals in the first 36 months, are predictive of BP and prehypertension/hypertension at 48 months.

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The GUSTO study group includes Allan Sheppard, Amutha Chinnadurai, Anne Eng Neo Goh, Anne Rifkin-Graboi, Anqi Qiu, Arijit Biswas, Bee Wah Lee, Birit FP Broekman, Boon Long Quah, Borys Shuter, Carolina Un Lam, Chai Kiat Chng, Cheryl Ngo, Choon Looi Bong, Christiani Jeyakumar Henry, Claudia Chi, Cornelia Yin Ing Chee, Yam Thiam Daniel Goh, Doris Fok, E Shyong Tai, Elaine Tham, Elaine Quah Phaik Ling, Evelyn Xiu Ling Loo, Falk Mueller- Riemenschneider, George Seow Heong Yeo, Helen Chen, Heng Hao Tan, Hugo P S van Bever, Iliana Magiati, Inez Bik Yun Wong, Ivy Yee-Man Lau, Jeevesh Kapur, Jenny L Richmond, Jerry Kok Yen Chan, Joanna D Holbrook, Joanne Yoong, Joao N Ferreira, Jonathan Tze Liang Choo, Joshua J Gooley, Kenneth Kwek, Kok Hian Tan, Krishnamoorthy Niduvaje, Kuan Jin Lee, Leher Singh, Lieng Hsi Ling, Lin Lin Su, Lourdes Mary Daniel, Lynette Pei-Chi Shek, Marielle V Fortier, Mark Hanson, Mary Foong-Fong Chong, Mary Rauff, Mei Chien Chua, Melvin Khee-Shing Leow, Michael Meaney, Neerja Karnani, Ngee Lek, Oon Hoe Teoh, PC Wong, Paulin Tay Straughan, Pratibha Agarwal, Queenie Ling Jun Li, Rob M van Dam, Salome A Rebello, See Ling Loy, S Sendhil Velan, Seng Bin Ang, Shang Chee Chong, Sharon Ng, Shiao-Yng Chan, Shirong Cai, Sok Bee Lim, Stella Tsotsi, Chin-Ying Stephen Hsu, Sue Anne Toh, Swee Chye Quek, Victor Samuel Rajadurai, Walter Stunkel, Wayne Cutfield, Wee Meng Han, Yin Bun Cheung, Yiong Huak Chan and Zhongwei Huang. This study is under Translational Clinical Research (TCR) Flagship Programme on Developmental Pathways to Metabolic Disease, NMRC/TCR/004-NUS/2008; NMRC/TCR/012-NUHS/2014 funded by the National Research Foundation (NRF) and administered by the National Medical Research Council (NMRC), Singapore. KMG is supported by the National Institute for Health Research through the NIHR Southampton Biomedical Research Centre and by the European Union's Seventh Framework Programme (FP7/2007-2013), project Early Nutrition under grant agreement no. 289346.

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Correspondence to Y S Lee.

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Keith M Godfrey, Yap Seng Chong and Yung Seng Lee have received reimbursement for speaking at conferences sponsored by companies selling nutritional products. Keith M Godfrey and Yap Seng Chong are part of an academic consortium that has received research funding from Abbot Nutrition, Nestec and Danone. The remaining authors have no financial relationships relevant to this article to disclose.

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