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BMI trajectory and inflammatory effects on metabolic syndrome in adolescents

Pediatric Research volume 94, pages 153–160 (2023)Cite this article

Abstract

Background

Various life course factors can affect susceptibility to diseases during adolescence and adulthood, and those relationships are complex. However, few studies have assessed the potential mediating factors. Therefore, we assessed the mediating effects of factors related to growth and inflammation between perinatal factors and metabolic syndrome risk during adolescence.

Methods

The study was conducted on adolescents who participated in the follow-up in the Ewha Birth and Growth Cohort. We considered the ponderal index (PI) as a perinatal factor and the continuous metabolic syndrome score (cMetS) as the outcome and confirmed the mediating effects of body mass index (BMI) trajectory pattern in childhood and inflammation levels by using the PROCESS macro for SAS.

Results

Although the direct effect of BMI trajectory on the relationship between PI and cMetS was not significant (0.545), the indirect effect was significant (1.044). In addition, the indirect effect was statistically significant in the pathways mediating the BMI trajectory pattern and inflammation (β = 1.456).

Conclusions

The direct and indirect effects on the relationship between PI and cMetS suggest that childhood factors related to growth may be involved in disease susceptibility. Therefore, appropriate interventions for the management of obesity during the growth phase are necessary.

Impact

  • Unlike other existing studies, this study assessed multiple mediating effects by considering the BMI trajectory pattern and inflammatory indexes as mediating factors between the ponderal index and the continuous metabolic syndrome score during adolescence.

  • We found significant indirect effects of the BMI trajectory between PI and cMetS, and also significant indirect effects in the pathways mediating the BMI trajectory and hs-CRP.

  • The significant indirect mediating effects support that childhood factors related to growth may be involved in disease susceptibility.

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Fig. 1: Trajectories of BMI from 3 to 12 years of age.
Fig. 2: Mediating effects of BMI trajectory on the relationship between ponderal index and cMetS.
Fig. 3: Mediating effects of BMI trajectory and inflammation factors on the relationship between ponderal index and cMetS.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author upon reasonable request.

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Funding

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF), funded by the Ministry of Education (NRF-2020R1F1A1062227). This research was also supported by the BK21 FOUR (Fostering Outstanding Universities for Research) funded by the Ministry of Education and National Research Foundation of Korea (NRF-5199990614253).

Author information

Authors and Affiliations

  1. Graduate Program in System Health Science and Engineering, Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Ui-Jeong Kim, Hyunjin Park & Hyesook Park

  2. Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Eun Jeong Choi

  3. Clinical Trial Center, Mokdong Hospital, Ewha Womans University, Seoul, Republic of Korea

    Hye Ah Lee

  4. National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea

    Bohyun Park

  5. Healthcare Analytics Unit, Children’s Hospital of Philadelphia, Philadelphia, PA, US

    Jungwon Min

  6. Department of Pediatrics, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Eun Ae Park, Su Jin Cho & Hae Soon Kim

  7. Department of Anatomy, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Hwayoung Lee

  8. Graduate Program in System Health Science and Engineering, Department of Obstetrics and Gynecology, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Young Ju Kim

  9. Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Young Sun Hong

  10. Graduate Program in System Health Science and Engineering, Department of Environmental Medicine, College of Medicine, Ewha Womans University, Seoul, Republic of Korea

    Eun Hee Ha

  11. Graduate Program in System Health Science and Engineering, Department of Nutritional Science and Food Management, Ewha Womans University, Seoul, Republic of Korea

    Seungyoun Jung

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Contributions

U.J.K. participated in the study design, performed the statistical analysis, interpreted the data, and drafted the manuscript. E.C. performed the statistical analysis and revised the manuscript. H.P. revised the manuscript, and H.L. made contributions to the study design as well as the interpretation of the data and revised the manuscript. B.P. helped with the interpretation of the data and revised the manuscript. J.M., E.P., S.C., and H.K. performed the statistical analysis and helped with the interpretation of the data. H.L., Y.K., and Y.H. helped with the interpretation of the data and revised the manuscript. E.H. and S.J. helped to conceive the study and revised the manuscript. H.P. conceived of the study and participated substantially in its design and coordination. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hyesook Park.

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The authors declare no competing interests.

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Informed consent was obtained from all participants who participated in the follow-up or their parents, and this study was approved by the Institutional Review Board of Ewha Womans University Seoul Hospital (IRB number: SEUMC 2020-07-016).

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Kim, UJ., Choi, E.J., Park, H. et al. BMI trajectory and inflammatory effects on metabolic syndrome in adolescents. Pediatr Res 94, 153–160 (2023). https://doi.org/10.1038/s41390-022-02461-6

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