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Nutrition and Health (including climate and ecological aspects)

Prepubertal BMI, pubertal growth patterns, and long-term BMI: Results from a longitudinal analysis in Chinese children and adolescents from 2005 to 2016

Abstract

Objective

To assess the effects of prepubertal BMI on pubertal growth patterns, and the influence of prepubertal BMI and pubertal growth patterns on long-term BMI among Chinese children and adolescents.

Methods

A total of 9606 individuals aged between 7 and 18 years from longitudinal surveys in Zhongshan city of China from 2005 to 2016 were enrolled. Age at peak height velocity (APHV) and peak height velocity (PHV) were estimated using Super-Imposition by Translation and Rotation (SITAR) model. Associations between prepubertal BMI, APHV, PHV, and long-term overweight and obesity were assessed by linear regression and multinominal logistic regression. Scatter plots were elaborated to show the associations between prepubertal BMI and pubertal growth patterns according to prepubertal BMI categories.

Results

Prepubertal BMI Z-Score was positively correlated with long-term BMI Z-Score, and negatively correlated with APHV in both sexes. In addition, there was a negative association between prepubertal BMI Z-Score and PHV in boys. With 1-year decrease in APHV, risk of long-term underweight decreased by 92%, while overweight increased by 33% in boys. Corresponding risk of long-term underweight and overweight for girls decreased by 42% and increased by 20%, respectively.

Conclusion

High prepubertal BMI levels were associated with earlier APHV and lower PHV, and the early onset of pubertal development could increase the risks of long-term overweight and obesity at 17–18 years of age both in boys and girls. Such evidence emphasized the importance of reducing prepubertal obesity risks combined with appropriate pubertal development timing, including later APHV and higher PHV, so as to prevent the obesity and related cardiovascular diseases in adulthood.

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Fig. 1: Scatter plot and linear fit line of association between prepubertal BMI and long-term BMI status, stratified by sex.
Fig. 2: Association between prepubertal BMI and pubertal growth patterns.
Fig. 3: Scatter plots and Linear fit line of participants’ prepubertal BMI z score and age at peak height velocity and magnitude of peak height velocity, stratified by prepubertal BMI status (underweight, normal weight, overweight, and obesity).

Data availability

The data are available from the corresponding author on reasonable request.

Code availability

The computer code and data sets generated and/or analyzed in the present study are not publicly available due to the need to protect participants privacy but are available from the corresponding author on reasonable request.

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Acknowledgements

The authors would like to acknowledge the support from all the team members and the participating students, teachers, parents and local education and health staff in the programs.

Funding

The present study was supported by the National Natural Science Foundation (Grant 81673192 to JM; 82103865 to YD), and Beijing Natural Science Foundation (No. 7222244 to YD), as well as the China Postdoctoral Science Foundation (BX20200019 and 2020M680266 to YD).

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Authors

Contributions

YL, DG, and JL conceptualized and designed the study, completed the statistical analyses, drafted the initial paper, and reviewed and revised the paper; YD and JM contributed to the conceptualization and design of the study, supervised the data collection, the statistical analyses and initial drafting of the paper, and reviewed and revised the paper; BD, YS, and SH assisted with the statistical analyses and critically reviewed and revised the paper; ZY, BW, LC, MC, YM, and TM assisted with the data processing, statistical analyses, and the interpretation of the data. All authors approved the final paper as submitted and agree to be accountable for all aspects of the work.

Corresponding authors

Correspondence to Yanhui Dong or Jun Ma.

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The authors declare no competing interests.

Ethics approval and consent to participate

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving students were approved by the Medical Research Ethics Committee of the Peking University Health Science Center (IRB00001052-20011). All participants and their parents signed informed consents voluntarily.

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Li, Y., Gao, D., Liu, J. et al. Prepubertal BMI, pubertal growth patterns, and long-term BMI: Results from a longitudinal analysis in Chinese children and adolescents from 2005 to 2016. Eur J Clin Nutr (2022). https://doi.org/10.1038/s41430-022-01133-2

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