Distinct child-to-adult body mass index trajectories are associated with different levels of adult cardiometabolic risk
Distinct child-to-adult body mass index trajectories are associated with different levels of adult cardiometabolic risk
复制标题
DOI：
10.1093/eurheartj/ehy161
复制
发表时间：
2018-06-21
影响因子：
39.3
通讯作者：
Magnussen, Costan G.
中科院分区：
文献类型：
--
作者：
Buscot, Marie-Jeanne;Thomson, Russell J.;Magnussen, Costan G.
生命过程中的体重指数（BMI）轨迹和成人心血管疾病（CVD）风险之间的关系描述不足。在一个纵向队列中，我们描述了从儿童早期到成年的BMI轨迹，并研究了它们与CVD危险因素[2型糖尿病（T2 DM）、高危血脂水平、高血压、和高颈动脉内膜中层厚度（cIMT）]（34-49岁）。方法和结果6个离散的长-在2631名芬兰年轻人心血管风险研究参与者中，使用潜在类别增长混合模型确定了长期BMI轨迹（6-49岁）：稳定正常（55.2%）、正在消退（1.6%）、进行性超重（33.4%）、进行性肥胖（4.2%）、快速超重/肥胖（4.3%）和持续增加超重/肥胖（1.2%）。肥胖恶化或持续的轨迹通常与成年期（24-49岁）CVD结局风险增加相关[所有风险比（RR）>15，与稳定正常组相比P < 0.05]。尽管成人T2 DM的剩余风险无法得到证实[RR = 2.6，95%置信区间（CI）=0.14-8.23]，但解决儿童BMI升高的参与者与从不肥胖或超重的参与者发生血脂异常和高血压的风险相似（所有RR均接近1）。结论BMI长期处于或持续处于高水平与成年期CVD危险因素有关。稳定肥胖成人的BMI，并在成年期解决儿童BMI升高可能会限制和减少不良的心脏代谢特征。然而，预防儿童肥胖的努力可能是降低成人动脉粥样硬化风险的最有效方法。
Aims The relationship between life-course body mass index (BMI) trajectories and adult risk for cardiovascular disease (CVD) is poorly described. In a longitudinal cohort, we describe BMI trajectories from early childhood to adulthood and investigate their association with CVD risk factors [Type 2 diabetes mellitus (T2DM), high-risk lipid levels, hypertension, and high carotid intima-media thickness (cIMT)] in adulthood (34-49 years).Methods and results Six discrete long-term BMI trajectories were identified using latent class growth mixture modelling among 2631 Cardiovascular Risk in Young Finns Study participants (6-49 years): stable normal (55.2%), resolving (1.6%), progressively overweight (33.4%), progressively obese (4.2%), rapidly overweight/obese (4.3%), and persistent increasing overweight/obese (1.2%). Trajectories of worsening or persisting obesity were generally associated with increased risk of CVD outcomes in adulthood (24-49 years) [all risk ratios (RRs) >15, P < 0.05 compared with the stable normal group]. Although residual risk for adult T2DM could not be confirmed [RR = 2.6, 95% confidence interval (CI)=0.14-8.23], participants who resolved their elevated child BMI had similar risk for dyslipidaemia and hypertension as those never obese or overweight (all RRs close to 1). However, they had significantly higher risk for increased cIMT (RR= 3.37, 95% CI = 1.80-6.39).Conclusion The long-term BMI trajectories that reach or persist at high levels associate with CVD risk factors in adulthood. Stabilizing BMI in obese adults and resolving elevated child BMI by adulthood might limit and reduce adverse cardiometabolic profiles. However, efforts to prevent child obesity might be most effective to reduce the risk for adult atherosclerosis.