Developmental origins of BMI trajectory among adolescents

描述（由申请人提供）：在美国，肥胖有望超过烟草，成为造成可预防死亡的最大因素。超重儿童成年后超重的风险增加，与一些负面健康结果（如心血管疾病、糖尿病、某些癌症和中风）相关的高发病率风险增加。超重和肥胖的危险因素在生命早期就开始了，甚至在产前就开始了，尽管研究早期生活因素和肥胖之间的纵向关系的研究很少。由于在大多数现有研究中缺乏重复的拟人化测量，我们对早期生活因素对跨越童年、青春期和成年早期的个体超重和肥胖轨迹的影响的理解尤其有限。我们建议研究产前和产后因素对青少年从儿童期晚期和青春期过渡到成年早期的BMI轨迹的影响。鉴于儿童期和青春期的肥胖会增加成年期肥胖的风险，旨在增强我们对BMI升高轨迹的潜在可改变风险因素的理解的研究是很重要的。迄今为止，大多数肥胖研究都未能探索解释BMI轨迹模式的风险因素。该项目使用一种统计分析技术，该技术能够描述不同年龄组的BMI随时间变化的不同模式——一般生长混合模型——该技术将评估关键时期暴露对肥胖风险的影响。这些目标将通过“今日成长研究”（GUTS）进行调查，这是一项正在进行的纵向队列研究，涉及9,039名青春期女孩和7,843名男孩（1996年基线年龄为9-14岁），他们是参加护士健康研究II （NHS II）的母亲的后代。因此，这些数据集也提供了一个独特的机会来探索肥胖的代际预测因素，以及产前和产后因素的交叉，以及儿童健康行为，以解释从儿童期到青年期过渡期间BMI不同轨迹的预测因素。

DESCRIPTION (provided by applicant): Obesity is poised to overtake tobacco as the greatest contributor to preventable death in the United States. Overweight children are at increased risk of being overweight as adults and are at increased risk of high morbidity related to a number of negative health outcomes (e.g., cardiovascular disease, diabetes, some cancers, and stroke). Risk factors for overweight and obesity start in early life, even prenatally although research that examines the longitudinal relationship between early life factors and obesity are sparse. We are particularly limited in our understanding of the influence of early life factors on individual overweight and obesity trajectories spanning over childhood, adolescence and early adulthood given the lack of repeated anthropomorphic measurements in most existing studies. We propose to examine the influence of prenatal and postnatal factors on BMI trajectory among youth transitioning from late childhood and adolescence into early adulthood. Given that obesity in childhood and adolescence increases risk for obesity in adulthood, research aimed at enhancing our understanding of potentially modifiable risk factors for an elevated BMI trajectory is important. To date most obesity research has failed to explore risk factors that explain patterns of BMI trajectory. Using a statistical analysis technique that is able to characterize groups of youth that express differential patterns of BMI over time-General Growth Mixture Modeling-this project will assess the impact of critical periods of exposure on obesity risk. These aims will be investigated using the Growing Up Today Study (GUTS), an ongoing longitudinal cohort study of 9,039 adolescent girls and 7,843 boys (aged 9-14 at baseline in 1996) who are offspring of mothers participating in the Nurses' Health Study II (NHS II). As a result, these datasets also allow for a unique opportunity to explore intergenerational predictors of obesity as well as the intersection of prenatal and postnatal factors, and childhood health behavior in explaining predictors of distinct trajectories of BMI during the transition from childhood to young adulthood. PUBLIC HEALTH RELEVANCE: The proposed study will use longitudinal cohort data (Growing Up Today Study) to investigate the influence of prenatal and postnatal factors on BMI trajectory among youth transitioning from late childhood and adolescence into early adulthood. The chosen outcome occurs with high prevalence in early life and influences a number of negative health outcomes (e.g., cardiovascular disease, diabetes, some cancers, stroke) throughout the life cycle. The central hypothesis is that adverse early life factors have both an independent and a cumulative impact on later weight trajectory but may be modified by lifestyles and behaviors. We will use growth mixture modeling to estimate the pattern of change in BMI across age beginning in late childhood to early adulthood and the relative influence of the pre- and post-natal factors and childhood behavior on the BMI trajectories. This novel analytic technique holds the promise of identifying distinct populations at risk for obesity and targeting critical time periods for long-term obesity prevention that may be unique to each subgroup.