The Association between Trajectories of Anthropometric Variables and Risk of Diabetes among Prediabetic Chinese

In order to explore the association between trajectories of body mass index (BMI) and mid-upper arm circumference (MUAC) and diabetes and to assess the effectiveness of the models to predict diabetes among Chinese prediabetic people, we conducted this study. Using a national longitudinal study, 1529 cases were involved for analyzing the association between diabetes and BMI trajectories or MUAC trajectories. Growth mixture modeling was conducted among the prediabetic Chinese population to explore the trajectories of BMI and MUAC, and logistic regression was applied to evaluate the association between these trajectories and the risk of diabetes. The receiver operating characteristic curve (ROC) and the area under the curve (AUC) were applied to assess the feasibility of prediction. BMI and MUAC were categorized into 4-class trajectories, respectively. Statistically significant associations were observed between diabetes in certain BMI and MUAC trajectories. The AUC for trajectories of BMI and MUAC to predict diabetes was 0.752 (95% CI: 0.690–0.814). A simple cross-validation using logistic regression indicated an acceptable efficiency of the prediction. Diabetes prevention programs should emphasize the significance of body weight control and maintaining skeletal muscle mass and resistance training should be recommended for prediabetes.

Trajectories of Body Mass Index and Multimorbidity in Old Age: 12-Year Results From a Population-Based Study

We aimed to study the association of long-terms trajectories of body mass index (BMI) with contemporaneous changes in multimorbidity development in older adults. Twelve-year BMI trajectories (2001–2013) were identified in subjects aged 60+ years from the Swedish National Study on Aging and Care-Kungsholmen (SNAC-K) using growth mixture models (N=2,189). Information on chronic diseases and multimorbidity was ascertained based on clinical examinations, lab tests, medications, and inpatient and outpatient medical records. Linear mixed models were used to study the association between BMI trajectories and the speed of chronic diseases accumulation, in general and by groups of cardiovascular and neuropsychiatric diseases. Eighty percent of the study population was included in a stable BMI trajectory, 18% in a slow-decline trajectory with an accelerated BMI decline from age 78 onwards, and 2% in a fast-decline trajectory that reached underweight values before age 85. A significantly higher yearly rate of chronic disease accumulation was observed in the fast-decline versus stable trajectories (β=0.221, 95% CI 0.090-0.352) after adjusting for age, sex, education and time to death. Subjects in the slow-decline trajectory showed a significantly higher rate of cardiovascular diseases accumulation (β=0.016, 95% CI 0.000-0.031); those in the fast-decline trajectory showed a faster accumulation of both cardiovascular (β=0.020, 95% CI -0.025, 0.064) and neuropsychiatric diseases (β=0.102, 95% CI 0.064-0.139), even if the former association did not reach statistical significance. Carefully monitoring older adults with sustained weight loss seems relevant given their likelihood to develop a phenotype of rapidly accumulating chronic -especially neuropsychiatric- diseases.

Body mass index trajectory from childhood to puberty and high blood pressure: the China Health and Nutrition Survey

ObjectivesThe prevalence of childhood hypertension is rising in parallel with the increasing prevalence of overweight and obesity in children. How growth trajectories from childhood to puberty relate to high blood pressure (HBP) is not well defined. We aimed to characterise potential body mass index (BMI) dynamic changing trajectories from childhood to puberty and investigate their association with HBP.DesignA dynamic prospective cohort.SettingChina Health and Nutrition Survey 1991–2015.ParticipantsThere were 1907 participants (1027 men and 880 women) in this study.OutcomesThe primary outcome was HBP defined as systolic blood pressure (SBP)/diastolic blood pressure (DBP) exceeding the standards or diagnosis by medical records or taking antihypertensive medication.ResultsA model of cubic parameters with three groups was chosen, labelled as normal increasing group (85.16%, n=1624), high increasing group (9.81%, n=187) and resolving group (5.03%, n=96). Compared with the normal increasing group, the unadjusted HRs (95% CIs) for the resolving and high increasing groups were 0.91 (0.45 to 1.86) and 1.88 (1.26 to 2.81), respectively. After adjusting for baseline age, region, sex, baseline BMI z-score, baseline SBP and baseline DBP in model 3, the HRs (95% CIs) for the resolving and high increasing groups were 0.66 (0.30 to 1.45) and 1.56 (1.02 to 2.38).ConclusionsThese results indicate that the BMI trajectories from childhood to puberty have significant impact on HBP risk. Puberty is a crucial period for the development of HBP.

Body Mass Index Trajectories in Adolescence And Incident Metabolic Syndrome in Early Adulthood

Background: The incidence of metabolic syndrome (MetS) is increasing each year, and MetS is closely related to cardiovascular diseases. Body mass index (BMI) has been widely used to measure obesity, and the relationship between MetS and BMI has been widely reported. However, the relationship between the trajectory of BMI and MetS is still unclear.Methods: Six waves of the cross-sectional China Health and Nutrition Survey (CHNS) were completed in nine provinces in China from 1993 to 2009, with more than 12,000 participants. We enrolled individuals who were aged 10 to 20 years in 1993, and 554 participants were finally included in our study. A latent class growth mixed model was used to identify different BMI trajectory patterns based on the BMI value measured at each follow-up. Participants completed blood tests and a physical examination in 2009 to allow for the diagnosis of MetS. The primary aim was to explore the relationship between different BMI trajectories and the incidence of MetS through logistic regression, adjusting for baseline age, sex, BMI, waist circumference, residence, educational background, smoking status, alcohol consumption, and nutritional intake.Result: During a follow-up of 16 years, 61 (11.01%) participants developed MetS. In multivariate-adjusted models, different BMI trajectories were significantly associated with the occurrence of MetS in early adulthood. Childhood or adolescents with a low-high BMI trajectory or a high-high BMI trajectory showed a significantly higher risk of MetS in early adulthood than those with a low-low trajectory (low-high: OR=3.40, 95% CI: 1.14-10.13, P <0.05; high-high: OR=5.81, 95% CI: 1.63-20.69, P <0.05).Conclusion: Our study identified three BMI trajectories from adolescence through 16 years of follow-up and found that in addition to baseline BMI, BMI trajectories were also an independent risk factor for incident MetS in early adulthood.

Genetic propensity for obesity, socioeconomic position, and trajectories of body mass index in older adults

Identifying how socioeconomic positioning and genetic factors interact in the development of obesity is imperative for population-level obesity prevention strategies. The current study investigated whether social positioning, either independently or through interaction with a polygenic score for Body Mass Index (BMI-PGS), influences BMI trajectories across older adulthood. Data were analysed from 7,183 individuals from the English Longitudinal Study of Aging (ELSA). Interactions between the BMI-PGS and; lower educational attainment, self-perceived social status (SSS), and income, on BMI trajectories over 12 years across older adulthood were investigated through linear mixed effects models. Lower educational attainment, SSS and income were each associated with a higher baseline BMI for women, but not for men. There were interaction effects between BMI-PGS and social positioning such that men aged > 65 with a lower educational attainment (β = 0.62; 95%CI 0.00 – 1.24, p < 0.05), men aged ≤ 65 of a lower income (β = − 0.72, 95%CI − 1.21 - − 0.23, p < 0.01) and women aged ≤ 65 of lower SSS (β = − 1.41; 95%CI − 2.46 – 0.36, p < 0.01) showed stronger associations between the BMI-PGS and baseline BMI. There were few associations between markers of socioeconomic position and rate of change in BMI over the follow-up period. In sum, lower socioeconomic positioning showed adverse associations with women’s BMI in older adulthood. Moreover, the expression of the BMI-PGS, or extent to which it translates to a higher BMI, was subtly influenced by socioeconomic standing in both women and in men.

Resolving early obesity leads to a cardiometabolic profile within normal ranges at 23 years old in a two-decade prospective follow-up study

Obesity is the most important predisposing factor for cardiovascular disease and type-2 diabetes. We explored the relationship between the age at onset of obesity and selected cardiometabolic parameters in young adults. Longitudinal study of n = 1,039 participants (48% males) in their early twenties. BMI was measured at birth, 1–5–10–12–14–16–23 years. BMI trajectories were interpolated. Five groups were identified: never obese (never-OB); early childhood obesity transitioning to non-obesity before adolescence (former-OB); obesity starting in preadolescence transitioning to non-obesity as adolescents (transient-OB); obesity from adolescence into early adulthood (recent-onset-OB); participants who were obese in early childhood and remained obese into adulthood (persistent-OB). Waist circumference (WC), blood pressure, lipids, glucose, and insulin were measured at 23 years. HOMA-IR and the Metabolic Syndrome Risk Z-Score were estimated. In the sample, 47% were obese during at least one time-point. Mean obesity duration was 20.7 years, 8.5 years, 6.2 years, and 3.3 years in persistent-OBs, recent-onset-OBs, former-OBs, and transient-OBs, respectively. The cardiometabolic profile was more adverse in recent-onset-OBs (12%) and persistent-OBs (15%) compared to never-OB participants (53%). Although former-OBs (15%) and transient-OBs (4%) had higher WC values than never-OBs, no differences were seen in other biomarkers. Both persistent and recent-onset obesity led to a cardiometabolic profile of risk in early adulthood, as suggested by values of WC, HOMA-IR, and hs-CRP above normal limits and HDL-chol values below normal limits. Participants who had obesity in early childhood or preadolescence but transitioned to a non-obesity status had a cardiometabolic profile similar to participants who were never obese and within normal limits. Obesity leads to risky values in a number of cardiometabolic biomarkers in young adulthood independent of age at obesity onset. Likewise, overcoming obesity during the pediatric age leads to a cardiometabolic profile within normal ranges at 23 years of age.

1019Socioeconomic inequities in 5-year weight trajectories in association with baseline weight-related perceptions: a longitudinal study

Background Recognition of overweight may be a necessary pre-cursor for weight-reduction, but some suggest under-perceiving overweight may be protective against obesity. Differential responses may occur across socioeconomic strata. Methods Five-year body mass index (BMI) trajectories were examined using multilevel models of 8174 participants stratified by gender, neighbourhood socioeconomic circumstances, baseline BMI and perceived weight status, adjusting for potential confounders. Results At baseline, weight-related dissatisfaction and perceived overweight were associated with higher mean BMI, regardless of whether people were classified as ‘normal’ or overweight by WHO criteria. Mean BMI did not decrease among people classified as overweight who perceived themselves as overweight, or expressed weight-related dissatisfaction. Among those with ‘normal’ BMI at baseline but dissatisfied with their weight, mean BMI increased disproportionately among people in disadvantaged areas. Mean BMI also rose disproportionately for people in disadvantaged areas among those feeling overweight, despite having a ‘normal’ BMI, compared to people with the same over-perception but living in affluent areas. Conclusions No evidence was found to suggest accurate recognition of overweight or expressing weight-related dissatisfaction leads to a lower BMI. However, there was evidence of an increase in mean BMI among people who felt dissatisfied with, or over-perceived their ‘normal’ weight, especially in socioeconomically disadvantaged areas. Key messages Correction of under-perceptions may not drive weight loss, but circumstances contributing to over-perception and dissatisfaction with weight status may contribute to increased weight gain and exacerbate socioeconomic inequities in BMI.

Predictive value of women’s weight trajectories in determining familial cardiovascular disorders: a family-based longitudinal study

Considering the dynamic nature of body mass index (BMI) and its importance in determining cardiovascular risks, this study aimed to investigate the life-course trajectory pattern of women’s BMI and its association with cardiovascular risk factors. A total of 1356 couples with 2976 children were recruited and followed up for an average period of 20 years. Latent growth curve modeling was applied to determine women's BMI trajectories; logistic regression was used to investigate the associations between trajectory patterns and cardiovascular risk factors, including hypertension (HTN), dyslipidemia, diabetes mellitus (DM), and obesity. Women were classified into three trajectories, including normal, stage 1 obesity, and stage 2 obesity. Compared to women’s in the normal trajectory group, those in obesity trajectories had higher odds ratios for HTN, DM, and dyslipidemia. Men with obese spouses showed a higher rate of HTN 1.54 (95% CI 1.05–2.25) and DM 1.55; (95% CI 1.00–2.44). The odds of men’s obesity were higher in obese spouses (OR 1.70; 95% CI 1.10–2.62). Offspring of stage 2 obese (OR 2.39; 95% CI 1.67–3.44) and stage 1 obese (OR 4.81; 95% CI 3.16–7.34) mothers were more likely to be obese. Our findings emphasized paying more attention to women with excessive weight to promote familial cardiovascular health in the communities.