Body mass index trajectories in the first two years and subsequent childhood cardio-metabolic outcomes: a prospective multi-ethnic Asian cohort study

• Published in: Scientific reports 2017-08, Vol.7 (1), p.8424-10, Article 8424
• Main Authors: Aris, Izzuddin M., Chen, Ling-Wei, Tint, Mya Thway, Pang, Wei Wei, Soh, Shu E., Saw, Seang-Mei, Shek, Lynette Pei-Chi, Tan, Kok-Hian, Gluckman, Peter D., Chong, Yap-Seng, Yap, Fabian, Godfrey, Keith M., Kramer, Michael S., Lee, Yung Seng
• Format: Article
• Language: English
• Subjects: 692/308/174; 692/499; 692/699/75; Adipose tissue; Anthropometry; Asian People; Blood pressure; Body mass; Body Mass Index; Body weight gain; Cardiovascular Diseases - epidemiology; Child, Preschool; Childhood; Children; Cohort analysis; Ethnicity; Female; Humanities and Social Sciences; Humans; Infant; Male; Metabolic Diseases - epidemiology; Metabolism; Minority & ethnic groups; multidisciplinary; Obesity - epidemiology; Offspring; Pregnancy; Prospective Studies; Risk Assessment; Science; Science (multidisciplinary); Singapore
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-017-09046-y

We investigated body mass index (BMI) trajectories in the first 2 years of life in 1170 children from an Asian mother-offspring cohort in Singapore, and examined their predictors and associations with childhood cardio-metabolic risk measures at 5 years. Latent class growth mixture modelling analyses were performed to identify distinct BMI z-score (BMIz) trajectories. Four trajectories were identified: 73.2%(n = 857) of the children showed a normal BMIz trajectory, 13.2%(n = 155) a stable low-BMIz trajectory, 8.6%(n = 100) a stable high-BMIz trajectory and 5.0%(n = 58) a rapid BMIz gain after 3 months trajectory. Predictors of the stable high-BMIz and rapid BMIz gain trajectories were pre-pregnancy BMI, gestational weight gain, Malay and Indian ethnicity, while predictors of stable low-BMIz trajectory were preterm delivery and Indian ethnicity. At 5 years, children with stable high-BMIz or rapid BMIz gain trajectories had increased waist-to-height ratios [B(95%CI) 0.02(0.01,0.03) and 0.03(0.02,0.04)], sum of skinfolds [0.42(0.19,0.65) and 0.70(0.36,1.03)SD units], fat-mass index [0.97(0.32,1.63)SD units] and risk of obesity [relative risk 3.22(1.73,6.05) and 2.56 (1.19,5.53)], but not higher blood pressure. BMIz trajectories were more predictive of adiposity at 5 years than was BMIz at 2 years. Our findings on BMIz trajectories in the first 2 years suggest important ethnic-specific differences and impacts on later metabolic outcomes.