Abstract P052: Not Only Velocity but Also Variability in Body Mass Index in Childhood Are Associated With HOMA-IR at Adulthood: 30 Years Follow-up Kangwha

Abstract

Introduction: Recent studies have reported that childhood obesity increased the risk of adult metabolic disorders. Moreover, the variability and rapid increase in body mass index (BMI) during childhood have been revealed as risk factors for adult obesity. Although obesity increases metabolic disorders through induction of insulin resistance, it has not been studied whether the rate of change and variability of BMI during childhood are independently associated with insulin resistance at adulthood. Hypothesis: We assessed the hypothesis that rate of change and variability of BMI during childhood would affect insulin resistance at adulthood. Method: The study cohort consisted of 284 Kangwha study participants (aged 25 - 38 years at follow-up) who had been screened at least four times during childhood (aged 6 - 19 years) and also had no diabetes at adulthood. The average follow-up period was 21.5 years. BMI Z-score was measured by considering the growth curve in Korea, and rate of change (velocity) in BMI during childhood for each individual was assessed by mixed models; BMI residual standard deviation (RSD) during childhood was calculated as a measure of variability. Outcome variable was homeostatic model assessment of insulin resistance (HOMA-IR) at adulthood follow-up. Results: The mean age of the participants 13.3 (SD 1.4) years and mean BMI was 18.6 (SD 2.3) at childhood. One SD increase in rate of change in BMI z-score ( β = 0.32, p -value <0.001) and in RSD of BMI ( β = 0.31, p -value <0.001) during childhood were positively and independently associated with HOMA-IR. Stratified by sex, adult HOMA-IR was also positively associated with the velocity ( β = 0.36, p = 0.001 in men, and β = 0.38, p = 0.001 in women) and variability ( β = 0.25, p = 0.03 in men; β = 0.27, p = 0.002 in women) of BMI during childhood. Conclusions: BMI velocity and variability during childhood appear to be independent risk factors for adult HOMA-IR. Our findings suggest prevention of rapid weight gain and body weight regulation during childhood would be important factors to reduce insulin resistance at adulthood related with metabolic disorders.