Body Mass Index Z Score vs Weight-for-Length Z Score in Infancy and Cardiometabolic Outcomes at Age 8-10 Years

Abstract

To confirm that World Health Organization weight-for-length z scores (zWFL) and World Health Organization body mass index z scores (zBMI) in infancy are associated with adiposity and cardiometabolic measures at 8-10years old and to compare the predictive ability of the 2 methods. zWFL and zBMI at 6, 12, and 18months of age were computed using data extracted from health booklets, among participants in the Québec Adipose and Lifestyle InvesTigation in Youth prospective cohort (n=464). Outcome measures at 8-10years included adiposity, lipid profile, blood pressure, and insulin dynamics. The relationships between zWFL, zBMI, and each outcome were estimated using multivariable linear regression models. Outcome prediction at 8-10years was compared between the 2 methods using eta-squared and the Lin concordance correlation coefficient. zWFL and zBMI were associated with all measures of adiposity at 8-10years. Associations with other cardiometabolic measures were less consistent. For both zWFL and zBMI across infancy, eta-squared were highly similar and the Lin coefficients were markedly high (≥0.991) for all outcomes. There was no evidence that zBMI and zWFL in infancy differed in their ability to predict adiposity and cardiometabolic measures in childhood. This lends support to the sole use of zBMI for growth monitoring and screening of overweight and obesity from birth to 18years. ClinicalTrials.gov: NCT03356262.