Childhood adiposity trajectories are associated with late adolescent blood pressure: birth to twenty cohort.

Richard J. Munthali,Shane A. Norris,Juliana Kagura,Zané Lombard

doi:10.1186/s12889-016-3337-x

Richard J. Munthali, Shane A. Norris + Show 2 more

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https://doi.org/10.1186/s12889-016-3337-x

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Abstract

BackgroundElevated blood pressure in childhood is a risk factor for adult hypertension which is a global health problem. Excess adiposity in childhood creates a predisposition to develop adult hypertension. Our aim was to explore distinct sex-specific adiposity trajectories from childhood to late adolescence and examined their association with blood pressure.MethodsLatent Class Growth Mixture Modeling (LCGMM) on longitudinal data was used to derive sex-specific and distinct body mass index (BMI: kg/m2) trajectories. We studied 1824 black children (boys = 877, girls = 947) from the Birth to Twenty (Bt20) cohort from Soweto, South Africa, and obtained BMI measures at ages 5 through 18 years. Participants with at least two age-point BMI measures, were included in the analysis. Analysis of variance (ANOVA), chi-square test, multivariate linear and standard logistic regressions were used to test study characteristics and different associations.ResultsWe identified three (3) and four (4) distinct BMI trajectories in boys and girls, respectively. The overall prevalence of elevated blood pressure (BP) was 34.9 % (39.4 % in boys and 30.38 % in girls). Boys and girls in the early onset obesity or overweight BMI trajectories were more likely to have higher BP values in late adolescence. Compared to those in the normal weight BMI trajectory, girls in early onset obesity trajectories had an increased risk of elevated BP with odds ratio (OR) of 2.18 (95 % confidence interval 1.31 to 4.20) and 1.95 (1.01 to 3.77). We also observed the weak association for boys in early onset overweight trajectory, (p-value = 0.18 and odds ratio of 2.39 (0.67 to 8.57))ConclusionsDistinct weight trajectories are observed in black South African children from as early as 5 years. Early onset adiposity trajectories are associated with elevated BP in both boys and girls. It is important to consider individual patterns of early-life BMI development, so that intervention strategies can be targeted to at-risk individuals.

Highlights

Elevated blood pressure in childhood is a risk factor for adult hypertension which is a global health problem
body mass index (BMI) Trajectories: optimal number of BMI trajectories Using Latent Class Growth Mixture Modeling (LCGMM), we explored linear, quadratic and cubic slopes to fit the model
We report that being in an early onset obese or overweight trajectory was associated with increased risk of elevated blood pressure (BP) in both girls and boys which is in agreement with other studies, comparative studies were performed in a different population and different age range [63]

Summary

Introduction

Elevated blood pressure in childhood is a risk factor for adult hypertension which is a global health problem. Hypertension is a global public health problem affecting more than one billion people globally [1]. It is a risk factor for developing cardiovascular disease (CVD) and contributes to an increase in mortality worldwide. Understanding the life-course progression of adiposity in children is important since childhood adiposity is associated with adult obesity which has been reported to be linked to increased hypertension risk in adults [11]. There are few studies that have used longitudinal data to understand the effect of life-course childhood adiposity on late adolescent blood pressure and lack of comprehensive longitudinal data have made it difficult to do such studies in an African setting

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