DYNAMIC CHANGES IN CHILD-TO-ADULT BODY MASS INDEX AND METABOLIC SYNDROME IN MIDDLE AGE: 30-YEAR HANZHONG ADOLESCENT HYPERTENSION STUDY

Abstract

Objective: It is well known that body mass index (BMI) developmental patterns from childhood to adulthood are diverse, but few studies have focused on the association between BMI patterns and adult metabolic syndrome. The aim of this study was to identify distinct BMI trajectories and their relationship with metabolic syndrome in the Chinese population. Design and method: This study included 4623 participants, aged 6–18 years, from the prospective Hanzhong Adolescent Hypertension Cohort Study, which was established in 1987 and followed up for over 30 years. To address BMI heterogeneity, we used latent mixture modeling to identify developmental patterns related to BMI. Poisson regression models with robust error variance were used to analyze BMI association with adult metabolic syndrome outcomes. After excluding only the first three BMI measurements and the last three BMI measurements, 2679 participants were included in the final analysis, including 1524 males and 1155 females. Results: Five distinct developmental BMI patterns were identified in this study: slightly increasing normal (25.9%), moderately increasing normal/overweight (49.9%), progressively overweight/obese (19.8%), resolving (1.8%) and rapidly overweight/obese (2.6%). Compared with the slightly increasing normal group, those who had relatively higher BMI levels had a higher risk of MetS [all risk ratios (RRs) > 4.0, P < 0.05]. Compared with those in the ‘progressively overweight/obese’ group, participants who resolved youth adiposity had lower risks of central obesity, triglycerides and high-density lipoprotein cholesterol [RR = 0.84 (0.68–1.04); RR = 0.86 (0.47–1.57); RR = 0.88 (0.63–1.24), respectively]. Conclusions: Our study indicated that the developmental patterns of BMI from childhood to adulthood are diverse and that adult BMI lacks stability. Obese subjects have an overall higher risk of MetS than that of subjects with normal BMI. The resolution of youth obesity may have a positive impact on lipid profiles. Early prevention and control of obesity at different stages of life is of utmost importance.