Early Growth and Dysmetabolism at 11.5 years: A Cohort Analysis of the PROBIT Study

Abstract

BackgroundRapid infant weight gain predicts higher BMI in later life, but few studies have examined interactions with size at birth or associations with other cardiometabolic risk markers.Methods: In 13,576 Belarusian children enrolled at birth in the Promotion of Breastfeeding Intervention Trial, we modeled weight gain trajectories from birth to 8.5 years and at 11.5 years we measured BMI and calculated an internal metabolic risk z‐score from fasting insulin, glucose, SBP, Apo A1 and waist circumference. Using linear regression models we adjusted for parental sociodemographics and BMI, and child weight & length at prior ages.Results: Faster postnatal weight gain in all age periods was associated all markers of cardio‐metabolic risk except ApoA1, with increasingly stronger estimates at successively older ages. Associations were strongest for adiposity outcomes. Effect estimates (all expressed as kg/year) of weight gain on overall metabolic z‐score were 0.03 (95% CI: 0.02, 0.04) for 0‐3 months; 0.08 (0.06, 0.09) for 3‐12 months; 0.21 (0.18, 0.23) for 12‐34 months, and 0.31 (0.29, 0.33) for 34 months – 8.5 years.In SGA, AGA, and LGA infants growth during infancy had similar associations with outcomes, but faster weight gain after 12 months was much more strongly associated with adverse outcomes in SGA vs. LGA or AGA infants, whereas effects were similar in LGA vs. AGA children. In all 3 groups, associations with adverse outcomes were strongest for growth at older vs. younger ages.ConclusionFaster growth in later childhood predicted adverse metabolic outcomes more strongly compared with growth during infancy.