Growth in Total Height and Its Components and Cardiometabolic Health in Childhood.

Line Klingen Haugaard,Wei Perng,Karen Switkowski,Matthew W Gillman,Jennifer L Baker,Mandy Brown Belfort,Emily Oken,Sheryl L Rifas-Shiman,Junwen Wang

doi:10.1371/journal.pone.0163564

Abstract

BackgroundShort stature or short legs is associated with cardiometabolic disease. Few studies have addressed this issue in children, incorporated repeated measures, or studied modern cohorts.MethodsWe examined if change in total height, leg length and trunk length between two time points from early (median: 3.2 years) to mid-childhood (median: 7.7 years), with and without adjustment for concurrent change in adiposity (subscapular plus triceps skinfold thickness), was associated with mid-childhood cardiometabolic risk in 315 boys and 295 girls from Project Viva. The main outcome was a cardiometabolic risk score based on sex-specific internal z-scores for systolic blood pressure, waist circumference, homeostatic model assessment of insulin resistance, triglycerides and high-density lipoprotein-cholesterol.ResultsMean (SD) total height was 97.9 (4.5) cm in boys and 97.1 (4.7) cm in girls in early childhood and 129.1 (7.2) cm in boys and 128.3 (7.9) cm in girls in mid-childhood. Trunk length constituted about half of total height. In linear regression models adjusted for parental anthropometry and socio-demographics, faster growth in total height, leg length and particularly trunk length, were associated with higher cardiometabolic risk in mid-childhood. Per 1 cm annual increase in trunk length, the cardiometabolic risk score was 0.23 z-score (95% confidence interval [CI] 0.08, 0.39) higher among boys and 0.47 z-score (95% CI 0.33, 0.60) higher among girls. Estimates were attenuated after adjusting for adiposity (boys: 0.03 z-score, 95% CI -0.11, 0.18; girls: 0.32 z-score, 95% CI 0.19, 0.45).ConclusionRapid linear growth, particularly in trunk length, was associated with higher cardiometabolic risk in childhood, which was explained by relationships of linear growth with adiposity in boys, but only partly in girls.

Highlights

Slower fetal and infant growth followed by faster growth during childhood is positively associated with a higher risk of later coronary heart disease (CHD) and diabetes [1,2,3]
The cardiometabolic risk score is composed of the mean of five sex-specific internal z-scores for systolic blood pressure, waist circumference, log-transformed HOMA-IR, log-transformed triglycerides and inverted high-density lipoprotein (HDL)-cholesterol. doi:10.1371/journal.pone.0163564.t001
The cardiometabolic risk score is composed of the mean of five sex-specific internal z-scores for systolic blood pressure, waist circumference, logtransformed HOMA-IR, log-transformed triglycerides and inverted HDL-cholesterol. doi:10.1371/journal.pone.0163564.t002

Summary

Introduction

Slower fetal and infant growth followed by faster growth during childhood is positively associated with a higher risk of later coronary heart disease (CHD) and diabetes [1,2,3]. A Finnish cohort study found positive associations of growth in total height from birth to age 7 years with risk of adult CHD in girls, but not in boys [4, 5]. A Danish cohort study reported associations of growth in total height from 7 to years, in both sexes, with higher risk of adult CHD [6]. Investigators from the Avon Longitudinal Study of Parents and Children found positive relations between faster linear growth from infancy to age 10 years with systolic blood pressure at 10 years. Few studies have addressed this issue in children, incorporated repeated measures, or studied modern cohorts.

Methods

Results

Discussion

Conclusion