Waist Size in 9‐11 Year‐old Black and White Girls Predicts Development of Cardiometabolic Risk over Ten Years

Abstract

Adult chronic diseases have their roots in childhood. The long‐term effect of waist circumference (WC), a simple anthropometric measure of central adiposity, in early adolescence on subsequent cardiometabolic risk (CMR) is unknown. Data from the NHLBI's Growth and Health Study was used to evaluate effects of early adolescent WC in 1791 black and white girls on later CMR outcomes. Percent body fat, diastolic (DBP) and systolic (SBP) blood pressures, lipid levels, and fasting glucose at 17‐20 years of age were compared across quintiles of WC at 9‐10 years. Age and height were retained in final ANCOVA models as confounders of CMR outcomes. While all girls had age‐related increases in body fat, BP, and glucose over time, girls with the highest WC at 9‐10 years had higher CMR in late adolescence. Some important race‐related differences were observed as well. While early adolescent black girls had significantly lower % body fat (23.6% vs. 26.4%) than whites, they gained fat more rapidly (34.7% vs. 14.0% increases, respectively), exceeding whites in percent body fat by later adolescence. SBP was 5.5 mmHg higher in later adolescence for girls in Q5 (vs. Q1) at baseline (p‐trend: <0.0001). Among whites, a higher WC (Q5) led to LDL levels in later adolescence that were 29.5 mg/dL higher than those of girls in Q1 (while the difference for blacks was only 17.9 mg/dL). Results for total cholesterol and triglycerides were similar. Finally, a higher WC at 9‐10 years led to disproportionately greater increases in glucose, with those in Q5 having a fasting glucose nearly 10 mg/dL higher (p<0.0001) than those in Q1. In this prospective study, WC at 9‐10 years of age was a strong determinant of later CMR in both black and white adolescent girls.