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. 2021 Mar:230:221-229.e5.
doi: 10.1016/j.jpeds.2020.11.047. Epub 2020 Nov 27.

Trajectory of Body Mass Index from Ages 2 to 7 Years and Age at Peak Height Velocity in Boys and Girls

Li-Kuang Chen  1 , Guoying Wang  2 , Wendy L Bennett  3 , Yuelong Ji  1 , Colleen Pearson  4 , Sally Radovick  5 , Xiaobin Wang  6
Affiliations

Trajectory of Body Mass Index from Ages 2 to 7 Years and Age at Peak Height Velocity in Boys and Girls

Li-Kuang Chen et al. J Pediatr. 2021 Mar.

Abstract

Objective: To examine the associations between body mass index (BMI) at 2-4 years and 5-7 years and age at peak height velocity (APHV), an objective measure of pubertal timing, among boys and girls from predominantly racial minorities in the US that have been historically underrepresented in this research topic.

Study design: This study included 1296 mother-child dyads from the Boston Birth Cohort, a predominantly Black and low-income cohort enrolled at birth and followed prospectively during 1998-2018. The exposure was overweight or obesity, based on Centers for Disease Control and Prevention reference standards. The outcome was APHV, derived using a mixed effects growth curve model. Multiple regression was used to estimate the overweight or obesity-APHV association and control for confounders.

Results: Obesity at 2-4 years was associated with earlier APHV in boys (B in years, -0.19; 95% CI, -0.35 to -0.03) and girls (B, -0.22; 95% CI, -0.37 to -0.07). Obesity at 5-7 years was associated with earlier APHV in boys (B, -0.18; 95% CI, -0.32 to -0.03), whereas overweight and obesity at 5-7 years were both associated with earlier APHV in girls (overweight: B, -0.24; 95% CI, -0.40 to -0.08; obesity: B, -0.27; 95% CI, -0.40 to -0.13). With BMI trajectory, boys with persistent overweight or obesity and girls with overweight or obesity at 5-7 years, irrespective of overweight or obesity status at 2-4 years, had earlier APHV.

Conclusions: This prospective birth cohort study found that overweight or obesity during 2-7 years was associated with earlier pubertal onset in both boys and girls. The BMI trajectory analyses further suggest that reversal of overweight or obesity may halt the progression toward early puberty.

Keywords: childhood obesity; endocrinology; epidemiology; health disparities; obesity; puberty; puberty onset; racial disparities.

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Figures

Figure 1;
Figure 1;
online. Flowchart of study inclusion and exclusion. Percentages are calculated using the number in the immediately previous step as the “total”.
Figure 2;
Figure 2;
online. Distribution of APHV by sex. Panel A, All children in study sample (N=1,296). Panel B: Black children only (N=853).
Figure 3.
Figure 3.
Distribution of APHV by BMI trajectory among boys and girls
Figure 4.
Figure 4.
Subgroup analysis of associations between APHV and overweight or obesityat 2–4y and 5–7y. Associations are presented as βs (95%CI) and adjusted for all other covariates except for the stratified variable.
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