BMI trajectories from birth to young adulthood associate with distinct cardiometabolic profiles

Abstract

Background: Numerous studies have investigated links between body mass index (BMI) trajectories and cardiovascular risk, yet discrepancies in BMI measurement duration and timing of the cardiovascular-related outcome evaluation have led to inconsistent findings.

Methods: We included participants from the Swedish birth cohort (BAMSE) and applied latent class mixture modeling to identify BMI trajectories using data of multiple BMI measures (≥ 4 times) from birth until 24-year follow-up (n = 3204). Subsequently, we analyzed the associations of BMI trajectories with lipids (n = 1974), blood pressure (n = 2022), HbA1c (n = 941), and blood leukocytes (n = 1973) using linear regression. We also investigated the circulating levels of 92 inflammation-related proteins (n = 1866) across BMI trajectories.

Results: Six distinct BMI groups were identified, denoted as increasing-persistent high (n = 74; 2.3%), high-accelerated increasing (n = 209; 6.5%), increasing-accelerated resolving (n = 142; 4.4%), normal-above normal (n = 721; 22.5%), stable normal (n = 1608; 50.2%), and decreasing-persistent low (n = 450; 14.1%) BMI groups. The increasing-persistent high and high-accelerated increasing BMI groups had higher levels of total cholesterol [mean difference (95% confidence intervals): 0.30 (0.04-0.56) and 0.16 (0.02-0.31) mmol/L], triglyceride, low-density lipoprotein, hemoglobin A1C [3.61 (2.17-5.54) and 1.18 (0.40-1.98) mmol/mol], and low-density lipoprotein/high-density lipoprotein ratios, but a lower level of high-density lipoprotein than the stable normal BMI group. These two groups also had higher leukocyte cell counts and higher circulating levels of 28 inflammation-related proteins. No increased cardiometabolic markers were observed in the increasing-accelerated resolving BMI group.

Conclusions: Participants with persistently high or accelerated increasing BMI trajectories from birth to young adulthood have elevated levels of cardiometabolic risk markers at young adulthood than those with stable normal BMI. However, a raised BMI in childhood may not be inherently harmful to cardiometabolic health, provided it does not persist into adulthood.

Keywords: Bioimpedance; Childhood; HbA1c; Inflammation; Lipid.

Fig. 1

Body mass index trajectories from birth to young adulthood in the BAMSE cohort. Body mass index trajectories were identified through latent class mixture models using z-score of body mass index. The dots show the mean values for body mass index z-scores around each follow-up point. The lines show the loess-smoothed body mass index trajectories for the six identified trajectory groups. The statistics (mean and standard deviation of BMI in each group) of this figure are presented in Table S7. BMI, body mass index

Fig. 2

Association of BMI trajectories with blood pressure, blood lipids, and HbA1c at young adulthood determined by linear regression. The stable normal BMI group was the reference group. The y-axis displays the β coefficients along with their corresponding 95% confidence intervals. The models were adjusted for age, sex, smoking status, parental education, maternal smoking during pregnancy, maternal body mass index at early pregnancy, maternal hypertension, parity before the index person was born, and cesarean section. The statistics of this figure are presented in Table S11. HDL, high-density lipoprotein; LDL, low-density lipoprotein; HbA1c, hemoglobin A1C; TG, triglycerides. *: Significant difference between stable normal and other groups (p < 0.05)

Fig. 3

Association of BMI trajectories with circulating inflammatory proteins determined by linear regression. The stable normal BMI group was the reference group. The x-axis displays the β coefficients along with their corresponding 95% confidence intervals. The models were adjusted for sex, smoking status, parental education, maternal smoking during pregnancy, maternal BMI at early pregnancy, maternal hypertension, parity before the index person was born, and cesarean section. The statistics of this figure are presented in Table S17. *: Significant difference between stable normal and other groups (p < 0.05)