Format

Send to

Choose Destination
Int J Obes (Lond). 2019 Jul;43(7):1354-1362. doi: 10.1038/s41366-019-0345-9. Epub 2019 Apr 2.

Association of accelerated body mass index gain with repeated measures of blood pressure in early childhood.

Author information

1
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada.
2
Applied Health Research Centre, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Canada.
3
Department of Pediatrics, St. Michael's Hospital, Toronto, Canada.
4
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada.
5
Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada.
6
Department of Nutritional Sciences, University of Toronto, Toronto, Canada.
7
Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Toronto, Canada.
8
Division of Endocrinology, The Hospital for Sick Children, Toronto, Canada.
9
Li Ka Shing Centre for Healthcare Analytics Research and Training, St. Michael's Hospital, Toronto, Canada.
10
Preventative Cardiology, The Hospital for Sick Children, Toronto, Canada.
11
Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada.
12
Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada. catherine.birken@sickkids.ca.
13
Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada. catherine.birken@sickkids.ca.
14
Department of Pediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada. catherine.birken@sickkids.ca.
15
Department of Nutritional Sciences, University of Toronto, Toronto, Canada. catherine.birken@sickkids.ca.

Abstract

BACKGROUND/OBJECTIVES:

We examined the association for rates of age- and sex-standardized body mass index (zBMI) gain between 0-3, 3-18, and 18-36 months with BP in children at 36-72 months of age.

METHODS:

We collected repeated measures of zBMI and BP in 2502 children. zBMI was calculated using the World Health Organization standards. Each child's zBMI at birth and rates of zBMI gain in each period from birth to 36 months were estimated using linear spline multilevel models. Generalized estimating equations were used to determine whether zBMI at birth and zBMI gain between 0-3, 3-18, and 18-36 months were each associated with repeated measures of BP at 36-72 months of age. We sequentially conditioned on zBMI at birth and zBMI gain in each period prior to each period tested, as covariates, and adjusted for important socio-demographic, familial, and study design covariates. We examined whether these associations were modified by birthweight or maternal obesity, by including interaction terms.

RESULTS:

After adjusting for all covariates and conditioning on prior zBMI gains, a 1 standard deviation unit faster rate of zBMI gain during 0-3 months, (β = 0.59 mmHg; 95% CI 0.31, 0.86) and 3-18 months (β = 0.74 mmHg; 95% CI 0.46, 1.03) were each associated with higher systolic BP at 36-72 months. No significant associations were observed, however, for zBMI at birth or zBMI gain in the 18-36 month growth period. zBMI gains from 0-3 and 3-18 months were also associated with diastolic BP. Birthweight significantly modified the relationship during the 3-18 month period (p = 0.02), with the low birthweight group exhibiting the strongest association for faster rate of zBMI gain with higher systolic BP (β = 1.31 mmHg; 95% CI 0.14, 2.48).

CONCLUSIONS:

Given that long-term exposure to small elevations in BP are associated with subclinical cardiovascular disease, promoting interventions targeting healthy growth in infancy may be important.

PMID:
30940913
DOI:
10.1038/s41366-019-0345-9

Supplemental Content

Full text links

Icon for Nature Publishing Group
Loading ...
Support Center