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Association between the FTO SNP rs9939609 and Metabolic Syndrome in Chilean Children. Nutrients 2021; 13:nu13062014. [PMID: 34208143 PMCID: PMC8230726 DOI: 10.3390/nu13062014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/05/2021] [Accepted: 06/08/2021] [Indexed: 11/05/2022] Open
Abstract
Background: The increasing prevalence of obesity in children has raised the incidence of Metabolic Syndrome (MetS) in this age group. Given the short- and long-term health impact of MetS, it is essential to prevent its onset by detecting its main triggers. Besides, genetic factors play an essential role in influencing which individuals within a population are most likely to develop obesity in response to a particular environment. In this regard, a common variation in the FTO gene is reproducibly associated with BMI and obesity from childhood and the genetic load has been linked to several cardiovascular risk factors, highlighting the FTO single nucleotide polymorphism (SNP) rs9939609. Therefore, this study aimed to establish the relationship between the FTO SNP rs9939609 and MetS. Methods: A cross-sectional study was carried out on 220 children from the Biobío region (Chile). MetS diagnosis was established through the modified Cook criteria, using prevalence ratios, COR curves, and linear regressions to determine its association with MetS and its components. Results: The prevalence of MetS was significantly increased among carriers of the risk allele (A): TT, 20.2%; TA, 25.4%; AA, 44.7% (p = 0.006). Also, the presence of A was associated with altered MetS-related variables. Conclusions: The FTO SNP rs9939609 was associated with a raised prevalence of MetS among A allele carriers, and was higher in the homozygous genotype (AA).
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An Approach to Early Detection of Metabolic Syndrome through Non-Invasive Methods in Obese Children. CHILDREN-BASEL 2020; 7:children7120304. [PMID: 33348633 PMCID: PMC7767015 DOI: 10.3390/children7120304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 12/06/2020] [Accepted: 12/15/2020] [Indexed: 01/21/2023]
Abstract
Background: Metabolic Syndrome (MetS) has a high prevalence in children, and its presence increases in those with a high BMI. This fact confirms the need for early detection to avoid the development of other comorbidities. Non-invasive variables are presented as a cost-effective and easy to apply alternative in any clinical setting. Aim: To propose a non-invasive method for the early diagnosis of MetS in overweight and obese Chilean children. Methods: We conducted a cross-sectional study on 221 children aged 6 to 11 years. We carried out multivariate logistic regressions, receiver operating characteristic curves, and discriminant analysis to determine the predictive capacity of non-invasive variables. The proposed new method for early detection of MetS is based on clinical decision trees. Results: The prevalence of MetS was 26.7%. The area under the curve for the BMI and waist circumference was 0.827 and 0.808, respectively. Two decision trees were calculated: the first included blood pressure (≥104.5/69 mmHg), BMI (≥23.5 Kg/m2) and WHtR (≥0.55); the second used BMI (≥23.5 Kg/m2) and WHtR (≥0.55), with validity index of 74.7% and 80.5%, respectively. Conclusions: Early detection of MetS is possible through non-invasive methods in overweight and obese children. Two models (Clinical decision trees) based on anthropometric (non-invasive) variables with acceptable validity indexes have been presented. Clinical decision trees can be applied in different clinical and non-clinical settings, adapting to the tools available, being an economical and easy to measurement option. These methods reduce the use of blood tests to those patients who require confirmation.
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Vasquez F, Correa-Burrows P, Blanco E, Gahagan S, Burrows R. A waist-to-height ratio of 0.54 is a good predictor of metabolic syndrome in 16-year-old male and female adolescents. Pediatr Res 2019; 85:269-274. [PMID: 30631139 PMCID: PMC6377811 DOI: 10.1038/s41390-018-0257-8] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 11/15/2018] [Accepted: 11/23/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND We aimed to determine the sensitivity and specificity of selected anthropometric indicators as predictors of cardiovascular risk in adolescents. METHODS Cross-sectional study in 678 adolescents (16.8 y ± 0.3) from an infancy cohort. Weight, height, waist circumference (WC), and hip circumference were measured. Body mass index (BMI), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were estimated. MetS was diagnosed with IDF/AHA/NHLBI. Optimal cutoffs of BMI, WC, WHR, and WHtR for diagnosing MetS were determined using ROC analysis. RESULTS In males, WHtR (0.96) had the greatest area under the ROC curve, followed by WC (0.95) and BMI (0.93). In females, BMI (0.84) had the greatest area under the ROC curve (0.84), followed by WHtR (0.83) and WC (0.83). In both sexes, the optimal WHtR cutoff for MetS diagnosis was 0.54. A BMI of 26.9 in males and 26.3 in females were the optimal cutoffs for diagnosing MetS. Finally, WC values of 92 and 81.6 cm in males and females, respectively, were the optimal cutoffs for MetS diagnosis. CONCLUSIONS In both sexes, a WHtR value of 0.54 was a good predictor of MetS. In males and females, the optimal cutoff of BMI for Mets diagnosis was below the values for diagnosing obesity.
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Affiliation(s)
- Fabian Vasquez
- Institute of Nutrition and Food Technology, University of Chile. Santiago, Chile
| | | | - Estela Blanco
- Division of Child Development and Community Health, University of California San Diego. La Jolla, California
| | - Sheila Gahagan
- Division of Child Development and Community Health, University of California San Diego. La Jolla, California
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.
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Abstract
This paper describes a 4-month pilot study that tested the suitability of a physical activity intervention for first graders (children aged 6 and 7 years) in a public school in Santiago, Chile. Teachers were trained to deliver the programme in the classroom during the school day. Teachers were surveyed to determine if this intervention fit within their curriculum and classroom routines and they reported in a focus group that it was suitable for them. All children actively participated in the programme and positive changes in their attitudes towards physical activity were observed by their teachers. Anthropometrics, blood pressure and hand grip strength were measured in the students. A significant reduction was observed in children with high waist circumference ≥ 90th percentile, and in mean systolic blood pressure. However, statistical power values for those comparisons were rather low. Anthropometry and hand grip strength were not modified. The latter calculations and the lack of a control group are showing the weaknesses of this pilot study and that further research with a larger sample size and an experimental design is strongly needed.
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Anthropometric indicators as predictors of total body fat and cardiometabolic risk factors in Chilean children at 4, 7 and 10 years of age. Eur J Clin Nutr 2016; 71:536-543. [PMID: 27827399 DOI: 10.1038/ejcn.2016.213] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 09/10/2016] [Accepted: 09/26/2016] [Indexed: 12/30/2022]
Abstract
BACKGROUND/OBJECTIVE To compare the association between anthropometric indicators of global and central obesity as predictors of total body fat (TBF) and cardiometabolic risk factors in children. SUBJECTS/METHODS A total of 1044 children were evaluated at 4 years (n=320), 7 years (n=1044) and 10 years (n=483). The following anthropometric indices were determined: body mass index (BMI) for age (BAZ, WHO), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR). To estimate TBF we used validated predictive equations. We measured blood sample concentrations of glucose, insulin, triglycerides, total cholesterol, Low-density lipoprotein (LDL) and High-density lipoprotein (HDL), adiponectin, C-reactive protein (CRP) and Insulin-like growth factor-1 (IGF-1). RESULTS Adiposity and cardiometabolic markers, particularly those related to glucose metabolism increased from 4 years to 10 years. BAZ and WC were highly correlated to body fat at all ages (all r>0.8) but at 10 years WC was more strongly correlated than BAZ (r=0.94 WC vs r=0.88 BAZ, P<0.05); conversely, WHtR was significantly associated with body fat from 7 years (r=0.85) and 10 years (r=0.88). WHR was unrelated all over the period studied at all ages. Anthropometrical adiposity indicators became associated to cardiometabolic markers only from 7 years on with associations being slightly higher at 10 years, particularly for adiponectin and lipid markers. At all ages, BAZ, WC and WHtR performed similarly as cardiometabolic markers (P<0.05) while WHR was a slightly weaker marker. CONCLUSIONS Relationship between anthropometrical indicators of adiposity and cardiometabolic markers becomes stronger from 7 years onwards; BAZ, WC and WHtR perform similarly as markers of cardiometabolic risk at least until 10 years of age.
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Peplies J, Börnhorst C, Günther K, Fraterman A, Russo P, Veidebaum T, Tornaritis M, De Henauw S, Marild S, Molnar D, Moreno LA, Ahrens W. Longitudinal associations of lifestyle factors and weight status with insulin resistance (HOMA-IR) in preadolescent children: the large prospective cohort study IDEFICS. Int J Behav Nutr Phys Act 2016; 13:97. [PMID: 27590045 PMCID: PMC5009569 DOI: 10.1186/s12966-016-0424-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2016] [Accepted: 08/24/2016] [Indexed: 12/31/2022] Open
Abstract
Background This study investigates prospective associations of anthropometrical and lifestyle indices with insulin resistance (IR) in European children from the IDEFICS cohort. Insulin resistance (IR) is a growing concern in childhood obesity and a central aspect of the metabolic syndrome (MS). It most likely represents the link between obesity and type 2 diabetes. Methods This longitudinal study included 3348 preadolescent children aged 3 to 10.9 years from 8 European countries who were observed from 2007/2008 to 2009/2010. The main outcome measure in the present analysis is HOMA-IR (homeostasis model assessment as a common proxy indicator to quantify IR) at follow-up and in its longitudinal development. Anthropometrical measures and lifestyle indices, including objectively determined physical activity, were considered, among others factors, as determinants of IR. Prospective associations between IR at follow-up and anthropometrical and lifestyle indices were estimated by logistic regression models. Results Country-specific prevalence rates of IR in the IDEFICS cohort of European children showed a positive trend with weight category. Prospective multivariate analyses showed the strongest positive associations of IR with BMI z-score (OR = 2.6 for unit change from the mean, 95 % CI 2.1–3.1) and z-score of waist circumference (OR = 2.2 for unit change from the mean, 95 % CI 1.9–2.6), which were analysed in separate models, but also for sex (OR = 2.2 for girls vs. boys, 95 % CI 1.5–3.1 up to OR 2.5, 95 % CI 1.8–3.6 depending on the model), audio-visual media time (OR = 1.2 for an additional hour per day, 95 % CI 1.0–1.4 in both models) and an inverse association of objectively determined physical activity (OR = 0.5 for 3rd compared to 1st quartile, 95 % CI 0.3–0.9 in both models). A longitudinal reduction of HOMA-IR was accompanied with a parallel decline in BMI. Conclusions This study is, to our knowledge, the first prospective study on IR in a preadolescent children’s population. It supports the common hypothesis that overweight and obesity are the main determinants of IR. Our data also indicate that physical inactivity and a sedentary lifestyle are likewise associated with the development of IR, independent of weight status. The promotion of physical activity should thus be considered as an equal option to dietary intervention for the treatment of IR in the paediatric practice.
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Affiliation(s)
- Jenny Peplies
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.,Faculty of Human and Health Sciences, Institute for Public Health and Nursing Research, Bremen University, Bremen, Germany
| | - Claudia Börnhorst
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Kathrin Günther
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Arno Fraterman
- MVZ Dortmund Dr. Eberhard und Partner, Dortmund, Germany
| | - Paola Russo
- Epidemiology & Population Genetics, Institute of Food Sciences, CNR, Avellino, Italy
| | | | | | | | - Staffan Marild
- Department of Public Health and Community Medicine, The Queen Silvia Children's Hospital, Göteborg, Sweden
| | - Dénes Molnar
- National Institute of Health Promotion, University of Pécs, Gyermekklinika, Pécs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, School of Health Sciences, University of Zaragoza, Zaragoza, Spain
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany. .,Faculty of Human and Health Sciences, Institute for Public Health and Nursing Research, Bremen University, Bremen, Germany. .,Epidemiological Methods and Etiologic Research, Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
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High cardiometabolic risk in healthy Chilean adolescents: associations with anthropometric, biological and lifestyle factors. Public Health Nutr 2015; 19:486-93. [PMID: 25990645 PMCID: PMC4654715 DOI: 10.1017/s1368980015001585] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To analyse the prevalence of cardiovascular risk factors in healthy adolescents of low to middle socio-economic status and to study the influence of anthropometric, biological and lifestyle factors on the risk of metabolic syndrome (MetS). DESIGN Cross-sectional study. BMI, waist circumference, blood pressure, fat and lean mass (by dual-energy X-ray absorptiometry), TAG, HDL-cholesterol, glucose, insulin, homeostatic model assessment-insulin resistance index (HOMA-IR), food intake and physical activity were measured. Cardiovascular risk factors were defined using the International Diabetes Federation criteria and insulin resistance using HOMA-IR ≥2.6. Bivariate and multivariate regressions examined the associations between MetS and anthropometric, biological and lifestyle factors. SETTING Observational cohort study including Chilean adolescents, who were part of a follow-up study beginning in infancy. SUBJECTS Adolescents aged 16-17 years (n 667). RESULTS In the sample, 16.2% had obesity and 9.5% had MetS. Low HDL-cholesterol (69.9%), abdominal obesity (33.3%) and fasting hyperglycaemia (8.7%) were the most prevalent cardiovascular risk factors. In males, obesity (OR=3.7; 95% CI 1.2, 10.8), insulin resistance (OR=3.0; 95% CI 1.1, 8.2), physical inactivity (OR=2.9; 95% CI 1.1, 7.7) and sarcopenia (OR=21.2; 95% CI 4.2, 107.5) significantly increased the risk of MetS. In females, insulin resistance (OR=4.9; 95% CI 1.9, 12.6) and sarcopenia (OR=3.6; 95% CI 1.1, 11.9) were significantly associated with MetS. CONCLUSIONS High prevalences of obesity, abdominal obesity, dyslipidaemia, fasting hyperglycaemia and MetS were found in healthy adolescents. In both sexes, sarcopenia and insulin resistance were important risk factors of MetS. Promotion of active lifestyles at the school level and regulation of the sale of energy-dense foods are needed.
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van der Aa MP, Fazeli Farsani S, Knibbe CAJ, de Boer A, van der Vorst MMJ. Population-Based Studies on the Epidemiology of Insulin Resistance in Children. J Diabetes Res 2015; 2015:362375. [PMID: 26273668 PMCID: PMC4530262 DOI: 10.1155/2015/362375] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Revised: 05/05/2015] [Accepted: 05/05/2015] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND In view of the alarming incidence of obesity in children, insight into the epidemiology of the prediabetic state insulin resistance (IR) seems important. Therefore, the aim of this systematic review was to give an overview of all population-based studies reporting on the prevalence and incidence rates of IR in childhood. METHODS PubMed, Embase, and Cochrane library were searched in order to find all available population-based studies describing the epidemiology of IR in pediatric populations. Prevalence rates together with methods and cut-off values used to determine IR were extracted and summarized with weight and sex specific prevalence rates of IR if available. RESULTS Eighteen population-based studies were identified, describing prevalence rates varying between 3.1 and 44%, partly explained by different definitions for IR. Overweight and obese children had higher prevalence rates than normal weight children. In seven out of thirteen studies reporting sex specific results, girls seemed to be more affected than boys. CONCLUSION Prevalence rates of IR reported in children vary widely which is partly due to the variety of definitions used. Overweight and obese children had higher prevalence and girls were more insulin resistant than boys. Consensus on the definition for IR in children is needed to allow for comparisons between different studies.
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Affiliation(s)
- M. P. van der Aa
- Department of Pediatrics, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, Netherlands
| | - S. Fazeli Farsani
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, P.O. Box 80082, 3508 TB Utrecht, Netherlands
| | - C. A. J. Knibbe
- Department of Clinical Pharmacy, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, Netherlands
| | - A. de Boer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, P.O. Box 80082, 3508 TB Utrecht, Netherlands
| | - M. M. J. van der Vorst
- Department of Pediatrics, St. Antonius Hospital, P.O. Box 2500, 3430 EM Nieuwegein, Netherlands
- *M. M. J. van der Vorst:
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Burrows R, Correa-Burrows P, Reyes M, Blanco E, Albala C, Gahagan S. Healthy Chilean Adolescents with HOMA-IR ≥ 2.6 Have Increased Cardiometabolic Risk: Association with Genetic, Biological, and Environmental Factors. J Diabetes Res 2015; 2015:783296. [PMID: 26273675 PMCID: PMC4530255 DOI: 10.1155/2015/783296] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 01/06/2015] [Accepted: 01/07/2015] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To determine the optimal cutoff of the homeostasis model assessment-insulin resistance (HOMA-IR) for diagnosis of the metabolic syndrome (MetS) in adolescents and examine whether insulin resistance (IR), determined by this method, was related to genetic, biological, and environmental factors. METHODS In 667 adolescents (16.8 ± 0.3 y), BMI, waist circumference, glucose, insulin, adiponectin, diet, and physical activity were measured. Fat and fat-free mass were assessed by dual-energy X-ray absorptiometry. Family history of type 2 diabetes (FHDM) was reported. We determined the optimal cutoff of HOMA-IR to diagnose MetS (IDF criteria) using ROC analysis. IR was defined as HOMA-IR values above the cutoff. We tested the influence of genetic, biological, and environmental factors on IR using logistic regression analyses. RESULTS Of the participants, 16% were obese and 9.4 % met criteria for MetS. The optimal cutoff for MetS diagnosis was a HOMA-IR value of 2.6. Based on this value, 16.3% of participants had IR. Adolescents with IR had a significantly higher prevalence of obesity, abdominal obesity, fasting hyperglycemia, and MetS compared to those who were not IR. FHDM, sarcopenia, obesity, and low adiponectin significantly increased the risk of IR. CONCLUSIONS In adolescents, HOMA-IR ≥ 2.6 was associated with greater cardiometabolic risk.
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Affiliation(s)
- R. Burrows
- Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile
- *R. Burrows:
| | - P. Correa-Burrows
- Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile
| | - M. Reyes
- Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile
| | - E. Blanco
- Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive, MC 0927, La Jolla, San Diego, CA 92093-0927, USA
| | - C. Albala
- Institute of Nutrition and Food Technology, University of Chile, Avenida El Líbano 5524, Macul, 7840390 Santiago, Chile
| | - S. Gahagan
- Division of Child Development and Community Health, University of California, San Diego, 9500 Gilman Drive, MC 0927, La Jolla, San Diego, CA 92093-0927, USA
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Associations of prenatal growth with metabolic syndrome, insulin resistance, and nutritional status in Chilean children. BIOMED RESEARCH INTERNATIONAL 2014; 2014:472017. [PMID: 25025054 PMCID: PMC4082911 DOI: 10.1155/2014/472017] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 05/19/2014] [Indexed: 02/06/2023]
Abstract
Introduction. The association of prenatal growth with nutritional status, metabolic syndrome (MS), and insulin resistance (IR) was studied in school-age children. Methods. A retrospective cohort study was designed linking present data of children with perinatal records. 3325 subjects were enrolled. Anthropometry, blood pressure (BP), and pubertal status were assessed. Blood lipids, glucose, and insulin were measured. Linear associations were assessed using the Cochran-Armitage test. Odds ratios and nonlinear associations were computed.
Results. 3290 children (52% females, mean age of 11.4 ± 1 years) were analyzed. Prevalence of obesity, stunting, MS, and IR was 16.0%, 3.6%, 7.3%, and 25.5%, respectively. The strongest positive association was between birth weight (BW) and obesity (OR 2.97 (95% CI 2.01–4.40) at BW ≥ 4,000 g compared to BW 2,500–2,999). The strongest inverse association was between birth length (BL) and stunting (OR 8.70 (95% CI 3.66–20.67) at BL < 48 cm compared to BL 52-53 cm). A U-shaped association between BL and BP ≥ 90th percentile was observed. Significant ORs were also found for MS and IR. Adjustments for present fat mass increased or maintained the most prenatal growth influences. Conclusions. Prenatal growth influences MS, IR, and nutritional status. Prenatal growth was more important than present body composition in determining these outcomes.
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