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Michael N, Gupta V, Fogel A, Huang J, Chen L, Sadananthan SA, Ong YY, Aris IM, Pang WW, Yuan WL, Loy SL, Thway Tint M, Tan KH, Chan JK, Chan SY, Shek LPC, Yap F, Godfrey K, Chong YS, Gluckman P, Velan SS, Forde CG, Lee YS, Eriksson JG, Karnani N. Longitudinal characterization of determinants associated with obesogenic growth patterns in early childhood. Int J Epidemiol 2022; 52:426-439. [PMID: 36087338 PMCID: PMC10114026 DOI: 10.1093/ije/dyac177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 08/29/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Longitudinal assessment of the determinants of obesogenic growth trajectories in childhood can suggest appropriate developmental windows for intervention. METHODS Latent class growth mixture modelling was used to identify body mass index (BMI) z-score trajectories from birth to age 6 years in 994 children from a prospective mother-offspring cohort (Chinese, Indian and Malay ethnicities) based in Singapore. We evaluated the early-life determinants of the trajectories as well as their associations with cardiometabolic risk markers at age 6 years. RESULTS Five BMI z-score trajectory patterns were identified, three within the healthy weight range, alongside early-acceleration and late-acceleration obesogenic trajectories. The early-acceleration pattern was characterized by elevated fetal abdominal circumference growth velocity, BMI acceleration immediately after birth and crossing of the obesity threshold by age 2 years. The late-acceleration pattern had normal fetal growth and BMI acceleration after infancy, and approached the obesity threshold by age 6 years. Abdominal fat, liver fat, insulin resistance and odds of pre-hypertension/hypertension were elevated in both groups. Indian ethnicity, high pre-pregnancy BMI, high polygenic risk scores for obesity and shorter breastfeeding duration were common risk factors for both groups. Malay ethnicity and low maternal educational attainment were uniquely associated with early BMI acceleration, whereas nulliparity and obesogenic eating behaviours in early childhood were uniquely associated with late BMI acceleration. CONCLUSION BMI acceleration starting immediately after birth or after infancy were both linked to early cardiometabolic alterations. The determinants of these trajectories may be useful for developing early risk stratification and intervention approaches to counteract metabolic adversities linked to childhood obesity.
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Affiliation(s)
- Navin Michael
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Varsha Gupta
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Anna Fogel
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Jonathan Huang
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Li Chen
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Suresh Anand Sadananthan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore
| | - Yi Ying Ong
- Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Izzuddin M Aris
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, USA
| | - Wei Wei Pang
- Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Wen Lun Yuan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Université de Paris, CRESS, Inserm, INRAE, Paris, France
| | - See Ling Loy
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore.,Duke-NUS Medical School, Singapore
| | - Mya Thway Tint
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kok Hian Tan
- Department of Maternal Fetal Medicine, KK Women's and Children's Hospital, Singapore.,Academic Medicine, Duke-National University of Singapore Graduate Medical School, Singapore
| | - Jerry Ky Chan
- Duke-NUS Medical School, Singapore.,Department of Reproductive Medicine, KK Women's and Children's Hospital, Singapore
| | - Shiao-Yng Chan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Lynette Pei-Chi Shek
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Fabian Yap
- Duke-NUS Medical School, Singapore.,Department of Pediatrics, KK Women's and Children's Hospital, Singapore.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Keith Godfrey
- MRC Lifecourse Epidemiology Centre and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Yap Seng Chong
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Peter Gluckman
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Liggins Institute, University of Auckland, Auckland, New Zealand
| | - S Sendhil Velan
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Institute of Bioengineering & Bioimaging, Agency for Science Technology and Research, Singapore
| | - Ciarán G Forde
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, Netherlands
| | - Yung Seng Lee
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Pediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Johan G Eriksson
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland.,Folkhälsan Research Center, Helsinki, Finland
| | - Neerja Karnani
- Singapore Institute for Clinical Sciences, Agency for Science Technology and Research, Singapore.,Department of Biochemistry, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.,Bioinformatics Institute, Agency for Science Technology and Research, Singapore
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