TABLE 4.
Associations of categories of height-for-age z-scores (HAZ) at ages 1 to 59 months with cardiometabolic outcomes in childhood and adolescence1
| Childhood (5–9 years)2 | Adolescence (10–16 years)3 | |||||||
|---|---|---|---|---|---|---|---|---|
| Low HAZ (HAZ < −2) | HAZ below the median (−2 ≤ HAZ < 0) | P value | P-trend | Low HAZ (HAZ < −2) | HAZ below the median (−2 ≤ HAZ < 0) | P value | P-trend | |
| Height, cm | ||||||||
| Model 1 | −10.37 (−11.53 to −9.21) | −5.62 (−6.58 to −4.67) | <0.001 | <0.001 | −9.55 (−11.25 to −7.84) | −5.72 (−6.91 to −4.53) | <0.001 | <0.001 |
| Model 2 | −10.56 (−11.72 to −9.41) | −5.74 (−6.68 to −4.79) | <0.001 | <0.001 | −9.69 (−11.39 to −7.98) | −5.78 (−6.97 to −4.60) | <0.001 | <0.001 |
| BMI-z | ||||||||
| Model 1 | −1.08 (−1.48 to −0.68) | −0.72 (−1.04 to −0.39) | <0.001 | 0.001 | −0.77 (−1.17 to −0.38) | −0.66 (−0.93 to −0.39) | <0.001 | <0.001 |
| Model 2 | −1.22 (−1.60 to −0.84) | −0.79 (−1.11 to −0.48) | <0.001 | 0.001 | −0.86 (−1.24 to −0.47) | −0.69 (−0.96 to −0.42) | <0.001 | <0.001 |
| Plasma fasting glucose, mg/dL | ||||||||
| Model 1 | −1.32 (−2.97 to 0.31) | −1.09 (−2.45 to 0.26) | 0.215 | 0.121 | 0.14 (−1.76 to 2.04) | −0.22 (−1.56 to 1.11) | 0.885 | 0.969 |
| Model 2 | −1.60 (−3.23 to 0.02) | −1.23 (−2.57 to 0.10) | 0.117 | 0.058 | 0.03 (−1.87 to 1.93) | −0.26 (−1.60 to 1.07) | 0.891 | 0.940 |
| Model 3 | −0.13 (−1.73 to 1.47) | −0.20 (−1.51 to 1.09) | 0.950 | 0.886 | 0.97 (−0.92 to 2.87) | 0.51 (−0.83 to 1.85) | 0.581 | 0.298 |
| Plasma 2-hour glucose, mg/dL | ||||||||
| Model 1 | −5.02 (−11.42 to 1.37) | −3.27 (−8.46 to 1.91) | 0.290 | 0.125 | −1.06 (−8.18 to 6.05) | −2.61 (−7.47 to 2.25) | 0.557 | 0.571 |
| Model 2 | −6.11 (−12.39 to 0.15) | −3.93 (−9.01 to 1.15) | 0.150 | 0.058 | −1.92 (−9.03 to 5.17) | −2.91 (−7.75 to 1.92) | 0.496 | 0.422 |
| Model 3 | −0.65 (−6.49 to 5.18) | 0.31 (−4.40 to 5.02) | 0.911 | 0.809 | 3.27 (−3.38 to 9.93) | 1.14 (−3.41 to 5.69) | 0.626 | 0.348 |
| Serum fasting insulin,4 μU/mL | ||||||||
| Model 1 | −2.51 (−4.11 to −1.07) | −2.05 (−3.42 to −0.77) | <0.001 | <0.001 | −4.05 (−7.44 to −0.83) | −3.82 (−6.54 to −1.24) | 0.002 | 0.002 |
| Model 2 | −2.94 (−4.52 to −1.46) | −2.31 (−3.76 to −0.98) | <0.001 | <0.001 | −4.52 (−7.65 to −1.47) | −4.22 (−6.91 to −1.66) | <0.001 | <0.001 |
| Model 3 | −0.41 (−1.41 to 0.60) | −0.48 (−1.38 to 0.31) | 0.565 | 0.451 | 0.68 (−1.55 to 2.87) | −0.06 (−1.67 to 1.44) | 0.808 | 0.564 |
| Serum 2-hour insulin,4 μU/mL | ||||||||
| Model 1 | −8.36 (−23.9 to 6.51) | −8.54 (−21.6 to 3.16) | 0.280 | 0.261 | 1.64 (−28.2 to 35.5) | −12.8 (−34.0 to 6.47) | 0.236 | 0.561 |
| Model 2 | −10.9 (−27.8 to 4.69) | −10.4 (−24.5 to 1.55) | 0.158 | 0.155 | −1.13 (−30.6 to 30.8) | −14.3 (−36.1 to 4.83) | 0.213 | 0.415 |
| Model 3 | 5.02 (−7.05 to 17.1) | −0.50 (−10.6 to 8.77) | 0.485 | 0.323 | 27.5 (3.41–57.6) | 7.54 (−7.24 to 21.5) | 0.086 | 0.033 |
| Serum total cholesterol, mg/dL | ||||||||
| Model 1 | −4.55 (−11.31 to 2.20) | −3.59 (−9.09 to 1.90) | 0.354 | 0.191 | −7.36 (−15.57 to 0.85) | −3.80 (−9.54 to 1.92) | 0.190 | 0.068 |
| Model 2 | −4.84 (−11.62 to 1.94) | −3.72 (−9.22 to 1.78) | 0.319 | 0.166 | −7.68 (−15.9 to 0.55) | −3.93 (−9.66 to 1.80) | 0.166 | 0.058 |
| Model 3 | −3.81 (−10.76 to 3.12) | −3.00 (−8.60 to 2.59) | 0.501 | 0.289 | −6.41 (−14.77 to 1.95) | −2.96 (−8.80 to 2.87) | 0.312 | 0.128 |
| Serum HDL cholesterol, mg/dL | ||||||||
| Model 1 | 1.68 (−1.31 to 4.68) | 1.56 (−0.87 to 3.99) | 0.418 | 0.279 | −3.10 (−6.09 to −0.12) | −2.00 (−4.09 to 0.07) | 0.076 | 0.026 |
| Model 2 | 1.99 (−1.00 to 4.98) | 1.69 (−0.72 to 4.12) | 0.333 | 0.198 | −2.79 (−5.77 to 0.18) | −1.88 (−3.96 to 0.18) | 0.113 | 0.043 |
| Model 3 | −1.21 (−4.06 to 1.63) | −0.57 (−2.86 to 1.72) | 0.703 | 0.401 | −5.37 (−8.17 to −2.57) | −3.84 (−5.80 to −1.88) | <0.001 | <0.001 |
| Serum triglycerides,4 mg/dL | ||||||||
| Model 1 | −8.20 (−17.8 to 1.99) | −11.0 (−18.1 to −4.03) | 0.010 | 0.072 | 3.40 (−9.82 to 16.7) | −1.64 (−11.3 to 8.00) | 0.515 | 0.819 |
| Model 2 | −9.38 (−18.6 to 0.77) | −11.5 (−18.5 to −4.40) | 0.005 | 0.036 | 2.48 (−10.5 to 15.9) | −2.19 (−11.8 to 7.22) | 0.491 | 0.675 |
| Model 3 | 1.45 (−6.91 to 10.1) | −4.34 (−10.9 to 1.72) | 0.156 | 0.664 | 10.5 (−0.80 to 22.6) | 4.80 (−4.01 to 13.5) | 0.400 | 0.208 |
| SBP, mmHg | ||||||||
| Model 1 | −4.67 (−7.64 to −1.70) | −2.19 (−4.63 to 0.24) | 0.008 | 0.002 | −6.38 (−9.63 to −3.14) | −2.18 (−4.44 to 0.08) | <0.001 | <0.001 |
| Model 2 | −4.87 (−7.84 to −1.90) | −2.30 (−4.73 to 0.13) | 0.005 | 0.001 | −6.78 (−10.01 to −3.55) | −2.34 (−4.59 to −0.09) | <0.001 | <0.001 |
| Model 3 | −1.39 (−4.23 to 1.45) | −0.05 (−2.36 to 2.25) | 0.474 | 0.322 | −5.04 (−8.22 to −1.85) | −0.93 (−3.16 to 1.29) | 0.005 | 0.005 |
| DBP, mmHg | ||||||||
| Model 1 | −3.19 (−5.42 to −0.95) | 0.01 (−1.83 to 1.81) | 0.002 | 0.004 | −3.95 (−6.62 to −1.28) | −1.98 (−3.84 to −0.12) | 0.011 | 0.002 |
| Model 2 | −3.41 (−5.65 to −1.17) | −0.11 (−1.94 to 1.70) | <0.001 | 0.002 | −3.99 (−6.66 to −1.31) | −1.99 (−3.86 to −0.13) | 0.011 | 0.002 |
| Model 3 | −1.52 (−3.74 to 0.69) | 1.10 (−0.68 to 2.89) | 0.010 | 0.152 | −2.85 (−5.52 to −0.19) | −1.08 (−2.95 to 0.78) | 0.109 | 0.109 |
The reference category is the HAZ above the median, defined as an HAZ ≥0. Values are β coefficients (95% CI) from linear mixed-effects models. P values for trend were calculated using linear mixed-effects models (from inclusion of an ordered numeric variable). Model 1 was adjusted for sex and age. Model 2 was additionally adjusted for exposure to diabetes in utero. Model 3 was additionally adjusted for concurrent BMI. Abbreviations: DBP, diastolic blood pressure; HAZ, height-for-age z-score; SBP, systolic blood pressure; WHZ, weight-for-height z-score.
Sample sizes are 746 for height and BMI, 631 for fasting glucose, 416 for 2-hour glucose, 535 for fasting insulin, 353 for 2-hour insulin, 632 for total cholesterol, 629 for HDL cholesterol, 602 for triglycerides, 744 for SBP, and 739 for DBP.
Sample sizes are 598 for height and BMI, 574 for fasting glucose, 538 for 2-hour glucose, 521 for fasting insulin, 467 for 2-hour insulin, 581 for total cholesterol, 580 for HDL cholesterol, 562 for triglycerides, 597 for SBP, and 595 for DBP.
Values are presented as differences in adjusted geometric means, derived from the β coefficients of the linear mixed models, with 95% CIs.