TABLE 5.
Associations between WHZ trajectories at ages 1 to 59 months and cardiometabolic outcomes in childhood and adolescence1
| Childhood (5–9 years)2 | Adolescence (10–16 years)3 | |||||
|---|---|---|---|---|---|---|
| Intermediate (trajectory 2) | Increasing high (trajectory 3) | P value | Intermediate (trajectory 2) | Increasing high (trajectory 3) | P value | |
| Height, cm | ||||||
| Model 1 | −0.05 (−1.21 to 1.12) | 4.86 (3.29–6.42) | <0.001 | 2.67 (1.09–4.24) | 4.32 (2.10–6.55) | <0.001 |
| Model 2 | −0.04 (−1.21 to 1.12) | 4.88 (3.29–6.47) | <0.001 | 2.67 (1.09–4.25) | 4.31 (2.07–6.55) | <0.001 |
| BMI-z | ||||||
| Model 1 | 0.91 (0.61–1.22) | 3.14 (2.73–3.54) | <0.001 | 0.68 (0.35–1.01) | 2.03 (1.57–2.51) | <0.001 |
| Model 2 | 0.90 (0.60–1.20) | 3.01 (2.60–3.42) | <0.001 | 0.72 (0.39–1.05) | 1.94 (1.48–2.41) | <0.001 |
| Plasma fasting glucose, mg/dL | ||||||
| Model 1 | 0.91 (−0.47 to 2.30) | 4.43 (2.58–6.27) | <0.001 | 0.90 (−0.76 to 2.57) | 1.31 (−1.04 to 3.65) | 0.459 |
| Model 2 | 0.85 (−0.52 to 2.24) | 3.98 (2.09–5.86) | <0.001 | 0.94 (−0.72 to 2.61) | 1.21 (−1.15 to 3.58) | 0.467 |
| Model 3 | −0.27 (−1.64 to 1.08) | 0.22 (−1.88 to 2.34) | 0.793 | 0.08 (−1.57 to 1.74) | −1.21 (−3.72 to 1.29) | 0.496 |
| Plasma 2-hour glucose, mg/dL | ||||||
| Model 1 | 2.75 (−2.64 to 8.14) | 16.8 (9.59–23.9) | <0.001 | 8.74 (2.59–14.9) | 12.4 (3.75–21.1) | 0.005 |
| Model 2 | 2.72 (−2.57 to 8.03) | 14.3 (7.09–21.5) | <0.001 | 9.26 (3.12–15.4) | 11.7 (3.02–20.4) | 0.005 |
| Model 3 | −0.86 (−5.91 to 4.17) | 0.33 (−7.48 to 8.15) | 0.890 | 3.63 (−2.21 to 9.48) | −2.08 (−10.8 to 6.68) | 0.196 |
| Serum fasting insulin,4 μU/mL | ||||||
| Model 1 | 0.67 (−0.20 to 1.49) | 6.77 (4.42–9.49) | <0.001 | 2.18 (−0.10 to 4.54) | 9.48 (4.00–16.2) | <0.001 |
| Model 2 | 0.65 (−0.22 to 1.47) | 6.44 (4.19–9.18) | <0.001 | 2.54 (0.32–4.76) | 7.82 (3.04–13.3) | <0.001 |
| Model 3 | −1.11 (−1.90 to −0.38) | −1.27 (−2.40 to −0.11) | 0.018 | −0.61 (−2.49 to 1.21) | −2.10 (−4.66 to 0.70) | 0.156 |
| Serum 2-hour insulin,4 μU/mL | ||||||
| Model 1 | 7.87 (−2.20 to 16.6) | 54.5 (28.0–85.3) | <0.001 | 26.7 (9.80–43.9) | 34.1 (1.16–76.1) | 0.007 |
| Model 2 | 8.05 (−2.25 to 16.9) | 47.5 (24.7–74.3) | <0.001 | 29.2 (12.3–46.4) | 30.5 (0.36–70.2) | 0.004 |
| Model 3 | −2.46 (−14.3 to 7.71) | −3.76 (−20.8 to 12.8) | 0.918 | 11.7 (−6.60 to 28.7) | −16.2 (−37.6 to 6.91) | 0.022 |
| Serum total cholesterol, mg/dL | ||||||
| Model 1 | 5.01 (−0.96 to 10.9) | 8.74 (0.73–16.8) | 0.087 | 1.22 (−5.89 to 8.33) | 13.8 (3.90–23.8) | 0.012 |
| Model 2 | 4.96 (−1.02 to 10.9) | 8.32 (0.14–16.5) | 0.112 | 1.44 (−5.68 to 8.56) | 13.3 (3.34–23.3) | 0.019 |
| Model 3 | 4.10 (−2.03 to 10.2) | 5.23 (−4.36 to 14.8) | 0.392 | 1.12 (−6.17 to 8.41) | 12.5 (1.59–23.3) | 0.047 |
| Serum HDL cholesterol, mg/dL | ||||||
| Model 1 | −1.87 (−4.52 to 0.77) | −7.35 (−10.9 to −3.80) | <0.001 | −2.26 (−4.77 to 0.26) | −1.92 (−5.44 to 1.60) | 0.208 |
| Model 2 | −1.84 (−4.49 to 0.80) | −7.12 (−10.7 to −3.50) | <0.001 | −2.44 (−4.95 to 0.06) | −1.49 (−5.01 to 2.03) | 0.159 |
| Model 3 | 0.36 (−2.20 to 2.94) | 0.82 (−3.19 to 4.85) | 0.920 | −0.42 (−2.80 to 1.95) | 4.02 (0.46–7.57) | 0.017 |
| Serum triglycerides,4 mg/dL | ||||||
| Model 1 | 8.23 (0.55–15.5) | 27.8 (15.0–41.0) | <0.001 | 7.31 (−4.68 to 18.5) | 16.3 (−1.96 to 34.9) | 0.166 |
| Model 2 | 8.27 (0.59–15.4) | 28.2 (15.0–42.1) | <0.001 | 7.85 (−3.85 to 19.0) | 14.9 (−2.91 to 34.3) | 0.198 |
| Model 3 | 1.69 (−6.74 to 9.78) | 1.22 (−12.6 to 15.2) | 0.849 | 0.90 (−10.5 to 11.7) | −3.48 (−21.1 to 15.7) | 0.791 |
| SBP, mmHg | ||||||
| Model 1 | 3.77 (1.12–6.42) | 9.76 (6.21–13.3) | <0.001 | 2.40 (−0.35 to 5.17) | 6.17 (2.28–10.1) | 0.008 |
| Model 2 | 3.79 (1.13–6.44) | 10.0 (6.44–13.6) | <0.001 | 2.55 (−0.20 to 5.31) | 5.81 (1.90–9.72) | 0.013 |
| Model 3 | 0.96 (−1.59 to 3.53) | 0.62 (−3.34 to 4.58) | 0.750 | 0.99 (−1.73 to 3.72) | 1.58 (−2.51 to 5.68) | 0.699 |
| DBP, mmHg | ||||||
| Model 1 | 1.71 (−0.29 to 3.70) | 5.42 (2.74–8.09) | 0.001 | 1.84 (−0.53 to 4.23) | 2.00 (−1.35 to 5.36) | 0.281 |
| Model 2 | 1.72 (−0.28 to 3.72) | 5.61 (2.89–8.33) | 0.001 | 1.83 (−0.55 to 4.22) | 2.03 (−1.33 to 5.41) | 0.282 |
| Model 3 | 0.30 (−1.69 to 2.30) | 0.80 (−2.29 to 3.90) | 0.878 | 0.70 (−1.68 to 3.09) | −1.00 (−4.58 to 2.58) | 0.508 |
WHZ trajectories were derived using latent class trajectory analysis. The reference category is low WHZ trajectory (trajectory 1). Values are β coefficients (95% CIs) from linear mixed-effects models. 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; SBP, systolic blood pressure; WHZ, weight-for-height z-score.
Sample sizes are 555 for height and BMI, 470 for fasting glucose, 307 for 2-hour glucose, 418 for fasting insulin, 267 for 2-hour insulin, 466 for total cholesterol, 464 for HDL cholesterol, 447 for triglycerides, 555 for SBP, and 550 for DBP.
Sample sizes are 375 for height and BMI, 360 for fasting glucose, 335 for 2-hour glucose, 328 for fasting insulin, 291 for 2-hour insulin, 364 for total cholesterol, 364 for HDL cholesterol, 354 for triglycerides, 374 for SBP, and 373 for DBP.
Values are presented as differences in adjusted geometric means, derived from the β coefficients of the linear mixed models, with 95% CIs.