Long-term trajectories of BMI and cumulative incident metabolic syndrome: A cohort study

Abstract

BackgroundBody mass index (BMI) has been widely recognized as a risk factor for metabolic syndrome (MetS). However, the relationship between the trajectory of BMI and cumulative incident MetS is still unclear. We investigate the associations of long-term measurements of BMI with MetS among young adults in the China Health and Nutrition Survey.MethodsWe enrolled individuals aged 10 to 20 at baseline with recorded BMI at each follow-up interview, and 554 participants were finally included in our study. The assessment and incidence of MetS were evaluated by blood tests and physical examinations in their adulthood. A latent class growth mixed model was used to identify three BMI trajectory patterns: a low baseline BMI with slow development (low-slow, n=438), a low baseline BMI with fast development (low-fast, n=66), and a high baseline BMI with fast development (high-fast, n=50). Logistic regression was used to explore the relationship between different BMI trajectories and the incidence of MetS.ResultDuring a follow-up of 16 years, 61 (11.01%) participants developed MetS. The combination of elevated triglycerides and reduced high-density lipoprotein cholesterol was most frequent in diagnosed MetS. In multivariate adjusted models, the low-fast and high-fast BMI trajectories showed a significantly higher risk of MetS than those with the low-slow BMI trajectory (low-high: OR = 3.40, 95% CI: 1.14-10.13, P < 0.05; high-fast: OR = 5.81, 95% CI: 1.63-20.69, P < 0.05).ConclusionOur study identified three BMI trajectories in young adults and found that long-term measurements of BMI were also associated with cumulative incident MetS.

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“…Several other studies with the same approach, utilizing latent class modeling, reached different numbers of WC and BMI trajectory groups, which were labeled to the pattern of dynamic changes and ranged from two to 6 groups, in different studies. (25,26,(35)(36)(37)(38)(39) Also, the same number of BMI trajectory groups in our study was de ned in some previous studies with the follow-up of subjects from childhood to adulthood. (25,36,37,39) Childhood overweight/ obesity is de ned to be a major risk factor for adulthood obesity.…”

“…(25,26,(35)(36)(37)(38)(39) Also, the same number of BMI trajectory groups in our study was de ned in some previous studies with the follow-up of subjects from childhood to adulthood. (25,36,37,39) Childhood overweight/ obesity is de ned to be a major risk factor for adulthood obesity. The results of a systematic review study by Singh et al (6) showed that overweight and obese youth have an increased risk of being overweight during adulthood.…”

“…In another study on the Chinese population, the ratio risk of hypertension, type 2 diabetes mellitus, high-risk triglycerides, and high-risk HDL were more than 3.0 during adulthood among the high-increasing childhood BMI trajectory group. (36) Among other cardiometabolic risk factors, higher risk of hypertension incidence (20,43,44), metabolic syndrome (39), unfavorable levels of trunk fat (45), insulin (45), HDL (21,45), left ventricular mass (25,45), high plasma glucose (20) and incidence of diabetes, in adulthood are signi cantly associated with higher BMI trajectories during childhood.…”

The association of metabolic syndrome score trajectory patterns with risk of all cancer types

“…This analytical approach is especially vital in the context of MetS, given that the condition's severity and characteristics can fluctuate over time, potentially altering an individual's risk profile for serious ailments like heart disease, stroke, and type 2 diabetes. [5][6][7] By employing trajectory analysis, researchers gain the ability to not only monitor the dynamic progression of MetS but also to pinpoint specific patterns and shifts in its componentssuch as blood pressure, blood sugar levels, waist circumference, and lipid profiles. This enriched understanding enables a more nuanced comprehension of how transitions between metabolically healthy and unhealthy states influence the development and progression of related diseases.…”

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“…MetS in children and adolescents can be diagnosed using a variety of techniques. The International Diabetes Federation (IDF) states that MetS is diagnosed in children between the ages of 10 and 16 who have central obesity (90th percentile or higher), triglycerides (TG) of 150 mg/dl or higher, HDL-C of 40 mg/dl or higher, systolic or diastolic blood pressure (BP), fasting plasma glucose (FG) of 100 mg/dl, or a history of type 2 diabetes (Aditama et al, 2021;Ying et al, 2022). According to WHO guidelines, MetS is diagnosed when three or more of the following characteristics are present: BMI > 95th percentile, hyperinsulinemia, impaired fasting glucose, or impaired glucose tolerance, BP > 95th percentile, TG > 105/136 mg/dL (1.2/1.5 mmol/L) for children > 10 years old, and HDL-C > 35 mg/dL (0.9 mmol/L) (Wu et al, 2022).…”