Trajectories of early to mid-life adulthood BMI and incident diabetes: the China Health and Nutrition Survey

Abstract

IntroductionThis longitudinal study aims to characterize distinct body mass index (BMI) trajectories during early to mid-life adulthood and to explore the association between BMI change from young adulthood to midlife and incident diabetes.Research design and methodsThis study included 7289 adults who had repeatedly measured BMI 3–9 times during 1989–2011 and information on incident diabetes. Latent class growth mixed model (LCGMM) was used to identify different BMI trajectories. Cox proportional hazard models were used to investigate the association between the trajectory group membership and incident hyperglycemia, adjusting for covariates. The hyperglycemia group included individuals with prediabetes or diabetes. The model-estimated BMI levels and slopes were calculated at each age point in 1-year intervals according to the model parameters and their first derivatives, respectively. Logistic regression analyses were used to examine the association of model-estimated levels and slopes of BMI at each age point with incident hyperglycemia. The area under the curve (AUC) was computed from longitudinal growth curve models during the follow-up for each individual. Prior to the logistic regression analyses, quartiles of total, baseline, and incremental AUC values were calculated.ResultsThree distinct trajectories were characterized by LCGMM, comprising of low-increasing group (n=5136), medium-increasing group (n=1914), and high-increasing group (n=239). Compared with the low-increasing group, adjusted HRs and 95% CIs were 1.21 (0.99 to 1.48) and 1.56 (1.06 to 2.30) for the medium-increasing and the high-increasing group, respectively. The adjusted standardized ORs of model-estimated BMI levels increased among 20–50 years, ranging from 0.98 (0.87 to 1.10) to 1.19 (1.08 to 1.32). The standardized ORs of level-adjusted linear slopes increased gradually from 1.30 (1.16 to 1.45) to 1.42 (1.21 to 1.67) during 20–29 years, then decreased from 1.41 (1.20 to 1.66) to 1.20 (1.08 to 1.33) during 30–43 years, and finally increased to 1.20 (1.04 to 1.38) until 50 years. The fourth quartile of incremental AUC (OR=1.31, 95% CI 1.03 to 1.66) was significant compared with the first quartile, after adjustment for covariates.ConclusionsThese findings indicate that the BMI trajectories during early adulthood were significantly associated with later-life diabetes. Young adulthood is a crucial period for the development of diabetes, which has implications for early prevention.

Joint trajectories of body mass index and waist circumference in early-life to mid-life adulthood and incident hypertension: the China Health and Nutrition Survey

“…The low-increasing group, with baseline BMI around 20 kg/m 2 , increased slowly during the 20–60 years period, while the high-increasing group with lower baseline BMI increased rapidly. Some studies, using data from China, the UK and Finland, explored BMI trajectories for childhood and early adulthood, showed that BMI may have 2–6 trajectories 13 14 20–25. Though the numbers of trajectories were different among these studies, they all discovered a low-increasing or low-stable group and a high-increasing group, 13 1420–25 which was in line with our results.…”

“…Logistic regression models were used to examine the associations of model-estimated levels and linear slopes of BMI and WC at each age point with incident hypertension. Before logistic regression analyses, the model-estimated linear slope values of BMI and WC at each age point were adjusted for their corresponding levels to avoid collinearity of levels and linear slopes in the same model 20 21. Standardised ORs of levels and level-adjusted slopes of BMI and WC for incident hypertension were estimated, adjusted for gender, baseline SBP, smoking and alcohol drinking.…”

Weight gain in Chinese youth during a 4-month COVID-19 lockdown: a retrospective observational study

“…A sharp increase in weight has been associated with an increase in blood pressure. 23 Even more moderate increases over a longer period are associated with chronic diseases, 24 all of which are exacerbated when weight is gained during adolescence and early adulthood to have later life repercussions. 25 26 The interruption of individual routines and confinement may lead to a calorie imbalance pushed by concomitant lower physical activity and increased sedentary time, as well as irregular eating patterns and frequent snacking.…”

Trajectories of mid-life to elderly adulthood BMI and incident hypertension: the China Health and Nutrition Survey

“…With LCGMM, individual model-predicted BMI values and slopes could be used to characterise the critical period to develop hypertension. 27 On the basis of lifecourse epidemiology theory, exposure at a specific life period can greatly affect the development of diseases in later life. 37 As a result, our study suggested that maintaining a high BMI value or a rapid increase in BMI may increase the risk of hypertension in later life.…”