The association of long-term trajectories of BMI, its variability, and metabolic syndrome: a 30-year prospective cohort study

Guo, Tongshuai, Zheng, Sirui, Chen, Tao, Chu, Chao, Ren, Jie, Sun, Yue, Wang, Yang, He, Mingjun, Yan, Yu, Jia, Hao, Liao, Yueyuan, Cao, Yumeng, Du, Mingfei, Wang, Dan, Yuan, Zuyi, Wang, Duolao ORCID: https://orcid.org/0000-0003-2788-2464 and Mu, Jianjun (2024) 'The association of long-term trajectories of BMI, its variability, and metabolic syndrome: a 30-year prospective cohort study'. eClinicalMedicine, Vol 69, p. 102486.

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Abstract

Background
Limited data exists on how early-life weight changes relate to metabolic syndrome (MetS) risk in midlife. This study examines the association between long-term trajectories of body mass index (BMI), its variability, and MetS risk in Chinese individuals.

Methods
In the Hanzhong Adolescent Hypertension study (March 10, 1987–June 3, 2017), 1824 participants with at least five BMI measurements from 1987 to 2017 were included. Using group-based trajectory modeling, different BMI trajectories were identified. BMI variability was assessed through standard deviation (SD), variability independent of the mean (VIM), and average real variability (ARV). Logistic regression analyzed the relationship between BMI trajectory, BMI variability, and MetS occurrence in midlife (URL: https://www.clinicaltrials.gov; Unique identifier: NCT02734472).

Findings
BMI trajectories were categorized as low-increasing (34.4%), moderate-increasing (51.8%), and high-increasing (13.8%). Compared to the low-increasing group, the odds ratios (ORs) [95% CIs] for MetS were significantly higher in moderate (4.27 [2.63–6.91]) and high-increasing groups (13.11 [6.30–27.31]) in fully adjusted models. Additionally, higher BMI variabilities were associated with increased MetS odds (ORs for SDBMI, VIMBMI, and ARVBMI: 2.30 [2.02–2.62], 1.22 [1.19–1.26], and 4.29 [3.38–5.45]). Furthermore, BMI trajectories from childhood to adolescence were predictive of midlife MetS, with ORs in moderate (1.49 [1.00–2.23]) and high-increasing groups (2.45 [1.22–4.91]). Lastly, elevated BMI variability in this period was also linked to higher MetS odds (ORs for SDBMI, VIMBMI, and ARVBMI: 1.24 [1.08–1.42], 1.00 [1.00–1.01], and 1.21 [1.05–1.38]).

Interpretation
Our study suggests that both early-life BMI trajectories and BMI variability could be predictive of incident MetS in midlife.

Item Type:	Article
Subjects:	WD Disorders of Systemic, Metabolic or Environmental Origin, etc > Metabolic Diseases > General Metabolic Diseases > WD 200 General works
Faculty: Department:	Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1016/j.eclinm.2024.102486
SWORD Depositor:	JISC Pubrouter
Depositing User:	JISC Pubrouter
Date Deposited:	26 Feb 2024 10:02
Last Modified:	26 Feb 2024 10:02
URI:	https://archive.lstmed.ac.uk/id/eprint/24093

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