Effect of growth on cardiometabolic status at 4 y of age.
BACKGROUND
Cardiovascular disease (CVD) risks are increasingly being diagnosed in children and track into adulthood. Growth is associated with CVD risk in adulthood; however, its contribution to CVD risks in children facing the obesity epidemic is unclear.


OBJECTIVE
The objective was to assess relations between growth from age 0 to 4 y and CVD status at 4 y in 323 Chilean children with normal birth weight.


METHODS
From health records we obtained weight and height every 6 mo from age 0 to 3 y and calculated body mass index (BMI; weight/height(2)). At age 4 y, we measured height, waist circumference, insulin, glucose, and plasma lipids; infant feeding information was provided by the mothers. Outcomes were metabolic score (waist-to-height ratio + glucose + insulin + triglycerides - HDL-cholesterol z scores/5), total cholesterol (TC):HDL cholesterol, and homeostasis model of assessment of insulin resistance.


RESULTS
At 4 y, the prevalence of obesity was 13%. Changes in BMI, particularly from 6 to 24 mo, predicted a higher metabolic score (standardized regression coefficient = 0.29; 95% CI: 0.16, 0.42) but were unrelated to homeostasis model of assessment of insulin resistance and TC:HDL cholesterol. Height changes were not associated with CVD risks at the age of 4 y. Mode of infant feeding was unrelated to CVD status at 4 y; however, in children who were exclusively breastfed at 4 mo, an increase in BMI from 0 to 6 mo was positively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = 0.24; 95% CI: -0.02, 0.50), whereas in children who were partially or nonbreastfed at 4 mo, it was negatively associated with TC:HDL cholesterol at 4 y (standardized regression coefficient = -0.30; 95% CI: -0.52, -0.08).


CONCLUSIONS
In children with normal birth weight and a high prevalence of obesity at 4 y, changes in BMI after 6 mo predicted a higher overall CVD risk at 4 y.
Corvalán
Camila
C
Emory University, Atlanta, GA, USA. ccorvalan@meduchile.cl
Uauy
Ricardo
R
Stein
Aryeh D
AD
Kain
Juliana
J
Martorell
Reynaldo
R
D001786:Blood Glucose; D015992:Body Mass Index; D049628:Body Size; D001942:Breast Feeding; D002318:Cardiovascular Diseases / Q000097:blood; D015362:Child Nutrition Disorders / Q000097:blood / Q000150:complications; D002675:Child, Preschool; D002677:Chile; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006128:Growth; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000453:epidemiology; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D008076:Cholesterol, HDL; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol