title: Childhood adiposity trajectories are associated with late adolescent blood pressure: birth to twenty cohort.
abstract: Elevated blood pressure in childhood is a risk factor for adult hypertension which is a global health problem. Excess adiposity in childhood creates a predisposition to develop adult hypertension. Our aim was to explore distinct sex-specific adiposity trajectories from childhood to late adolescence and examined their association with blood pressure.
  
  
  
  Latent Class Growth Mixture Modeling (LCGMM) on longitudinal data was used to derive sex-specific and distinct body mass index (BMI: kg/m(2)) trajectories. We studied 1824 black children (boys = 877, girls = 947) from the Birth to Twenty (Bt20) cohort from Soweto, South Africa, and obtained BMI measures at ages 5 through 18 years. Participants with at least two age-point BMI measures, were included in the analysis. Analysis of variance (ANOVA), chi-square test, multivariate linear and standard logistic regressions were used to test study characteristics and different associations.
  
  
  
  We identified three (3) and four (4) distinct BMI trajectories in boys and girls, respectively. The overall prevalence of elevated blood pressure (BP) was 34.9 % (39.4 % in boys and 30.38 % in girls). Boys and girls in the early onset obesity or overweight BMI trajectories were more likely to have higher BP values in late adolescence. Compared to those in the normal weight BMI trajectory, girls in early onset obesity trajectories had an increased risk of elevated BP with odds ratio (OR) of 2.18 (95 % confidence interval 1.31 to 4.20) and 1.95 (1.01 to 3.77). We also observed the weak association for boys in early onset overweight trajectory, (p-value = 0.18 and odds ratio of 2.39 (0.67 to 8.57)) CONCLUSIONS: Distinct weight trajectories are observed in black South African children from as early as 5 years. Early onset adiposity trajectories are associated with elevated BP in both boys and girls. It is important to consider individual patterns of early-life BMI development, so that intervention strategies can be targeted to at-risk individuals.
authors.affiliation: School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, The Mount, 9 Jubilee Road, Parktown, Johannesburg, 2193, South Africa. munthalirichard@gmail.com.|Sydney Brenner Institute for Molecular Biosciences (SBIMB), University of the Witwatersrand, Johannesburg, South Africa. munthalirichard@gmail.com.|MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa. munthalirichard@gmail.com.|Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa. munthalirichard@gmail.com.
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Munthali
authors.affiliation: MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Juliana
authors.initials: J
authors.lastname: Kagura
authors.affiliation: School of Molecular and Cell Biology, Faculty of Science, University of the Witwatersrand, The Mount, 9 Jubilee Road, Parktown, Johannesburg, 2193, South Africa.|Division of Human Genetics, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand and National Health Laboratory Service, Johannesburg, South Africa.
authors.forename: Zané
authors.initials: Z
authors.lastname: Lombard
authors.affiliation: MRC/Wits Developmental Pathways for Health Research Unit (DPHRU), University of the Witwatersrand, Johannesburg, South Africa.
authors.forename: Shane A
authors.initials: SA
authors.lastname: Norris
mesh_terms: D050154:Adiposity; D000293:Adolescent; D016497:Adolescent Health Services; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000517:prevention & control; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008297:Male; D063766:Pediatric Obesity / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D015995:Prevalence; D012307:Risk Factors; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult
keywords: Blood pressure; Body mass index trajectories; Childhood adiposity; Hypertension; Latent class growth mixture modeling; Latent classes; Obesity; Trajectories