title: Weight Gain Trajectories Associated With Elevated C-Reactive Protein Levels in Chinese Adults.
abstract: Recent longitudinal work suggests that weight change is an important risk factor for inflammation across the full range of BMI. However, few studies have examined whether the risk of inflammation differs by patterns of weight gain over time. Using latent class trajectory analysis, we test whether patterns of weight gain are associated with elevated high-sensitivity C-reactive protein (hs-CRP 2-10 mg/L).
  
  
  
  Data come from China Health and Nutrition Survey (CHNS) participants (n=5536), aged 18 at baseline to 66 years in 2009, with measured weight over 18 years. Latent class trajectory analysis was used to identify weight-change trajectories in 6 age and sex strata. Multivariable general linear mixed-effects models fit with a logit link were used to assess the risk of elevated hs-CRP across weight trajectory classes. Models were fit within age and sex strata, controlling for baseline weight, adult height, and smoking, and included random intercepts to account for community-level correlation. Steeper weight-gain trajectories were associated with greater risk of elevated hs-CRP compared to more moderate weight-gain trajectories in men and women. Initially high weight gain followed by weight loss was associated with lower risk of elevated hs-CRP in women aged 18 to 40.
  
  
  
  Latent class trajectory analysis identified heterogeneity in adult weight change associated with differential risk of inflammation independently of baseline weight and smoking. These results suggest that trajectories of weight gain are an important clinical concern and may identify those at risk for inflammation and the development of cardiometabolic disease.
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, NC althomps@email.unc.edu.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Thompson
authors.affiliation: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Koehler
authors.affiliation: Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Amy H
authors.initials: AH
authors.lastname: Herring
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Lauren
authors.initials: L
authors.lastname: Paynter
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Shufa
authors.initials: S
authors.lastname: Du
authors.affiliation: National Institute for Nutrition and Health, China Center for Disease Control, Beijing, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Barry
authors.initials: B
authors.lastname: Popkin
authors.affiliation: Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.
authors.forename: Penny
authors.initials: P
authors.lastname: Gordon-Larsen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People; D002097:C-Reactive Protein / Q000276:immunology*; D002681:China; D018450:Disease Progression; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009749:Nutrition Surveys; D009765:Obesity / Q000276:immunology*; D050177:Overweight / Q000276:immunology; D012737:Sex Factors; D015430:Weight Gain / Q000276:immunology*; D055815:Young Adult
chemical_list: D002097:C-Reactive Protein
keywords: inflammation; latent‐class trajectory analysis; obesity; weight gain