title: Long-term Impact of Temporal Sequence from Childhood Obesity to Hyperinsulinemia on Adult Metabolic Syndrome and Diabetes: The Bogalusa Heart Study.
abstract: This study aims to delineate the temporal relations between body mass index (BMI) and insulin in childhood and their impact on adult metabolic syndrome (MetS) and type 2 diabetes mellitus (T2DM).The longitudinal cohort consisted of 609 whites and 339 blacks who had BMI and fasting insulin measured twice in childhood (mean age = 10.5 years at baseline and 15.9 years at follow-up). Incident MetS and T2DM were identified in adulthood (mean age = 30.5 years). Cross-lagged panel and mediation analysis models were used. After adjusting for age, race, gender, and follow-up years, the cross-lagged path coefficient of BMI → insulin (β = 0.326, p < 0.001) was significantly greater than that of insulin → BMI (β = -0.023, p = 0.207) in childhood, with p < 0.001 for the difference in βs. The path coefficient for BMI → insulin was significantly greater in MetS than in non-MetS groups (0.510 vs 0.190, p < 0.001), and greater in hyperglycemia than in normoglycemia groups (0.503 vs 0.285, p = 0.026). The mediation effect of childhood insulin on the BMI-MetS and BMI-hyperglycemia associations was estimated at 19.2% (p < 0.001) and 18.3% (p < 0.001), respectively. These findings provide evidence that higher BMI levels precede hyperinsulinemia during childhood, and this one-directional relation plays a significant role in the development of MetS and T2DM in adult life.
authors.affiliation: Department of Biostatistics, School of Public Health, Shandong University, Jinan, China.|Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Tao
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.|Department of Endocrinology and Metabolism, the First Hospital of Xiamen, Xiamen University, Xiamen, China.
authors.forename: Huijie
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.|Department of Nutrition and Food Hygiene, School of Public Health, Harbin Medical University, Harbin, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Shengxu
authors.initials: S
authors.lastname: Li
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Camilo
authors.initials: C
authors.lastname: Fernandez
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Lydia
authors.initials: L
authors.lastname: Bazzano
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Jiang
authors.initials: J
authors.lastname: He
authors.affiliation: Department of Biostatistics, School of Public Health, Shandong University, Jinan, China.
authors.forename: Fuzhong
authors.initials: F
authors.lastname: Xue
authors.affiliation: Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA, USA.
authors.forename: Wei
authors.initials: W
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000704:Analysis of Variance; D044383:Black People; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D008875:Middle Aged; D063766:Pediatric Obesity / Q000097:blood / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D044465:White People
chemical_list: D001786:Blood Glucose; D007328:Insulin