Linear Growth and Fat and Lean Tissue Gain during Childhood: Associations with Cardiometabolic and Cognitive Outcomes in Adolescent Indian Children

BackgroundWe aimed to determine how linear growth and fat and lean tissue gain during discrete age periods from birth to adolescence are related to adolescent cardiometabolic risk factors and cognitive ability.MethodsAdolescents born to mothers with normal glucose tolerance during pregnancy from an Indian birth cohort (N = 486, age 13.5 years) had detailed anthropometry and measurements of body fat (fat%), fasting plasma glucose, insulin and lipid concentrations, blood pressure and cognitive function. Insulin resistance (HOMA-IR) was calculated. These outcomes were examined in relation to birth measurements and statistically independent measures (conditional SD scores) representing linear growth, and fat and lean tissue gain during birth-1, 1–2, 2–5, 5–9.5 and 9.5–13.5 years in 414 of the children with measurements at all these ages.ResultsBirth length and linear growth at all ages were positively associated with current height. Fat gain, particularly during 5–9.5 years was positively associated with fat% at 13.5 years (0.44 SD per SD [99.9% confidence interval: 0.29,0.58]). Greater fat gain during mid-late childhood was associated with higher systolic blood pressure (5–9.5 years: 0.23 SD per SD [0.07,0.40]) and HOMA-IR (5–9.5 years: 0.24 [0.08,0.40], 9.5–13.5 years: 0.22 [0.06,0.38]). Greater infant growth (up to age 2 years) in linear, fat or lean components was unrelated to cardiometabolic risk factors or cognitive function.ConclusionThis study suggests that factors that increase linear, fat and lean growth in infancy have no adverse cardiometabolic effects in this population. Factors that increase fat gain in mid-late childhood may increase cardiometabolic risk, without any benefit to cognitive abilities.**研究背景**：本研究旨在明确从出生至青春期的各离散年龄段中，线性生长、脂肪组织与瘦组织的积累与青少年心血管代谢危险因素及认知能力之间的关联。**研究方法**：本研究纳入来自印度出生队列、母亲妊娠期间糖耐量正常的青少年受试者（N=486，年龄13.5岁），对其开展详细人体测量，检测体脂率（fat%）、空腹血浆葡萄糖、胰岛素及血脂浓度、血压与认知功能，并计算稳态模型胰岛素抵抗指数（HOMA-IR）。本研究针对414名在上述所有年龄段均完成测量的儿童，分析其出生测量指标、各离散年龄段（出生至1岁、1~2岁、2~5岁、5~9.5岁及9.5~13.5岁）的线性生长、脂肪与瘦组织积累的统计学独立指标（条件标准差评分）与上述结局指标的关联。**研究结果**：出生身长及各年龄段的线性生长均与当前身高呈正相关。脂肪积累（尤其在5~9.5岁期间）与13.5岁时的体脂率呈正相关（每1个标准差的脂肪积累对应0.44个标准差的体脂率升高，99.9%置信区间：0.29~0.58）。儿童中晚期的脂肪积累更多与更高的收缩压（5~9.5岁：每1个标准差的脂肪积累对应0.23个标准差的收缩压升高，99.9%置信区间：0.07~0.40）及稳态模型胰岛素抵抗指数（HOMA-IR）相关（5~9.5岁：0.24，99.9%置信区间：0.08~0.40；9.5~13.5岁：0.22，99.9%置信区间：0.06~0.38）。婴儿期（2岁以内）线性、脂肪或瘦组织维度的生长更快，与心血管代谢危险因素或认知功能均无关联。**研究结论**：本研究表明，在该队列人群中，促进婴儿期线性生长、脂肪与瘦组织积累的因素不会对心血管代谢产生不良影响；而促进儿童中晚期脂肪积累的因素可能升高心血管代谢风险，且对认知能力无任何益处。