Abstract 11205: Weight Gain in Infancy is a Key Determinant of Obesity, Blood Pressure and Arterial Thickening in Later Childhood

Abstract

Introduction: Obesity and vascular risk factors in mid and late childhood are significant predictors of adult risk of cardiovascular events. The determinants of early postnatal weight gain, from 0-18 months, and the relationship of early weight gain to atherogenic risk factors in later childhood, are not well characterized.

Hypothesis: We assessed the hypothesis that early weight gain is an important predictor of overweight/obesity, higher blood pressure, systemic inflammation and arterial wall thickening, in later childhood.

Methods: We analyzed data from 395 non-diabetic children recruited antenatally, with complete data for early weight gain and arterial wall thickness at age 8-years. To account for differences in weight gain due to height, we adjusted early weight gain for height gain over the same period.

Results: Independent predictors of early weight gain included male gender (0.378 kg [SE 0.104], P<0.001), fewer weeks gestation (-0.118 kg [SE 0.044] per week, P=0.007), birth length (0.158 kg [SE 0.024] per cm, P<0.001), and failure to breastfeed to 6-months of age (0.499 kg [SE 0.108], P<0.001). Early weight gain was significantly associated with later childhood overweight (OR= 1.65 [95% CI 1.25, 2.18] per kg) and obesity (OR= 2.06 [95% CI 1.52, 2.77] per kg), excess central adiposity (OR= 1.53 [95% CI 1.19, 1.96] per kg), higher systolic blood pressure (1.19 mm Hg [SE 0.33] per kg, P<0.001), higher C-reactive protein (0.16 mg/dL [SE 0.06] per 100% increase in weight gain, P=0.007) and greater carotid intima-media thickness (figure). The association with carotid intima-media thickness was independent of childhood BMI (0.010 mm [SE 0.004] per kg, P=0.02).

Conclusion: Early weight gain between 0-18 months is a significant predictor of later childhood overweight and obesity, excess central adiposity, and greater arterial wall thickness.