Abstract
Background/objectives
Childhood body mass index (BMI) predicts adult glucose homeostasis measures and type 2 diabetes mellitus, but little is known about the predictive utility of other anthropometric measures in childhood. We aimed to identify the anthropometric measure in childhood that best predicts adult glucose homeostasis measures and examine if the combination of additional anthropometric measures further improves predictive utility.
Methods
A 20-year follow-up of children participating in the Childhood Determinants of Adult Health Study (n = 2345, aged 7–15 years at baseline). Baseline anthropometric measures were waist circumference (WC), WC adjusted for height, weight adjusted for height, hip circumference, waist-hip-ratio, waist-height-ratio, BMI, conicity index, abdominal volume index (AVI), body adiposity index, and a body shape index. Fasting glucose and insulin levels measured at follow-up were used to define insulin resistance (HOMA2-IR), low beta-cell function (HOMA2-β), high fasting insulin, and impaired fasting glucose (IFG).
Results
All child anthropometric measures were significantly associated with HOMA2-IR, HOMA2-β, and high fasting insulin (relative risk = 1.12–1.55), but not IFG. AVI had the largest area under receiver-operating curve (AUC) in predicting adult HOMA2-IR (AUC, 95% confidence interval: 0.610, 0.584–0.637), HOMA2-β (0.615, 0.588–0.642) and high fasting insulin (0.613, 0.587–0.639). Combining each additional anthropometric measure with AVI did not appreciably increase predictive utility (an increase of 0.001–0.002 in AUC, p > 0.05 for all).
Conclusions
Anthropometric measures from a single time-point in childhood are associated with insulin-related outcomes 20-year later in adulthood. However, overall predictive utility was low and was not substantially enhanced by combining multiple different child anthropometric measures.
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Acknowledgments
We gratefully acknowledge the contribution of CDAH staff and volunteers, both past and present, in addition to the ongoing commitment of CDAH participants to this study. The baseline study was supported by grants from the Commonwealth Departments of Sport, Recreation and Tourism, and Health; The National Heart Foundation; and the Commonwealth Schools Commission. The follow-up study was funded by grants from the National Health and Medical Research Council (211316), the National Heart Foundation (GOOH 0578), the Tasmanian Community Fund (D0013808) and Veolia Environmental Services. Sponsors included Sanitarium, ASICS and Target. This work was funded by the National Health and Medical Research Council (Grant APP1098369). B.J.F. is supported by the Patricia F. Gordon Scholarship in Medical Research. C.G.M. is supported by a National Heart Foundation of Australia Future Leader Fellowship (100849). Funding bodies and sponsors did not play a role in the study design, collection, analysis, and interpretation of data, in the writing of the manuscript, or the decision to submit the manuscript for publication.
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Wu, F., Ho, V., Fraser, B.J. et al. Predictive utility of childhood anthropometric measures on adult glucose homeostasis measures: a 20-year cohort study. Int J Obes 42, 1762–1770 (2018). https://doi.org/10.1038/s41366-018-0177-z
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DOI: https://doi.org/10.1038/s41366-018-0177-z
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