medwireNews: A small number of clinical predictors and blood metabolites at birth may accurately predict which infants will have a BMI trajectory leading to overweight or obesity, a study suggests.
“In this study, the first year after birth seemed to be an important period closely associated with childhood overweight/obesity”, write the researchers in The Journal of Clinical Endocrinology & Metabolism.
Yongjun Zhang (Shanghai Jiao Tong University, China) and co-researchers included data from two prospective cohorts – one with data on 848 infants followed up to 2 years of age and the other on 22,691 monitored to the age of 7 years.
Across the two cohorts, the researchers identified four to five dominant growth trajectories, with marked changes – either increases or decreases from birth BMI – that occurred during the first year of life. Thereafter, BMI remained relatively stable.
Although birth BMI was initially associated with overweight or obesity at the age of 7 years, this association disappeared after accounting for BMI at the age of 1 year, highlighting the importance of these early BMI changes.
The only growth trajectory to be independently associated with overweight or obesity at the age of 2 years (not significantly) or 7 years (significantly) was the “accelerative” trajectory, where infants with a relatively high birth BMI, at around the 60th to 80th percentile, had a further increase to about the 80th to 95th percentile. This pattern was observed in 13–14% of infants across the two cohorts.
The researchers found a number of differences in blood metabolites during the first 7 days of life between infants with an accelerative growth trajectory and those with other trajectories.
Specifically, the metabolites tyrosine, glycine, octenoylcarnitine (C8:1) and stearoylcarnitine (C18), when combined with three clinical predictors – sex, birthweight and maternal prepregnancy BMI – were highly predictive of an accelerative growth trajectory. The sensitivity was 83.3% and the specificity 81.1%, and the positive and negative predictive values were 41.7% and 96.8%, respectively.
Zhang and team note that “blood metabolite tests are not always available in clinics/centers in many parts of the world”, but highlight that the three clinical predictors performed well, with a sensitivity of 85.0%, a specificity of 60.1% and positive and negative predictive values of 22.4% and 96.7%, respectively.
“Accurately predicting infants who are likely to have accelerative BMI trajectories may be helpful to identify children at risk as early as possible, so that prompt intervention can begin before overweight/obesity becomes evident”, conclude the researchers.
“Healthcare professionals and parents need to become aware of BMI growth patterns during this critical period.”
By Eleanor McDermid
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