Background: Growth patterns in infancy and early childhood have been linked to risks of obesity and cardiometabolic disorders in adulthood. Body fat partitioning, particularly increased fat accumulation at ectopic sites, has been strongly associated with cardiometabolic disorders. However, the lack of precise body composition measures in prior longitudinal birth-cohort studies has made it difficult to ascertain if early growth patterns could result in consolidation of distinct body fat partitioning phenotypes later in childhood, which could in turn track to adulthood.
Objective: In this study, we evaluated differences in body fat depots in 4.5-year-old children who had grown along different BMI trajectories in their first 2 years of life.
Method: Study participants were from the Growing Up in Singapore Towards Healthy Outcomes (GUSTO) mother-child birth cohort (n=1170). Using latent class growth mixture modeling of BMI-for-age z-scores in the first two years of life, we previously identified 4 distinct trajectories: stable low, normal, stable high and rapid gain after 3 months. In a subset of 335 children (244 normal, 45 stable low, 29 stable high and 17 rapid gain), MR imaging and spectroscopy at 4.5 years was used to quantify subcutaneous adipose tissue (SAT), intra-abdominal adipose tissue (IAT), liver fat and intramyocellular lipids (IMCL). Differences in fat depots across the 4 infant BMI trajectory classes were adjusted for ethnicity, sex, maternal education, maternal BMI at booking in the first trimester, maternal age, parity, gestational fasting glucose, rate of gestational weight gain, gestational age, and breastfeeding duration.
Results: Compared to the normal trajectory, IMCL levels were significantly higher among children in the rapid gain trajectory [adjusted difference (AD)=0.23% of water signal; 95%CI: 0.05, 0.41]. SAT volumes were significantly higher in the rapid gain (AD=679.8 ml, 95%CI: 443.9, 915.8) and stable high (AD=172.9 ml, 95%CI: 17.4, 328.4), and lower in the stable low (AD=-256.8 ml, 95%CI: −398.1, −115.5) trajectories. IAT volumes were significantly elevated in the rapid gain (AD=125.8 ml, 95%CI: 76.9, 174.7) and lower in the stable low (AD=−34.5 ml, 95%CI: −63.8, −5.2) trajectories. No statistically significant ADs were observed in liver fat among the trajectory classes.
Conclusion: Characterizing the dynamic aspects of early growth patterns using BMI trajectories revealed distinct body fat partitioning phenotypes even in early childhood, with a significant elevation in the pathogenic IAT and IMCL depots in the rapid gain group. These pathogenic depots could mediate future cardiometabolic risk.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology