Research Article: Association of anthropometric measures and cardiovascular risk factors in children and adolescents: Findings from the Aboriginal Birth Cohort study

Date Published: June 21, 2018

Publisher: Public Library of Science

Author(s): Angela Gialamas, Angela Kinnell, Murthy N. Mittinty, Belinda Davison, Gurmeet Singh, John Lynch, Yan Li.

http://doi.org/10.1371/journal.pone.0199280

Abstract

This study examined the association of anthropometric measures including height, leg length, trunk length and body mass index (BMI) at 11 and 18 years with systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol, low-density lipoprotein cholesterol (LDL-c) and high-density lipoprotein cholesterol (HDL-c) at 11 and 18 years. We analysed data from 661 participants from the Aboriginal Birth Cohort study–a longitudinal study based in the Northern Territory, Australia. Associations between anthropometric measures and cardiovascular risk factors were investigated in linear regression analyses adjusted for confounding, with imputation for missing data. In adjusted analyses, increasing leg length [males: 0.47mmHg/cm (0.23, 0.72); females: 0.50mmHg/cm (0.18, 0.83)], trunk length [males: 0.50mmHg/cm (0.28, 0.73); females: 0.57mmHg/cm (0.33, 0.81)] and height [males: 0.32mmHg/cm (0.16, 0.48); females: 0.32mmHg/cm (0.12, 0.52)] at 11 years was associated with higher SBP at 11 years. When these exposures were measured at 18 years the effect on SBP at 18 years had attenuated, and only increased trunk length was associated with higher SBP at 18 years for both sexes [males: 0.46mmHg/cm (0.05, 0.87); females: 0.69mmHg/cm (0.30, 1.08)]. We observed little association between height, leg length and trunk length and DBP, total cholesterol, LDL-c and HDL-c. Increased BMI was associated with elevated SBP and DBP at 11 and 18 years. Our findings suggest that height, leg length, and trunk length measured at 11 and 18 years was generally not associated with cardiovascular risk factors at 11 and 18 years. However, greater childhood BMI was associated with higher blood pressure and this association persisted into adolescence. This study contributes to the limited body of evidence on the association between measures of early anthropometry and cardiovascular risk among the Australian Aboriginal population.

Partial Text

Numerous studies in western countries have found that greater adult height and, in particular longer legs, has been associated with lower pulse pressure, systolic blood pressure, and decreased risk for cardiovascular disease (CVD) and death [1–6]. However, evidence that childhood height and its components (leg length and trunk length) are associated with adult outcomes has been less clear. For instance, analyses of deaths occurring up to 1995 from the Boyd Orr cohort (n = 2990) found that greater childhood height and leg length was associated with decreasing risk of cardiovascular mortality [7]. In contrast, a later study of the Boyd Orr cohort (n = 2642) that included more death data than the previous publication, found no association between childhood height, leg length and trunk length with all cause, all cardiovascular, ischaemic heart disease (IHD),stroke mortality and self-reported IHD [8].

Characteristics of the study participants at birth, at the childhood and adolescent visit are shown in Table 1 (results for the response sample are shown in S5 Table). The mean age of children at the childhood visit was 11.4 years (range, 8.8–14.0 years) and 18.3 years (range, 15.5–21.2 years) at the adolescent visit. At 11 years SBP was similar for both sexes (107.8 vs 107.6 mmHg), but by age 18 males had higher SBP than females (113.2 vs 107.1 mmHg). DBP, cholesterol, LDL-c and HDL-c was similar for both sexes at 11 and 18 years. Mean WHO BMI z-scores were -0.66 (S.D. 1.6) and -0.55 (S.D. 1.6) for males and -0.40 (S.D. 1.5) and -0.24 (S.D 1.5) for females at 11 and 18 years respectively.

Our study adds to the literature in this area by examining associations between aspects of early life anthropometry and CVD risk factors in an Aboriginal birth cohort whose childhoods were largely spent in rural and remote areas of Northern Australia. We find little evidence to support the hypothesis that aspects of growth at early ages including birth weight, birth length, height, leg length, and trunk length measured at 11 and 18 years was consistently associated with cardiovascular risk factors such as SBP, DBP, total cholesterol, LDL-c and HDL-c at 11 and 18 years. Our study demonstrated that increasing leg length, trunk length, and height measured at 11 years was associated with higher SBP at 11 years in both sexes, but when these exposures were measured at 18 years the effect on SBP at 18 years had attenuated, and only increased trunk length measured at 18 was associated with higher SBP at 18 years for males, and SBP and DBP for females. However, greater childhood BMI was associated with higher SBP and DBP for males and females, and this association persisted into adolescence.

We found that birth weight, birth length, height, leg length, and trunk length measured at 11 and 18 years was generally not associated with cardiovascular risk factors at 11 and 18 years among an Aboriginal population. However, increased BMI was consistently associated with increased SBP and DBP in both sexes. This study contributes to the limited body of evidence on the association between measures of early anthropometry and cardiovascular risk among the Australian Aboriginal population.

 

Source:

http://doi.org/10.1371/journal.pone.0199280

 

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