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A Dyadic Growth Modeling Approach for Examining Associations Between Weight Gain and Lung Function Decline.

ABSTRACT: The relationship between body weight and lung function is complex. Using a dyadic multilevel linear modeling approach, treating body mass index (BMI; weight (kg)/height (m)2) and lung function as paired, within-person outcomes, we tested the hypothesis that persons with more rapid increase in BMI exhibit more rapid decline in lung function, as measured by forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio (FEV1:FVC). Models included random intercepts and slopes and adjusted for sociodemographic and smoking-related factors. A sample of 9,115 adults with paired measurements of BMI and lung function taken at ≥3 visits were selected from a pooled set of 5 US population-based cohort studies (1983-2018; mean age at baseline = 46 years; median follow-up, 19 years). At age 46 years, average annual rates of change in BMI, FEV1, FVC, and FEV1:FVC ratio were 0.22 kg/m2/year, -25.50 mL/year, -21.99 mL/year, and -0.24%/year, respectively. Persons with steeper BMI increases had faster declines in FEV1 (r = -0.16) and FVC (r = -0.26) and slower declines in FEV1:FVC ratio (r = 0.11) (all P values < 0.0001). Results were similar in subgroup analyses. Residual correlations were negative (P < 0.0001), suggesting additional interdependence between BMI and lung function. Results show that greater rates of weight gain are associated with greater rates of lung function loss.

SUBMITTER: Cornelius T

PROVIDER: S-EPMC7670871 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundEpidemiologic studies investigating prenatal exposures in relation to growth typically rely on cumulative growth measures such as weight or BMI. However, less is known about how prenatal exposure may impact other aspects of growth dynamics, including timing and velocity.ObjectivesTo describe and apply a nonlinear growth model previously used in other health science fields to characterize postnatal growth trajectories for use in environmental epidemiology studies.MethodsWe used a double logistic function to model child weight trajectories from birth to 5.5 years using data from the Swedish Environmental Longitudinal Mother and Child, Asthma and Allergy (SELMA) study. From this, we approximated several infant growth metrics: 1) duration of time needed to complete 90% of the infant growth spurt (?t1), 2) the maximum growth rate in infancy or infant peak growth velocity (PGV), 3) the age at infant PGV (?1), a measure of growth tempo, and 4) the weight plateau at the end of the infant growth spurt (?1). We assessed these metrics in relation to prenatal perfluorooctanoic acid (PFOA) exposure among 1334 mother-child pairs, and differences between boys and girls.ResultsAverage estimated infant PGV and its timing (?1) were 0.68 kg/month and 3.4 months, respectively. Mean infant growth spurt duration (?t1) was 13 months, ending at an average weight plateau (?1) of 8.2 kg. Higher prenatal PFOA concentrations were related to a longer duration of infant growth (?t1: 0.06; 95% CI = 0.01, 0.11). PGV was not impacted, but higher prenatal PFOA concentrations were significantly related to delayed infant PGV (?1: 0.58; 95% CI = 0.17, 0.99) and a higher post-spurt weight plateau (?1: 0.81; 95% CI = 0.21, 1.41). After adjusting for false discovery, results were only significant for ?1 and ?1. We observed a significant interaction by sex for the association with ?1, and stratified analyses revealed the association was only significant among girls.ConclusionModel-derived growth metrics were consistent with published growth standards. This novel application of nonlinear growth modeling enabled detection of altered infant growth dynamics in relation to prenatal PFOA exposure. Our results may help describe how PFOA yields lower birthweights, but higher weight later in childhood. Future applications may characterize adolescent growth or additional metrics of biological interest.

Project description:Background:Excessive gestational weight gain and rapid infancy weight gain (RIWG) are associated with increased susceptibility to childhood obesity. Since low-income and minority children are particularly at risk, investigation of the associations between gestational weight gain and rate of infancy weight gain may inform childhood obesity prevention. This study investigated the associations between gestational weight gain and rate of infancy weight gain during the first four to six months postpartum in participants from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) in Hawai'i and Puerto Rico. Methods:This was a cross-sectional secondary data analysis from a text message-based intervention in WIC participants in Hawai'i and Puerto Rico. The analysis included 80 mother/infant pairs from the control group who completed the follow-up visit when infants were four to six months old. Maternal weight, height, and gestational weight gain were self-reported. Infant weight was measured at baseline and follow-up. A proportional odds model was used to investigate the association between gestational weight gain and infancy weight gain rate (rapid or extremely rapid, on-track, or slow), adjusting for maternal age, pregravid body mass index (BMI) status, parity, and being up-to-date with infant vaccinations. Results:In comparison to recommended gestational weight gain, excessive and inadequate (under the recommended amount) gestational weight gain was associated with 77% decreased (adjusted odds ratio [AOR]?=?0.23; 95% confidence interval [CI]?=?0.08, 0.70; p?=?0.01) and 71% decreased (AOR?=?0.29; 95% CI?=?0.09, 0.94; p?=?0.04) odds of RIWG versus on-track or slow infant weight gain, respectively. In comparison to women with one child, women with two children (AOR?=?0.31; 95% CI?=?0.11, 0.87; p?=?0.03) or three or four children (AOR?=?0.24; 95% CI?=?0.07, 0.88; p?=?0.03) had significantly lower odds of RIWG versus on-track or slow infancy weight gain. Conclusions:Women with excessive or inadequate gestational weight gain had lower proportional odds of RIWG and were more likely to have slower infant weight gain than women who gained the recommended amount of weight. Trial registration:ClinicalTrials.gov Identifier; NCT02903186; September 16, 2016.

Project description:Weight management strategies during pregnancy reduce child cardiometabolic risk. However, because maternal weight has an overall positive correlation with offspring bone mass, pregnancy weight management could adversely affect child bone health. We aimed to estimate associations between gestational weight gain (GWG) and bone mineralization in the offspring at 7 years of age, and test early pregnancy body mass index (BMI) as an effect modifier. We analyzed prospective data from 2167 mother-child pairs from the Generation XXI birth cohort who underwent whole-body dual-energy X-ray absorptiometry at 7 years of age. GWG was analyzed as a continuous measure and using the Institute of Medicine categories. In the whole sample and for each early pregnancy BMI category (under/normal weight and overweight/obese), relationships between GWG and offspring bone measures (bone mineral content [BMC], bone areal density [aBMD], size-corrected BMC [scBMC], and height) at 7 years were fitted through local polynomial regression and smoothing splines. The magnitude of associations was estimated through linear regression coefficients (95% CIs), crude and adjusted for maternal age, height, educational level, and child gestational age. In under/normal weight mothers, GWG was associated with slightly increased bone measures at 7 years (per 5 kg of GWG, BMC: 0.07 SD [95% CI, 0.01 to 0.12]; aBMD: 0.10 SD [95% CI, 0.05 to 0.15], scBMC: 0.11SD [95% CI, 0.06 to 0.16], and height: 0.05 SD [95% CI, 0.00 to 0.10]), while in overweight/obese mothers no effect of GWG on bone was observed (BMC: 0.02 SD [95% CI, -0.04 to 0.09]; aBMD: 0.02 SD [95% CI, -0.04 to 0.08], scBMC: 0.01 SD [95% CI, -0.06 to 0.08], and height: 0.02 SD [95% CI, -0.04 to 0.08]). Also, no advantageous effect of gaining weight above the Institute of Medicine recommendations was observed in either early pregnancy BMI group. Our results suggest that adherence to Institute of Medicine recommendations for pregnancy weight gain is unlikely to have a negative repercussion on offspring bone health, particularly in women with excess weight in early pregnancy. © 2018 American Society for Bone and Mineral Research.

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A Dyadic Growth Modeling Approach for Examining Associations Between Weight Gain and Lung Function Decline.

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