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Comparing BMI with skinfolds to estimate age at adiposity rebound and its associations with cardio-metabolic risk markers in adolescence

Comparing BMI with skinfolds to estimate age at adiposity rebound and its associations with cardio-metabolic risk markers in adolescence
Comparing BMI with skinfolds to estimate age at adiposity rebound and its associations with cardio-metabolic risk markers in adolescence

Background: Body mass index (BMI) reaches a nadir in mid-childhood, known as the adiposity rebound (AR). Earlier AR is associated with a higher risk of cardio-vascular diseases in later life. Skinfolds, which are a more direct measure of adiposity, may give better insight into the relationship between childhood adiposity and later obesity and cardio-metabolic risk. 

Objective: We aimed to assess whether AR corresponds to a rebound in skinfolds, and compare associations of BMI-derived AR and skinfold-derived AR with cardio-metabolic risk markers in adolescence. 

Methods: We used penalised splines with random coefficients to estimate BMI and skinfold trajectories of 604 children from the Mysore Parthenon Birth Cohort. Age at AR was identified using differentiation of the BMI and skinfold growth curves between 2 and 10 years of age. At 13.5 years, we measured blood pressure, and glucose, insulin and lipid concentrations. 

Results: BMI and skinfolds had different growth patterns. Boys reached BMI-derived AR earlier than skinfold-derived AR (estimated difference: 0.41 years; 95% CI:[0.23, 0.56]), whereas the opposite was observed in girls (estimated difference: −0.71 years; 95% CI:[−0.90, −0.54]). At 13.5 years, children with earlier BMI-derived AR had higher BMI (−0.58 SD per SD increase of AR; 95%CI:[−0.65, −0.52]), fat mass (−0.44; 95%CI:[−0.50, −0.37]), insulin resistance (HOMA-IR: −0.20; 95%CI:[−0.28, −0.12]) and systolic blood pressure (−0.20; 95%CI:[−0.28, −0.11]), and lower HDL-cholesterol (0.12; 95%CI:[0.04, 0.21]). The associations were independent of BMI at time of rebound, but were fully explained by fat mass at 13.5 years. Similar associations were found for skinfold-derived AR. 

Conclusion: BMI-derived adiposity rebound predicts later cardio-metabolic risk markers similarly to that derived from skinfolds, a direct measure of adiposity.

0307-0565
683-690
Di Gravio, Chiara
4033fc31-5d17-4329-b741-aee8ba31d971
Krishnaveni, G.V.
eb73f522-17b0-4aa9-a7c7-df0014ced8c3
Somashekara, R.
163434c9-e4b2-4847-92cc-9e24c6341d6c
Veena, S.R.
379349f3-cee7-4a58-93b2-1caa5271118e
Kumaran, K.
de6f872c-7339-4a52-be84-e3bbae707744
Krishna, Murali
323774b9-e195-4608-8aa2-adb3d16f4637
Karat, S.C.
6d394c4d-6f7a-43eb-b53b-e03b6be85a0c
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18
Di Gravio, Chiara
4033fc31-5d17-4329-b741-aee8ba31d971
Krishnaveni, G.V.
eb73f522-17b0-4aa9-a7c7-df0014ced8c3
Somashekara, R.
163434c9-e4b2-4847-92cc-9e24c6341d6c
Veena, S.R.
379349f3-cee7-4a58-93b2-1caa5271118e
Kumaran, K.
de6f872c-7339-4a52-be84-e3bbae707744
Krishna, Murali
323774b9-e195-4608-8aa2-adb3d16f4637
Karat, S.C.
6d394c4d-6f7a-43eb-b53b-e03b6be85a0c
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18

Di Gravio, Chiara, Krishnaveni, G.V., Somashekara, R., Veena, S.R., Kumaran, K., Krishna, Murali, Karat, S.C. and Fall, Caroline H.D. (2019) Comparing BMI with skinfolds to estimate age at adiposity rebound and its associations with cardio-metabolic risk markers in adolescence. International Journal of Obesity, 43 (4), 683-690. (doi:10.1038/s41366-018-0144-8).

Record type: Article

Abstract

Background: Body mass index (BMI) reaches a nadir in mid-childhood, known as the adiposity rebound (AR). Earlier AR is associated with a higher risk of cardio-vascular diseases in later life. Skinfolds, which are a more direct measure of adiposity, may give better insight into the relationship between childhood adiposity and later obesity and cardio-metabolic risk. 

Objective: We aimed to assess whether AR corresponds to a rebound in skinfolds, and compare associations of BMI-derived AR and skinfold-derived AR with cardio-metabolic risk markers in adolescence. 

Methods: We used penalised splines with random coefficients to estimate BMI and skinfold trajectories of 604 children from the Mysore Parthenon Birth Cohort. Age at AR was identified using differentiation of the BMI and skinfold growth curves between 2 and 10 years of age. At 13.5 years, we measured blood pressure, and glucose, insulin and lipid concentrations. 

Results: BMI and skinfolds had different growth patterns. Boys reached BMI-derived AR earlier than skinfold-derived AR (estimated difference: 0.41 years; 95% CI:[0.23, 0.56]), whereas the opposite was observed in girls (estimated difference: −0.71 years; 95% CI:[−0.90, −0.54]). At 13.5 years, children with earlier BMI-derived AR had higher BMI (−0.58 SD per SD increase of AR; 95%CI:[−0.65, −0.52]), fat mass (−0.44; 95%CI:[−0.50, −0.37]), insulin resistance (HOMA-IR: −0.20; 95%CI:[−0.28, −0.12]) and systolic blood pressure (−0.20; 95%CI:[−0.28, −0.11]), and lower HDL-cholesterol (0.12; 95%CI:[0.04, 0.21]). The associations were independent of BMI at time of rebound, but were fully explained by fat mass at 13.5 years. Similar associations were found for skinfold-derived AR. 

Conclusion: BMI-derived adiposity rebound predicts later cardio-metabolic risk markers similarly to that derived from skinfolds, a direct measure of adiposity.

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Accepted/In Press date: 18 May 2018
e-pub ahead of print date: 13 July 2018
Published date: April 2019

Identifiers

Local EPrints ID: 422607
URI: http://eprints.soton.ac.uk/id/eprint/422607
ISSN: 0307-0565
PURE UUID: 6872b1a0-e876-4263-8165-49338ffb4b56
ORCID for Caroline H.D. Fall: ORCID iD orcid.org/0000-0003-4402-5552

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Date deposited: 26 Jul 2018 16:30
Last modified: 16 Mar 2024 02:38

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Contributors

Author: Chiara Di Gravio
Author: G.V. Krishnaveni
Author: R. Somashekara
Author: S.R. Veena
Author: K. Kumaran
Author: Murali Krishna
Author: S.C. Karat

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