Timing and tempo of first-year rapid growth in relation to cardiovascular and metabolic risk profile in early adulthood
Context: Growth during infancy appears to be an important determinant of cardiovascular disease and type 2 diabetes later in life. Objectives: To specify which period in the first year of life is related to determinants of cardiovascular disease and type 2 diabetes in early adulthood and to investigate the association between tempo of first-year weight gain (>0.67 SDs) and these determinants. Design, Setting, and Participants: Observational study using longitudinal data collected in the Programming Factors for Growth and Metabolism (PROGRAM) study of 217 healthy participants, aged 18 to 24 years, including a relatively large sample of participants born small for gestational age and participants with short stature, performed at a medical center in the Netherlands between August 2004 and September 2007. The association of cardiovascular disease and type 2 diabetes with tempo of weight gain was assessed in a subgroup of 87 participants. Main Outcome Measures: Associations between periods of first-year growth and tempo of weight gain and determinants of cardiovascular disease and type 2 diabetes in early adulthood. Results: Weight gain in the first 3 months of life was inversely associated with insulin sensitivity (β, -0.223; 95% confidence interval [CI], -0.386 to -0.060) and serum high-density lipoprotein cholesterol level (β, -0.053; 95% CI, -0.090 to -0.016) and positively associated with waist circumference (β, 1.437; 95% CI, 0.066 to 2.808), acute insulin response (β, 0.210; 95% CI, 0.024 to 0.395), ratio of total cholesterol to high-density lipoprotein cholesterol (β, 0.052; 95% CI, 0.010 to 0.094), and level of triglycerides (β, 0.066; 95% CI, 0.003 to 0.129) in early adulthood. Rapid weight gain during the first 3 months of life resulted in a higher percentage of body fat, more central adiposity, and reduced insulin sensitivity in early adulthood than when slower weight gain occurred during the entire first year. Conclusion: Rapid weight gain in the first 3 months of life is associated with several determinants of cardiovascular disease and type 2 diabetes in early adulthood.