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Potential selection effects when estimating associations between the infancy peak or adiposity rebound and later body mass index in children
Biometry and Data Management, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
Unit of Epidemiology and Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy.
Research and Education Institute of Child Health, Strovolos, Cyprus.
Department of Pediatrics, University of Pécs, Pécs, Hungary.
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2017 (English)In: International Journal of Obesity, ISSN 0307-0565, E-ISSN 1476-5497, Vol. 41, no 4, 518-526 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION:This study aims to evaluate a potential selection effect caused by exclusion of children with non-identifiable infancy peak (IP) and adiposity rebound (AR) when estimating associations between age and body mass index (BMI) at IP and AR and later weight status

SUBJECTS AND METHODS: In 4744 children with at least 4 repeated measurements of height and weight in the age interval from 0 to 8 years (37 998 measurements) participating in the IDEFICS (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants)/I.Family cohort study, fractional polynomial multilevel models were used to derive individual BMI trajectories. Based on these trajectories, age and BMI at IP and AR, BMI values and growth velocities at selected ages as well as the area under the BMI curve were estimated. The BMI growth measures were standardized and related to later BMI z-scores (mean age at outcome assessment: 9.2 years).

RESULTS: Age and BMI at IP and AR were not identifiable in 5.4% and 7.8% of the children, respectively. These groups of children showed a significantly higher BMI growth during infancy and childhood. In the remaining sample, BMI at IP correlated almost perfectly (r⩾0.99) with BMI at ages 0.5, 1 and 1.5 years, whereas BMI at AR correlated perfectly with BMI at ages 4-6 years (r⩾0.98). In the total study group, BMI values in infancy and childhood were positively associated with later BMI z-scores where associations increased with age. Associations between BMI velocities and later BMI z-scores were largest at ages 5 and 6 years. Results differed for children with non-identifiable IP and AR, demonstrating a selection effect.

CONCLUSIONS: IP and AR may not be estimable in children with higher-than-average BMI growth. Excluding these children from analyses may result in a selection bias that distorts effect estimates. BMI values at ages 1 and 5 years might be more appropriate to use as predictors for later weight status instead. © 2017 Macmillan Publishers Limited, part of Springer Nature. All rights reserved.

Place, publisher, year, edition, pages
London: Nature Publishing Group, 2017. Vol. 41, no 4, 518-526 p.
Keyword [en]
cohort of European children, growth velocity, fractional polynomial mixed effects model, IDEFICS study, I.Family study
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hh:diva-33158DOI: 10.1038/ijo.2016.218PubMedID: 27899810Scopus ID: 2-s2.0-85006340401OAI: oai:DiVA.org:hh-33158DiVA: diva2:1069489
Projects
The IDEFICS study (Identification and Prevention of Dietary- and Lifestyle-Induced Health Effects in Children and Infants)and I.Family cohort study
Available from: 2017-01-29 Created: 2017-01-29 Last updated: 2017-05-09Bibliographically approved

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CiteExportLink to record
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