Identification of early, modifiable predictors of cardiometabolic risk and impacts of family-based stress on child obesity
MetadataShow full item record
Childhood obesity puts children at risk for chronic metabolic diseases. Identification of weight-related risk factors in childhood is important to prevent adult cardiovascular disease (CVD). This dissertation evaluates risk factors for adolescent obesity and dyslipidemia. Multivariable regression analyses of data from black and white girls in the National Growth and Health Study (n=2,379) were used to identify predictors of these cardiometabolic risks (CMR). The first aim was to compare the impact of different measures of early adolescent adiposity (body mass index, BMI; waist circumference, WC; waist-to-hip ratio, WHR; percent body fat from bioelectrical impedance, %BF) as predictors of later adolescent lipid levels. Black girls had significantly lower pre-adolescent %BF (23.6% vs. 26.4%) than whites, but gained fat more rapidly (34.7% vs. 14.0% increases), exceeding whites in %BF by late adolescence. WC was a stronger predictor of subsequent low-density lipoprotein (LDL) levels than other measures of body composition (LDL difference between WC of highest and lowest quintiles: 29.5 mg/dL, whites; 17.9 mg/dL, blacks). Regardless of race, BMI was associated with lower levels of high-density lipoprotein (HDL), and higher levels of LDL, TG, and TG/HDL (triglyceride to HDL ratio). The second aim compared pre- and post-menarche measures of early adolescent body fat as determinants of later LDL, HDL, TG, and TG/HDL. BMI measures post-menarche were generally better predictors of later lipids in white girls compared with pre-menarche measures, while pre- and post-menarche BMI measures were equally good as predictors of later lipid levels in black girls. The third aim examined the role of maternal depressive symptoms as a risk factor for increased BMI among daughters. Daughters of mothers with higher depression scores had greater BMI increases throughout adolescence (p<0.0001), and a late adolescent BMI that was 0.88 kg/m2 higher than those of mothers with lower depression scores. These findings underline the importance of monitoring early physical and psychosocial CMR factors during adolescence to prevent CVD risk.
RightsAttribution-NonCommercial-NoDerivatives 4.0 International