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Association between Weight Change during Early Life and Metabolic Syndrome Risk Factors among Mexican Young Adults. Flávia C. D. Andrade, PhD a ; Michelle J. de Tavárez , MD a ; Marcela Raffaelli, PhD b ; Margarita Teran -Garcia, PhD c ; Celia Aradillas -Garcia, PhD c

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  1. Association between Weight Change during Early Life and Metabolic Syndrome Risk Factors among Mexican Young Adults FláviaC. D. Andrade, PhDa; Michelle J. de Tavárez, MDa; Marcela Raffaelli, PhDb; Margarita Teran-Garcia, PhDc; Celia Aradillas-Garcia, PhDc aDepartmentof Kinesiology en Community Health, College of Applies Health Sciences, University of Illinois at Urbana-Champaign; bDepartmentof Human and Community development, University of Illinois at Urbana-Champaign; cFoodScience and Human Nutrition, University of Illinois at Urbana-Champaign; dFacultyof Medicine, University Autonomous of San Luis Potosí, San Luis Potosí, Mexico • Table 2 displays the regression coefficients for the association between weight change patterns and each individual component of the MetS according to ATP III. Weight gain in early ages and being constantly overweight or obese was positively associated with increases on SBP, DBP and WC for both males and females. Weight gain in early ages was positively associated with glucose and TG levels. Weight gain in early ages was negatively associated with C_HDL among males and females. • Discussion • Our findings support that, compared to those who were always of normal weight (reference category): • Those who gained weight at early ages or who were constantly overweight/obese had higher levels of systolic and diastolic blood pressure. • Those who were constantly underweight had lower levels of systolic blood pressure. • Those who gained weight or were constantly overweight/obese had larger waist circumference, whereas those constantly underweight had smaller waist circumference. • Those who gained weight at early ages had higher levels of fasting glucose. • Those who gained weight at early ages had lower levels of high density lipoprotein cholesterol and higher levels of triglycerides. • Self-reported weight statuses over the life course may provide valuable information to predict MetS risk particularly in settings where longitudinal data on weight changes are limited, and therefore it can be used to access weight changes and metabolic risk. • Limitations • The cross-sectional study design makes it impossible to establish causality or to determine the direction of effects between weight change and metabolic risk factors. • Our data only included college applicants, thus the study sample is not representative of the general Mexican population. • Weight change patterns were mainly based on self-reported weight status, thus results can be affected by recall bias. • Introduction • The metabolic syndrome (MetS) represents a pre-morbid condition that increases the risk of cardiovascular disease (CVD), type 2 diabetes (T2D), and other chronic diseases.Its prevalence is increasing in developing countries along with the rising on obesity rates.1-10 • By 2006, 55.8% of Mexican young adults aged 20 to 29 years were overweight or obese. Accordingly, the prevalence of MetS was 21.3% in this age group. In a younger cohort of Mexicans aged 18 to 25 years the prevalence of MetS was 10.6%.10-14 • Excessive weight gain during childhood and adolescence increases the likelihood of presenting abnormal lipids profile, higher blood pressure, insulin resistance and hyperglycemia, as well as constitutes a relevant determinant of cardiovascular risk during early adulthood.15-19 • Previous studies have suggested that strategies to limit MetS and cardiovascular risk should address weight gain during childhood. Yet, little is known about the validity of self-reported weigh as a tool to access weigh gain and metabolic risk among Mexican young adults.15, 20 • Methods (Cont.) • Measurements • Anthropometric measurements (weight, height and waist circumference), blood pressure and blood biomarkers were obtained during the visit to the health clinic. • Self-reported weight categories during childhood and adolescence was obtained through survey questionnaire and compared to measured current weight category. • Indicators of metabolic risk: • Data analysis • STATA S.E. 12 • Descriptive statistics and regression analyses were conducted to assess whether weight change patterns predict MetS risk factors. • All analyses were performed separately by gender. • Results • Descriptive statistics are displayed in Table 1. Mean SBP, DBP and WC were higher for males than for females (p<0.001). • Mean FG was slightly higher for males than for females (p<0.001). However, mean C_HDL was 2.9 mg/dLlower for males in comparison to females (p<0.001). TG were 19 mg/dL higher for males than for females (p<0.001). Table 1. Characteristics of MetSa risk factors according to ATP IIIb clinical identification criteria in Mexican young adults, Up Amigos 2009 Table 2. Regression models for the association between weight change patterns and each individual component of the MetSa according to ATP IIIb classification in Mexican young adults, Up Amigos 2009 Aims To assess the association between weight change patterns across childhood, adolescence and into adulthood and metabolic syndrome risk (MetS) factors. Acknowledgements Up Amigos acknowledges the contributions of research staff and study participants. Funding was provided by grants from the UASLP Hormones Laboratory at the School of Medicine, Clinical Biochemistry Laboratory at the Chemical Sciences School, and the University Health Center under agreement support C09-PIFI-030606 (to C. Aradillas-Garcia); the University of Illinois at Urbana-Champaign Research Board (#09070) and Center on Health, Aging, and Disability (to F. Andrade); and the USDA National Institute of Food and Agriculture, Hatch Projects # 600108-793000-793323 (to M. Raffaelli) and # 600109-698000-698354 (to M. Terán-Garcia). • Methods • Data • We analyzed cross-sectional data from a large-scale project—Up Amigos—being conducted in collaboration between the Universidad Autónoma de San Luis Potosí [UASLP] and the University of Illinois at Urbana-Champaign. Participants were applicants to UASLP for the 2009 academic year. • Selection of participants • Recruitment: n = 5,989 participants aged 18 to 25 years • 2,939 males and 3,050 females • Phase 1: n=4,181 • All participants who had 1) survey information, 2) anthropometric measurements and 3) fasting glucose. • Phase 2: n=333 • Subsample of Phase 1 participants with lipids profile. References Simmons, et al. The metabolic syndrome: useful concept or clinical tool? Report of a WHO Expert Consultation. Diabetologia. 2010;53(4):600-5. Eckel, et al. The metabolic syndrome. The Lancet. 2005;365(9468):1415-28. Vgontzas, et al. Sleep apnea is a manifestation of the metabolic syndrome. Sleep medicine reviews. 2005;9(3):211-24. McCullough & Dasarathy. Nonalcoholic fatty liver disease. Textbook of Clinical Gastroenterology and Hepatology, 2 Ed. 2012:658-74. Albu, et al. Impact of obesity during adulthood on chronic disease: diabetes, hypertension, metabolic syndrome, cardiovascular disease, and cancer. Textbook of obesity: biological, psychological and cultural influences. 2012:209-19. Ford, et al. Sedentary behavior, physical activity, and the metabolic syndrome among US adults. Obesity research. 2012;13(3):608-14. Misra& Vikram. Clinical and pathophysiological consequences of abdominal adiposity and abdominal adipose tissue depots. Nutrition. 2003;19(5):457-66. Weiss, et al. Obesity and the Metabolic Syndrome in Children and Adolescents. New England Journal of Medicine. 2004;350(23):2362-74. Cueva, et al. Epidemic of metabolic syndrome in Latin America. Current Opinion in Endocrinology, Diabetes and Obesity. 2011;18(2):134. Cantó, et al. Overweight and obesity in Mexican children under 20 years of age. Bol MedHospInfantMex. 2011;68(1):71-3. Rojas, et al. Metabolic syndrome in Mexican adults. Results from the National Health and Nutrition Survey 2006. SaludPública de México. 2010;52(1):11. Barquera, et al. Obesity and central adiposity in Mexican adults: results from the Mexican National Health and Nutrition Survey 2006. Salud Pública de México. 2009;51(4):595. Aguilar-Salinas, et al. High prevalence of metabolic syndrome in Mexico. Archives of Medical Research. 2004;35(1):76-81. Mosley M. Dietary associations that may reduce metabolic syndrome risk in Mexican young adults. Urbana: University of Illinois at Urbana-Champaign; 2012. Nadeau KJ. Childhood obesity and cardiovascular disease: links and prevention strategies. Nature reviews Cardiology. 2011;8(9):513. SliningMM. Evaluating the Indirect Effect of Infant Weight Velocity on Insulin Resistance in Young Adulthood: A Birth Cohort Study From the Philippines. American Journal of Epidemiology. 2011(Journal Article). Freedman DS, Burke GL, Harsha DW, Srinivasan SR, Cresanta JL, Webber LS, et al. Relationship of changes in obesity to serum lipid and lipoprotein changes in childhood and adolescence. JAMA: The Journal of the American Medical Association. 1985;254(4):515. Steinberger J, Daniels SR. Obesity, Insulin Resistance, Diabetes, and Cardiovascular Risk in Children An American Heart Association Scientific Statement From the Atherosclerosis, Hypertension, and Obesity in the Young Committee (Council on Cardiovascular Disease in the Young) and the Diabetes Committee (Council on Nutrition, Physical Activity, and Metabolism). Circulation. 2003;107(10):1448-53. Sinaiko, et al. Relation of weight and rate of increase in weight during childhood and adolescence to body size, blood pressure, fasting insulin, and lipids in young adults: The Minneapolis Children's Blood Pressure Study. Circulation. 1999;99(11):1471. Contact information Flavia Andrade. Email: fandrade@illinois.edu

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