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Longitudinal trajectories of BMI z‐score: an international comparison of 11,513 Australian, American and German/Austrian/Luxembourgian youth with type 1 diabetes
Author(s) -
Phelan Helen,
Foster Nicole C.,
Schwandt Anke,
Couper Jennifer J.,
Willi Steven,
Kroschwald Peter,
Jones Timothy W.,
Wu Mengdi,
SteiglederSchweiger Claudia,
Craig Maria E.,
Maahs David M.,
Prinz Nicole
Publication year - 2020
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/ijpo.12582
Subject(s) - medicine , overweight , body mass index , demography , cohort , longitudinal study , obesity , type 2 diabetes , cohort study , ethnic group , population , childhood obesity , pediatrics , diabetes mellitus , environmental health , endocrinology , pathology , sociology , anthropology
Summary Background BMI fluctuations during puberty are common. Data on individual change in BMI from childhood to young adulthood are limited in youth with type 1 diabetes. Objectives To compare longitudinal trajectories of body mass index z score (BMIz) from childhood to adolescence across three registries spanning five countries. Methods Data sources: T1DX (USA), DPV (Germany/Austria/Luxembourg) and ADDN (Australia). The analysis included 11,513 youth with type 1 diabetes, duration > 1 year, at least one BMI measure at baseline (age 8‐10 years) and > 5 aggregated BMI measures by year of age during follow‐up until age 17 years. BMIz was calculated based on WHO charts. Latent class growth modelling was used to identify subgroups following a similar trajectory of BMIz over time. Results Five distinct trajectories of BMIz were present in the T1DX and ADDN cohorts, while six trajectories were identified in the DPV cohort. Boys followed more often a low/near‐normal pattern while elevated BMIz curves were more likely in girls (ADDN; DPV). For T1DX cohort, no sex differences were observed. Comparing the reference group (BMIz ~0) with the other groups during puberty, higher BMIz was significantly associated with older age at T1D onset, racial/ethnic minority and elevated HbA1c (all p<0.05). Conclusion This multinational study presents unique BMIz trajectories in youth with T1D across three continents. The prevalence of overweight and the longitudinal persistence of overweight support the need for close monitoring of weight and nutrition in this population. The international and individual differences likely result from diverse genetic, environmental and therapeutic factors.