Growth during infancy and early childhood and its association with metabolic risk biomarkers at 11.5 years

Xun Zhang, Richard M Martin, Emily Oken, Izzuddin M Aris, Seungmi Yang, Michael S Kramer*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

9 Citations (Scopus)
27 Downloads (Pure)


The evidence that fetal life and early infancy are “critical” or “sensitive” ages for later cardiometabolic disease is based on flawed methods for comparing different age periods. Moreover, most previous studies have limited their focus to weight gain, rather than growth in length/height or body mass index (BMI). We undertook a secondary analysis of PROBIT (1996-2010), a birth cohort study nested within a large cluster-randomized trial in the Republic of Belarus, with repeated measures of weight and length/height from birth
to 11.5 years of age. We used mixed effects linear models to analyze associations of changes in standardized weight, length/height, and BMI during five age periods (conception to birth, birth to 3 months, 3 to 12 months, 12 months to 6.5 years, and 6.5 to 11.5 years) with fasting glucose, insulin, insulin resistance, β-cell function, and adiponectin at age 11.5 years. We observed strong associations between the metabolic markers and all three growth measures, with the largest effect sizes observed during the latest age period (6.5 to 11.5 years) and negligible associations during gestation and the first year of life. Later age-periods appear more “sensitive” than earlier periods to the
adverse metabolic effects of rapid growth in childhood.
Original languageEnglish
Article numberkwz234
Number of pages8
JournalAmerican Journal of Epidemiology
Early online date8 Oct 2019
Publication statusE-pub ahead of print - 8 Oct 2019


  • growth
  • metabolic risk
  • developmental origins of health and disease
  • sensitive period
  • pregnancy
  • body mass index procedure
  • insulin resistance
  • biological markers
  • belarus
  • child
  • fetus
  • infant
  • weight gain
  • fasting blood glucose measurement
  • insulin
  • adiponectin
  • conception
  • probit trial
  • metabolic risk factors
  • secondary data analysis


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