The cumulative effect and sensitive period of overweight/obesity on high blood pressure in children based on the Tianjin Birth Cohort Study

Abstract

Aim: Sensitive periods in child development are times when certain exposures may exert greater influences on health outcomes. The exposure to overweight/obesity and its cumulative effect during children’s sensitive periods may be associated with a higher risk of high blood pressure (HBP) in childhood.

Methods: A total of 522 boys and 534 girls (mean age: 9.6 years old, standard deviation: 0.6) from the birth cohort were selected for subsequent analysis. The curves of body mass index Z-score were generated by mixed-effect models. The statistically significant relative risk (RR) values of the first derivatives of the curves, evaluated at 0.5 year intervals, were used to identify the sensitive period. The area under the curve was employed to measure the cumulative exposure to overweight/obesity. Binary logistic regression model was used to investigate the association between the cumulative effect and risk of HBP in children.

Results: The sensitive periods identified were 2.5-5.5 years in boys and 7.0-8.5 years in girls. During these sensitive periods, the cumulative effect [RR: 1.12, 95% confidence interval (CI): 1.07-1.17, P < 0.001] and the average cumulative effect (RR: 1.21, 95%CI: 1.16-1.28, P < 0.001) of overweight/obesity exerted a greater impact on the risk of HBP than during periods outside the sensitive periods (cumulative effect: RR: 1.01, 95%CI: 1.00-1.03, P = 0.036; average cumulative effect: RR: 1.02, 95%CI: 1.00-1.03, P = 0.049).

Conclusion: This study identified the sensitive periods during which overweight/obesity influences the risk of HBP in children aged 9-10 years and demonstrated the greater cumulative effect of overweight/obesity on the elevated risk of HBP.

Keywords

Overweight / sensitive period / cumulative effect / child / high blood pressure / birth cohort

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