Associations of growth from birth to puberty with glycemic indicators at ~17.5 years: Evidence from Hong Kong's “Children of 1997” birth cohort

Background: From an evolutionary biology perspective, where growth and reproduction trade-off against longevity, we assessed the associations of growth from birth to puberty by phase with later glycemic indicators and any differences by sex. Methods: In the population-representative Hong Kong Chinese “Children of 1997” birth cohort (n = 8327), the relation of initial size (weight-for-age z score (WAZ) at birth, length/height-for-age z score (LAZ) at 3 months or body-mass-index-for-age z score (BAZ) at 3 months based on the World Health Organization growth standards/references) and growth at different phases (WAZ gains from 0 to 2 and 2 to 8 years, LAZ or BAZ gains from 3 months to 3 years, 3 to 8 years and 8 to 14 years) with fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) at ~17.5 years, was assessed using adjusted partial least squares regression. Additional analyses further considered growth in late and early infancy. Results: This study included 3276 of the cohort participants. Higher WAZ gain from 2 to 8 years, LAZ and BAZ gains from 3 to 8 years were consistently associated with higher FPG, adjusted for maternal and infant characteristics, family history of diabetes and household income. Also, higher BAZ gain from 3 to 8 years was associated with higher HbA1c. These associations did not differ by sex. Conclusions: Our findings suggest different mechanisms could underlie the pathogenesis of glucose intolerance. Factors that drive specific growth at different phases need to be evaluated to better inform child growth management for long-term health outcomes.