Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants
Abstract Background Mechanisms underlying the association of life-course adiposity with incident hypertension in adulthood have not been comprehensively investigated. In this study, we aimed to investigate the potential biochemical and metabolomic mechanisms underlying the association between adipos...
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2025-01-01
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| Online Access: | https://doi.org/10.1186/s12916-025-03884-8 |
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| author | Shujing Ma Xue Liu Ruilang Lin Ye Yao Min Zhao Yongfu Yu Costan G. Magnussen Bo Xi |
| author_facet | Shujing Ma Xue Liu Ruilang Lin Ye Yao Min Zhao Yongfu Yu Costan G. Magnussen Bo Xi |
| author_sort | Shujing Ma |
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| description | Abstract Background Mechanisms underlying the association of life-course adiposity with incident hypertension in adulthood have not been comprehensively investigated. In this study, we aimed to investigate the potential biochemical and metabolomic mechanisms underlying the association between adiposity and incident hypertension. Methods A total of 180,527 participants from the UK Biobank aged 37 to 73 years were included. Associations of childhood body size or adulthood adiposity status as well as child–adult weight status change with incident adulthood hypertension were estimated by multivariate Cox proportional regression models. Results Participants with childhood thinner body size and adulthood obesity had the highest risk of incident hypertension (hazard ratio, HR = 3.09, 95% CI = 2.88–3.32) compared with those with “average → normal” pattern, followed by those with “average → obese” pattern (HR = 2.45, 95% CI = 2.31–2.61) and “plumper → obese” pattern (HR = 2.82, 95% CI = 2.62–3.02). Of note, those with “plumper → normal” pattern (HR = 1.11, 95% CI = 1.00–1.23) and “thinner → normal” pattern (HR = 1.17, 95% CI = 1.10–1.24) had the second and third lowest risk of incident hypertension. Adulthood overweight (mediation proportion: 58.7%, 95% CI: 40.4–74.8%) or obesity (mediation proportion = 46.7%, 95% CI: 29.4–64.9%) largely mediated the association between childhood plumper body size and hypertension. The association between adiposity and hypertension was mediated by biochemical indices (e.g., liver function, immunometabolism) and metabolites (e.g., alanine aminotransferase, apolipoprotein A) (mediation proportions ranging from 3.2 to 23.4%). Conclusions Thinner or plumper body size in childhood increases the risk of incident adulthood hypertension, and adulthood adiposity partly mediated this association, suggesting the importance of maintaining normal weight across the life course. Several biochemical indices and metabolites mediated these associations providing clues to underlying biological mechanisms. |
| format | Article |
| id | doaj-art-a3f0caad85214699bc827d211727e82b |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMC |
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| series | BMC Medicine |
| spelling | doaj-art-a3f0caad85214699bc827d211727e82b2025-02-02T12:28:13ZengBMCBMC Medicine1741-70152025-01-0123111210.1186/s12916-025-03884-8Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participantsShujing Ma0Xue Liu1Ruilang Lin2Ye Yao3Min Zhao4Yongfu Yu5Costan G. Magnussen6Bo Xi7Department of Scientific Research, Women and Children’s Hospital, Qingdao UniversityDepartment of Cardiology, Jining First People’s HospitalDepartment of Biostatistics, Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory for Health Technology Assessment, School of Public Health, Fudan UniversityDepartment of Biostatistics, Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory for Health Technology Assessment, School of Public Health, Fudan UniversityDepartment of Nutrition and Food Hygiene, School of Public Health, Qilu Hospital, Shandong UniversityDepartment of Biostatistics, Key Laboratory of Public Health Safety of Ministry of Education, NHC Key Laboratory for Health Technology Assessment, School of Public Health, Fudan UniversityBaker Heart and Diabetes InstituteDepartment of Epidemiology/Department of Maternal, Child and Adolescent Health, School of Public Health, Qilu Hospital, Shandong UniversityAbstract Background Mechanisms underlying the association of life-course adiposity with incident hypertension in adulthood have not been comprehensively investigated. In this study, we aimed to investigate the potential biochemical and metabolomic mechanisms underlying the association between adiposity and incident hypertension. Methods A total of 180,527 participants from the UK Biobank aged 37 to 73 years were included. Associations of childhood body size or adulthood adiposity status as well as child–adult weight status change with incident adulthood hypertension were estimated by multivariate Cox proportional regression models. Results Participants with childhood thinner body size and adulthood obesity had the highest risk of incident hypertension (hazard ratio, HR = 3.09, 95% CI = 2.88–3.32) compared with those with “average → normal” pattern, followed by those with “average → obese” pattern (HR = 2.45, 95% CI = 2.31–2.61) and “plumper → obese” pattern (HR = 2.82, 95% CI = 2.62–3.02). Of note, those with “plumper → normal” pattern (HR = 1.11, 95% CI = 1.00–1.23) and “thinner → normal” pattern (HR = 1.17, 95% CI = 1.10–1.24) had the second and third lowest risk of incident hypertension. Adulthood overweight (mediation proportion: 58.7%, 95% CI: 40.4–74.8%) or obesity (mediation proportion = 46.7%, 95% CI: 29.4–64.9%) largely mediated the association between childhood plumper body size and hypertension. The association between adiposity and hypertension was mediated by biochemical indices (e.g., liver function, immunometabolism) and metabolites (e.g., alanine aminotransferase, apolipoprotein A) (mediation proportions ranging from 3.2 to 23.4%). Conclusions Thinner or plumper body size in childhood increases the risk of incident adulthood hypertension, and adulthood adiposity partly mediated this association, suggesting the importance of maintaining normal weight across the life course. Several biochemical indices and metabolites mediated these associations providing clues to underlying biological mechanisms.https://doi.org/10.1186/s12916-025-03884-8ChildhoodAdulthoodBody size changeLife-course adiposityHypertensionMechanisms |
| spellingShingle | Shujing Ma Xue Liu Ruilang Lin Ye Yao Min Zhao Yongfu Yu Costan G. Magnussen Bo Xi Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants BMC Medicine Childhood Adulthood Body size change Life-course adiposity Hypertension Mechanisms |
| title | Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants |
| title_full | Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants |
| title_fullStr | Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants |
| title_full_unstemmed | Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants |
| title_short | Childhood body size, adulthood adiposity, underlying mechanisms, and risk of incident hypertension: a prospective cohort study of 180,527 participants |
| title_sort | childhood body size adulthood adiposity underlying mechanisms and risk of incident hypertension a prospective cohort study of 180 527 participants |
| topic | Childhood Adulthood Body size change Life-course adiposity Hypertension Mechanisms |
| url | https://doi.org/10.1186/s12916-025-03884-8 |
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