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Indirect Effects of Body Mass Index Growth on Glucose Dysregulation via Inflammation: Causal Moderated Mediation Analysis.


ABSTRACT:

Objective

No existing studies have examined the mediating role of chronic inflammation between obesity and dysregulated glucose homeostasis in adolescent samples. This study evaluated whether C-reactive protein (CRP), an inflammation biomarker, mediated the effects of growth (annual increase) in body mass index (BMI) on glycated hemoglobin (HbA1c).

Methods

BMI and biomarker data were used from wave I to wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add Health study; 4,545 adolescents; mean age = 14.9 years; 55.7% female) with valid CRP data. A causal moderated mediation analysis evaluated the direct and indirect effects of BMI slope on HbA1c via CRP across gender, with demographic and clinical characteristics as model covariates.

Results

The participants displayed a linear BMI growth of 0.53-0.58 kg/m2/year throughout adolescence, with substantial interindividual variation. The BMI slope showed positive direct and indirect effects on HbA1c via CRP across gender, and there was a significant exposure-mediator interaction effect. A standardized increase in the BMI slope raised the probability of an abnormal HbA1c value by 6.0-8.5% in participants with various profiles. The total natural indirect effect accounted for 13.3-15.9% of the total effect in males and 21.2-22.7% in females.

Conclusions

The findings provide support for the inflammation mechanism in the effects of adiposity on glucose homeostasis. In adolescents, excess BMI growth was linked with a higher risk of glucose dysregulation either directly or indirectly via chronic inflammation.

SUBMITTER: Fong TCT 

PROVIDER: S-EPMC6696889 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Indirect Effects of Body Mass Index Growth on Glucose Dysregulation via Inflammation: Causal Moderated Mediation Analysis.

Fong Ted Chun Tat TCT  

Obesity facts 20190527 3


<h4>Objective</h4>No existing studies have examined the mediating role of chronic inflammation between obesity and dysregulated glucose homeostasis in adolescent samples. This study evaluated whether C-reactive protein (CRP), an inflammation biomarker, mediated the effects of growth (annual increase) in body mass index (BMI) on glycated hemoglobin (HbA1c).<h4>Methods</h4>BMI and biomarker data were used from wave I to wave IV of the National Longitudinal Study of Adolescent to Adult Health (Add  ...[more]

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