Adverse waist-for-height ratio trajectories in childhood are associated with cardiometabolic and cardiovascular risk by age 10

David Horner; Bo Chawes; Klaus Bonnelykke; Jakob Stokholm; Morten Rasmussen; Vinding Rebecca Kofod

doi:10.1530/endoabs.110.P652

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Endocrine Abstracts (2025) 110 P652 | DOI: 10.1530/endoabs.110.P652

ECEESPE2025 Poster Presentations MTEabolism, Nutrition and Obesity (125 abstracts)

Adverse waist-for-height ratio trajectories in childhood are associated with cardiometabolic and cardiovascular risk by age 10

David Horner ¹ , Bo Chawes ¹ , Klaus Bønnelykke ¹ , Jakob Stokholm ¹ , Morten Rasmussen ¹ & Rebecca Kofod Vinding ¹

Author affiliations

¹COPSAC clinical research unit, Copenhagen, Denmark

JOINT3276

Introduction: Waist-for-height ratio reflects central adiposity, a key predictor of cardiometabolic health. This study examines how adverse waist-for-height trajectories in childhood are associated with increased cardiometabolic and cardiovascular risk by age 10.

Methods: Analysis was conducted within the COPSAC2010 cohort, comprising 700 mother-child pairs with detailed phenotyping across 14 visits. We used latent class analysis to identify child waist-for-height ratio trajectories from 1 week to 10 years. Cardiometabolic risk (CMR) was derived from composite z-scores of HDL, triglycerides, glucose, blood pressure (height-adjusted), and HOMA-IR, while cardiovascular disease (CVD) risk was calculated using NMR blood metabolomics and Cox models from the UK Biobank. Scores were z-scored within the cohort for interpretation. Models were adjusted for demographics, lifestyle factors, physical activity, sleep, diet, and relevant clinical measures.

Results: We identified three distinct waist-for-height ratio trajectories from 1 week to 10 years: a stable “Reference group” (66%), a “Rising-then-falling” group (18%), and a “Slow-rising” group (15%). Compared to the reference group, the “Slow-rising” group (15%) had significantly higher CMR (α=0. 79, P < 0. 0001) and CVD scores (α=0. 53, P < 0. 0001), reflecting worse cardiometabolic risk. This group also showed elevated levels of C-peptide (α=106, P < 0. 0001), HOMA-IR (α=0. 15, P < 0. 0001), GlycA (α=0. 04, P < 0. 0001), and hs-CRP (α=0. 60, P < 0. 0001), alongside lower HDL (α=-0. 17, P < 0. 001). Compared to the reference group, the “Rising-then-falling” group (18%) had significantly lower HbA1c levels (α=-0. 90, P = 0. 003) and slightly higher ApoB levels (α=0. 03, P = 0. 032). Adjusting for waist-for-height ratio cross-sectionally at 10 years explained most of the variance in risk, rendering previous associations for the “Slow-rising” group nonsignificant, however findings for the “Rising-then-falling” remained significant.

Conclusion: Childhood waist-for-height ratio trajectories are strongly linked to cardiometabolic and cardiovascular risk by age 10. These findings emphasise the need for early monitoring and intervention to address central adiposity patterns and reduce the risk of long-term adverse health outcomes.