medwireNews: Overweight and obesity during childhood may be associated with an increased risk for systemic lupus erythematosus (SLE) and psoriatic arthritis (PsA) that persists even if a healthy bodyweight is achieved during adulthood, researchers report.
Therefore, weight-loss interventions “may be more effectively targeted during early life rather than adulthood” in order to reduce the risk for these diseases in susceptible individuals, say Sizheng Steven Zhao (The University of Manchester, UK) and colleagues.
For the study, Zhao et al estimated the impact of overweight and obesity on the risk for several rheumatic diseases using data from 453,169 individuals of European descent who took part in a UK Biobank genome-wide association study (GWAS).
People were categorized into one of three groups based on the presence of single nucleotide polymorphisms associated with adiposity, as well as proxy measures of adiposity. The childhood groups were defined as “thinner,” “about average,” and “plumper” on the basis of participant recall for age 10 years, while adults had their BMI measured at 57 years of age and were split into three categories “to match the proportions for childhood body size,” say the researchers.
They note that “[g]enetic instruments for these body size definitions were previously validated against BMI data from three independent populations: the Avon Longitudinal Study of Parents and Children, the Young Finns Study and the Trøndelag Health (HUNT) study.”
Using GWAS data for various rheumatic diseases combined with a Mendelian randomization (MR) approach, the team estimated that each increase in childhood bodyweight category was associated with a significantly increased risk for SLE (odds ratio [OR]=2.44), PsA (OR=2.18), and gout (OR=1.94), but not for rheumatoid arthritis or ankylosing spondylitis.
Zhao et al say that when accounting for adult bodyweight category in a multivariable MR model, “the direct effect of childhood body size was little changed” for both SLE (OR=2.69) and PsA (OR=1.92), whereas the association for gout was attenuated and lost statistical significance.
Therefore, “the risk conferred from having a larger body size during childhood may not be fully reversible even when a healthy size is achieved in adulthood,” write the researchers in RMD Open.
They conclude: “Further studies of the immune mechanism through which childhood adiposity independently influences adult disease risk is needed.”
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