Adolescent Tri-ponderal Mass Index Growth Trajectories and Incident Diabetes Mellitus in Early Adulthood

Yi-Fan Wu, Hsien-Yu Fan, Yang-Ching Chen, Kuan-Liang Kuo, Kuo-Liong Chien

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)


Purpose: Studies have reported the influence of adolescent obesity on development of adult diabetes, but the effect of the growth pattern during this period has rarely been explored. Also, the tri-ponderal mass index (TMI) was thought to be a better estimation of adolescent body fat levels than the body mass index (BMI), so we sought to investigate whether growth trajectories derived by these two indices could predict incident diabetes. Methods: We conducted a study by using the Taipei City Hospital Radiation Building Database, a longitudinal cohort established in 1996. Physical exam results including blood test results were collected annually and the BMI z-score/TMI growth trajectory groups during 13 to 18 years of age were identified using growth mixture modeling. A Cox proportional hazard model for incident diabetes was used to examine the risk of baseline obese status and different BMI/TMI growth trajectories. Results: Five growth trajectory groups were identified for the BMI z-score and the TMI. During approximately 20 400 person-years follow-up, 33 of 1387 participants developed diabetes. Baseline obesity defined by the BMI z-score and the TMI were both related to adult diabetes. The persistent increase TMI growth trajectory exhibited a significantly increased risk of diabetes after adjusting for baseline obese status and other correlated covariates (hazard ratio: 2.85, 95% confidence interval: 1.01-8.09). There was no association between BMI growth trajectory groups and incident diabetes. Conclusions: A specific TMI growth trajectory pattern during adolescence might be critical for diabetes prevention efforts.

Original languageEnglish
Pages (from-to)E2919-E2927
JournalThe Journal of clinical endocrinology and metabolism
Issue number8
Early online dateApr 11 2021
Publication statusPublished - Aug 1 2021


  • adolescent growth trajectories
  • diabetes mellitus
  • tri-ponderal mass index
  • Body Mass Index
  • Models, Theoretical
  • Blood Pressure/physiology
  • Diabetes Mellitus/epidemiology
  • Pediatric Obesity/complications
  • Humans
  • Risk Factors
  • Male
  • Incidence
  • Adiposity/physiology
  • Adolescent
  • Adult
  • Female
  • Body-Weight Trajectory
  • Longitudinal Studies

ASJC Scopus subject areas

  • Biochemistry, medical
  • Endocrinology
  • Biochemistry
  • Clinical Biochemistry
  • Endocrinology, Diabetes and Metabolism


Dive into the research topics of 'Adolescent Tri-ponderal Mass Index Growth Trajectories and Incident Diabetes Mellitus in Early Adulthood'. Together they form a unique fingerprint.

Cite this