Emerging self-regulatory skills in childhood predict cardiometabolic risk in adolescence

• In Event: 1-037 - Developmental Influences on Cardiometabolic Risk in the Early Lifespan

Integrative Statement

Obesity among young people in the United States has reached an all-time high and adolescents’ cardiometabolic health has declined. Indeed, rates of cardiometabolic risk factors—including high waist circumference, elevated lipids, hypertension, and elevated fasting glucose—have reached unprecedented rates among young people. Systematic elevations of these factors constitute the metabolic syndrome (MetS), which was formerly viewed as a health risk solely of aging populations. 40+ varied and controversial definitions of MetS have been applied to children and adolescents, without necessarily propelling insights into pediatric cardiometabolic health forward. In response, the American Academy of Pediatricians has recommended moving away from dichotomous MetS categories for this age-group and to examine clusters of cardiometabolic risk factors instead. The first aim of this study was to identify latent profiles of adolescent MetS risk factors.

Moffitt and colleagues (2011) highlighted that MetS factors are concentrated among young adults with deficits in childhood self-regulation. Although ground-breaking, their study did not measure cardiometabolic risk in adolescence, only considered behavioral regulation, and used an aggregated measure of behavioral regulation across childhood. Importantly, however, self-regulation is a multifaceted construct—subsuming behavioral, attentional, emotional, and cognitive dimensions. Furthermore, these self-regulatory skills unfold over time, with earlier skills providing the basis for more advanced self-regulatory processes that emerge over time. The second aim of this study was to examine how different aspects of self-regulation at different stages of childhood predict clusters of cardiometabolic risk during late adolescence.

Data came from N=117 children (60% female, 60% Caucasian). At ages 2, 4, and 7, children were observed during laboratory tasks eliciting emotional, behavioral, and cognitive responding. Mothers completed the Children’s Behavior Questionnaire-Short Form. At age 16, adolescents’ waist circumference (WC) and mean arterial pressure (MAP) were measured, and adolescents completed blood draws that were assayed for fasted serum levels of leptin (L), cholesterol (HDL and non-HDL), glucose (G), and C-reactive protein (CRP).

Latent profile analysis identified three subgroups of adolescents with similar patterns of cardiometabolic risk factors (Figure 1). The 3-class model was chosen because it had the smallest Bayesian information criterion (BIC=6597.12) value, high entropy (E=.92), and a significant adjusted Lo-Mendell-Rubin Likelihood Ratio Test (LMR-LRT=81.65, p < .05). The Low Risk group (41.0%) included adolescents who had low L, G, and non-HDL, but high HDL. The Dyslipidemia Risk group (49.6%) included adolescents who had high G and non-HDL, but low HDL, L, WC, MAP, and CRP. The High MetS Risk group (9.4%) included adolescents who had high L, G, WC, MAP, CRP, and moderate non-HDL.

Results from longitudinal multinomial logistic regression models indicated that greater age 2 emotional regulation skills, age 4 emotional, behavioral, and attentional regulation skills, and age 7 attentional and cognitive regulation skills were uniquely associated with membership in the Low Risk, and sometimes in the Dyslipidemia Risk group, when compared to the High MetS Risk group (Figure 2).

Specific dimensions of self-regulatory skills, at specific ages, uniquely predict adolescent cardiometabolic risk. Self-regulatory skills are trainable; therefore, results may have important implications for the prevention of cardiometabolic risk.

Authors

• Jessica Dollar, University of North Carolina at Greensboro
  Presenting Author

• Laurie Wideman, University of North Carolina at Greensboro
  Non-Presenting Author

• Susan Calkins, University of North Carolina at Greensboro
  Non-Presenting Author

• Lenka Shriver, The University of North Carolina at Greensboro
  Non-Presenting Author

• Susan Phillips Keane, University of North Carolina at Greensboro
  Non-Presenting Author

• Lilly Shanahan, Jacobs Center for Productive Youth Development, Department of Psychology, University of Zurich
  Non-Presenting Author