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dc.contributor.authorLinda Aurpibulen_US
dc.contributor.authorÉadaoin M. Butleren_US
dc.contributor.authorAntika Wongthaneeen_US
dc.contributor.authorAmaraporn Rerkasemen_US
dc.contributor.authorSakda Pruenglampooen_US
dc.contributor.authorAmpica Mangklabruksen_US
dc.contributor.authorKittipan Rerkasemen_US
dc.contributor.authorJosé G.B. Derraiken_US
dc.description.abstract© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ. Background: There is a growing body of evidence showing that early life events are associated with increased risk of cardiovascular and metabolic diseases later in adult life. However, there is a paucity of data in this field from Asian populations. In this study, we examined the association of birth order with obesity risk and cardiometabolic outcomes in young adults in Thailand. Methods: Participants were the offspring from a birth cohort study in Chiang Mai (northern Thailand), who were followed up at ∼20.5 years of age. Clinical assessments included anthropometry, blood pressure, fasting blood samples and carotid intima-media thickness. Insulin sensitivity was estimated using homeostatic model assessment of insulin resistance (HOMA-IR). Participants were stratified into two groups: first-borns and later-borns. Health outcomes between groups were compared using multivariable models adjusting for important confounders, in particular maternal body mass index (BMI). Results: A total of 559 participants were studied: 316 first-borns (46% males) and 243 later-borns (47% males). Adjusted models showed anthropometric differences, with first-borns being 2.3 kg heavier (p=0.023) with a BMI 0.86 kg/m2 greater (p=0.019) than later-borns. Thus, rates of obesity were higher in first-borns than in later-borns (6.6% vs 2.9%), so that first-borns had an adjusted relative risk of obesity 3.3 times greater than later-borns [95% CI 1.42 to 7.88; p=0.006]. There were no observed differences in cardiovascular or metabolic parameters assessed, including HOMA-IR. Conclusion: As observed in other populations, first-borns in Thailand had greater BMI and an increased risk of obesity in young adulthood. However, we observed no other cardiometabolic differences between first- and later-borns.en_US
dc.titleBirth order is associated with an increased risk of obesity in young adults in Thailanden_US
article.title.sourcetitleJournal of Epidemiology and Community Healthen_US of Auckland, Liggins Instituteen_US of Aucklanden_US Universityen_US Universiteten_US Mai Universityen_US
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