Subclasses of glucose trajectories in early childhood stratified the risk of abnormal glucose tolerance in adolescence and young adulthood

Early-life exposures may shape long-term effects on glucose regulation. This study aimed to stratify long-term abnormal glucose tolerance (AGT) risk from early childhood. A total of 906 children were enrolled at baseline and re-evaluated in adolescence and young adulthood. By using the latent class trajectory analysis, glucose trajectories of children were measured via 5-timepoint OGTT and then grouped into three latent subclasses: Mild excursion–Normal reversion (MN), Moderate excursion–Delayed reversion (MD), and Severe excursion–Delayed reversion (SD). Logistic regression was performed to estimate the risk of AGT and associations between cardiometabolic factors and subclasses. In adolescence, compared to the MN subclass, the risk of AGT was 1.7-fold in the MD subclass and 5.5-fold in the SD subclass, after adjusting for age, sex, body mass index (BMI) and Tanner Stage. In young adulthood, the adjusted risk of AGT was 3.6-fold and 11.6-fold in the MD and SD subclass, respectively. During the full the natural history of glucose tolerance, the risk of AGT was 3.6-fold in the MD subclass and 18.1-fold in the SD subclass, after adjusting for childhood covariates. The MD/SD subclass membership was strongly associated with childhood hypertension, maternal gestational diabetes and maternal hypertension during pregnancy. Glucose trajectory subclasses in early childhood effectively stratified the long-term risk of AGT. The association between maternal cardiometabolic health and childhood subclass membership highlighted that prenatal exposures may influence metabolic outcomes in offspring.