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Incident MetS and T2DM were identified in adulthood (mean age\u2009=\u200930.5 years). Cross-lagged panel and mediation analysis models were used. After adjusting for age, race, gender, and follow-up years, the cross-lagged path coefficient of BMI\u2009\u2192\u2009insulin (\u03b2\u2009=\u20090.326, p\u2009&lt;\u20090.001) was significantly greater than that of insulin\u2009\u2192\u2009BMI (\u03b2\u2009=\u2009\u22120.023, p\u2009=\u20090.207) in childhood, with p\u2009&lt;\u20090.001 for the difference in \u03b2s. The path coefficient for BMI\u2009\u2192\u2009insulin was significantly greater in MetS than in non-MetS groups (0.510 vs 0.190, p\u2009&lt;\u20090.001), and greater in hyperglycemia than in normoglycemia groups (0.503 vs 0.285, p\u2009=\u20090.026). The mediation effect of childhood insulin on the BMI-MetS and BMI-hyperglycemia associations was estimated at 19.2% (p\u2009&lt;\u20090.001) and 18.3% (p\u2009&lt;\u20090.001), respectively. These findings provide evidence that higher BMI levels precede hyperinsulinemia during childhood, and this one-directional relation plays a significant role in the development of MetS and T2DM in adult life.<\/jats:p>","DOI":"10.1038\/srep43422","type":"journal-article","created":{"date-parts":[[2017,2,23]],"date-time":"2017-02-23T11:11:49Z","timestamp":1487848309000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Long-term Impact of Temporal Sequence from Childhood Obesity to Hyperinsulinemia on Adult Metabolic Syndrome and Diabetes: The Bogalusa Heart Study"],"prefix":"10.1038","volume":"7","author":[{"given":"Tao","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijie","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shengxu","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camilo","family":"Fernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Bazzano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiang","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuzhong","family":"Xue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2017,2,23]]},"reference":[{"key":"BFsrep43422_CR1","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1016\/j.jacc.2013.05.064","volume":"62","author":"H Beltr\u00e1n-S\u00e1nchez","year":"2013","unstructured":"Beltr\u00e1n-S\u00e1nchez, H., Harhay, M. 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