Longitudinal Analysis of Facial Growth in High BMI (Obese) Children

Introduction: From 1976-2010, childhood obesity rates have had a 3 fold increase with obesity currently affecting 18.5% of the youth (Hales et al., 2017). Childhood obesity has also been linked to accelerated skeletal maturation and accelerated dental development (Hilgers et al., 2006; Mack et al., 2013). Limited evidence shows obesity affects craniofacial growth (Gordon et al., 2021; Guevara et al., 2016; Öhrn et al., 2002; Sadeghianrizi et al., 2005). Materials and Methods: This study was performed using longitudinal data (including height, weight, and lateral cephalograms) from the Iowa Facial Growth Study (IFSG; Bishara et al., 1994) for subjects at ages 6, 8, 10, and 14. The total sample size included 77 subjects, 41 males and 36 females. Height and weight data were used to calculate BMI percentile using the CDC’s growth charts (Kuczmarski et al., 2002). Digital Landmark Identification was completed to identify 15 craniofacial points. Geometric Morphometrics were used to analyze size and shape data over time. Principle Component Analysis were completed to identify areas of variation in size and shape. Cervical Vertebrae Maturation was determined to verify skeletal growth maturation. Results: Evidence of association was found between increased facial size and high BMI at age 4, and weak evidence at age 6. We found evidence that high BMI children at age 6 have taller nasal apertures, shorter nasoalveolar clivuses, and relatively more convex facial profiles. Weak evidence was found between children with high BMI at age 6 and advanced CVM, as well as between increased facial size and advanced CVM. Conclusion: Overall, our study failed to identify significant longitudinal relationships between obesity and craniofacial growth. We cannot draw conclusions about how this will affect growth over time at this time. Though the literature is growing in this area, effects of obesity on growth are not as well understood as previously thought.