World Journal of Pediatrics最新文献

{"title":"Precision medicine in pediatric sepsis-associated acute kidney injury: when systemic heterogeneity meets organ-level heterogeneity.","authors":"Meng-Yuan Wu, Yu Zhao, Xiao-He Chen, Xu-Hua Ge","doi":"10.1007/s12519-026-01096-5","DOIUrl":"10.1007/s12519-026-01096-5","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"969-975"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and molecular characterization of non-PIK3CA-related vascular malformations with overgrowth in a pediatric cohort.","authors":"Giuseppe Reynolds, Maria Luca, Paola Coppo, Roberta La Selva, Chiara Leoni, Iacopo Bellani, Simona Ragusa, Stefania Massuras, Sonia Perrelli, Stefania Martino, Paola Sabrina Buonuomo, Federico Rondot, Alessandro Mauro Spinelli, Carla Morando, Marilidia Piglionica, Nicoletta Resta, Alessandro Mussa","doi":"10.1007/s12519-026-01098-3","DOIUrl":"10.1007/s12519-026-01098-3","url":null,"abstract":"<p><strong>Introduction: </strong>Vascular malformations (VMs) associated with overgrowth represent a heterogeneous group of congenital disorders driven by somatic or germline variants in genes regulating vascular morphogenesis and cellular proliferation. While PIK3CA-related overgrowth spectrum (PROS) is relatively well characterized, non-PIK3CA VMs with overgrowth remain poorly defined, with limited genotype-phenotype correlations and no standardized therapeutic strategies. This study aimed to characterize the clinical and molecular features of this underrecognized group in a pediatric cohort.</p><p><strong>Methods: </strong>We conducted a multicentric retrospective study across five Italian tertiary centers. Patients were included if they presented with a vascular malformation, clinically appreciable regional overgrowth beyond the vascular lesion itself, and a confirmed pathogenic or likely pathogenic variant in genes of the PI3K/AKT/mTOR or related signalling pathways, excluding PIK3CA. Genetic testing was performed via next-generation sequencing (NGS) using a 17-gene targeted panel (read depth >2000 ×) on peripheral blood, buccal swab, or affected-tissue biopsies. Clinical data were systematically collected across six predefined domains including phenotype, imaging, hemostatic parameters, and therapeutic management.</p><p><strong>Results: </strong>A total of 41 patients were enrolled, including 20 males and 21 females. The mean age at diagnosis was 12.1 ± 1.4 years. Variants were identified in TEK (24.4%), GNAQ (21.9%), GNA11 (21.9%), PTEN (14.6%), RASA1 (12.2%), AKT3 (2.4%) and EPHB4 (2.4%). Somatic variants accounted for 65.9% of cases. Phenotypic features included skeletal anomalies (46.3%), soft tissue overgrowth (60.9%), macrocrania (19.5%), and segmental undergrowth in a subset. A syndromic diagnosis was established in 63.4% of patients; however, marked phenotypic overlap across genes was observed. Functional limitations affected 43.9% of patients. Alpelisib yielded clinical improvement in selected TEK-variant patients, whereas sirolimus showed limited efficacy.</p><p><strong>Conclusions: </strong>Non-PIK3CA VMs with overgrowth constitute a clinically and molecularly heterogeneous spectrum with substantial phenotypic overlap across genotypes, rendering phenotype-based classification unreliable. Somatic mosaicism, variable allele frequency, and tissue-specific expression underlie this heterogeneity. Our findings advocate for broad NGS panels with tissue-based analysis, systematic parental testing, and molecularly driven classification. The observed response to alpelisib in TEK-related disease supports the concept of convergent downstream pathway activation as a rationale for targeted therapies beyond PROS.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"1024-1039"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health equity begins with children: dismantling barriers to healthcare access in low- and middle-income countries.","authors":"Li-Yang Ou, Yuan Zhang, Yu-Tong Zhang","doi":"10.1007/s12519-026-01100-y","DOIUrl":"10.1007/s12519-026-01100-y","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"976-981"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149031596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of sirolimus in pediatric vascular anomalies: a BKMR-PopPK exposure-response framework for individualized risk and dosing.","authors":"Bo Liu, Xiao-Lin Xu, Jia-Lu Wang, Jia Li, Yu-Xin Wu, Xue-Xi Zhang, Qiao-Yin Liu, Yi-Ming Zhao, Peng Guo, Rui-Qi Zhang, Han Zhou, Xue-Ting Mao, Yu-Meng Jia, Xiao-Ling Cheng, Sheng-Cai Wang, Xiao-Ling Wang","doi":"10.1007/s12519-026-01076-9","DOIUrl":"10.1007/s12519-026-01076-9","url":null,"abstract":"<p><strong>Background: </strong>Vascular anomalies are rare, heterogeneous disorders that threaten the health of children. Sirolimus is an important drug therapy, but its high incidence of adverse drug reactions (ADRs) may cause treatment discontinuation and therefore poor disease control. Although prior studies suggest a strong link between sirolimus exposure and ADRs, the quantitative relationship remains unclear. This study aimed to systematically quantify the relationships between steady-state trough sirolimus concentrations (C_min) and three ADRs: myelosuppression, abnormal liver function, and dyslipidemia.</p><p><strong>Methods: </strong>We retrospectively analyzed the data using Bayesian kernel machine regression (BKMR) to characterize associations of C_min and its determinants with ADRs, and further developed an integrated BKMR-population pharmacokinetic (PopPK) framework for quantitative risk assessment and prediction.</p><p><strong>Results: </strong>A total of 257 patients were involved in this study (766-892 blood samples). BKMR results showed the quantitative exposure-response relationships between C_min and ADRs, identifying disease complexity and duration of treatment as key risk modifiers. We recommend routine C_min monitoring within safety windows: 5.0-7.5 ng/mL for simple lesions or milder disease; 8.0-10.2 ng/mL for complex or mixed vascular malformations. Stricter ADR surveillance is warranted in complex malformations, and during long-term therapy (> 6 months), vigilance for myelosuppression and dyslipidemia through regular screening is also warranted.</p><p><strong>Conclusions: </strong>This is the first study to quantify the relationship between C_min and ADRs in pediatric vascular anomalies. The integrated BKMR-PopPK framework provides a tool for translating pharmacological insights into practice and advancing model-informed precision dosing (MIPD). These findings support therapeutic drug monitoring (TDM)-based target ranges, addressing a knowledge gap and reducing reliance on empirical dosing. This paradigm also informs safety evaluation and early-phase trials in other pediatric rare diseases with limited samples.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"1040-1054"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148991629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating optimal patient-centered care: patient- and family-reported experiences after complex treatment for rare diseases.","authors":"Frederiek L Tijssens, Philippine Kies, Lissy de Ridder, Anne P J de Pagter, Jeanine M M van Klink","doi":"10.1007/s12519-026-01089-4","DOIUrl":"10.1007/s12519-026-01089-4","url":null,"abstract":"<p><strong>Background: </strong>Although life expectancy after complex treatments for rare diseases during childhood has increased, long-term medical, psychosocial and societal impacts remain for children and their families. Evaluating patient and family experiences is essential for the development and optimization of integrated patient-centered, value-based care pathways. This study aims to evaluate patient- and family-reported experiences across three follow-up care pathways for complex treatment of rare diseases.</p><p><strong>Methods: </strong>This cross-sectional study was conducted among patients/families in follow-up care after (1) fetal and/or neonatal intensive care treatment; (2) pediatric hematopoietic stem cell transplantation for non-malignant conditions; and (3) cardiac intervention for congenital heart disease. A combination of validated patient-reported experience measures (PREMs) was used to capture experiences with complete integrated care pathways regarding information provision, integrated care collaboration, communication and comprehensive care. Descriptive statistics were used to analyze quantitative ratings, whereas free-text responses were analyzed using thematic analysis.</p><p><strong>Results: </strong>Between April 2024 and June 2025, 70 families completed the PREMs. Likert-scale ratings, as well as an analysis of 286 free-text responses, revealed positive evaluations of relationship building, the humanistic approach and communication across all pathways. The identified areas of improvement varied across care pathways and included comprehensive (long-term) information provision and screening and support for the psychosocial impact on patients as well as their families.</p><p><strong>Conclusion: </strong>Through shared learning across care pathways, insights from patient and family experiences guide patient- and family-centered, value-based care pathway optimization to ultimately improve outcomes and quality of life for children and their families.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"1069-1082"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathogenesis and precision management of osteogenesis imperfecta: from genetic mechanisms to novel therapies.","authors":"Xue-Qian Wang, Cai Zhang, Xin Li, Yan Sun, Qiong Chen, Bing-Yu Yang, Yao-Shuang Li, Xin-Yi Jiang, Zhong-Hang Zhao, Li Wang, Xiao-Hong Sun, Hong-Ying Wang, Wen-Li Lu, Hai-Yan Wei, Zhe Su, Xiu-Zhi Ren, Bing-Yan Cao, Wei Wu, Ting Chen","doi":"10.1007/s12519-026-01086-7","DOIUrl":"10.1007/s12519-026-01086-7","url":null,"abstract":"<p><strong>Background: </strong>Osteogenesis imperfecta (OI) is a clinically and genetically heterogeneous skeletal dysplasia characterized by systemic bone fragility. Beyond skeletal manifestations, OI is a multisystem condition involving dentinogenesis imperfecta, hearing loss, joint hyperlaxity, and cardiopulmonary complications. The diagnostic paradigm for OI has undergone a revolutionary shift from traditional clinical phenotyping to a molecular etiology-based framework. Driven by advancements in high-throughput sequencing, mutations in over 20 implicated genes have expanded the current OI nosology to at least 23 distinct types.</p><p><strong>Data sources: </strong>This narrative review was conducted by searching for papers using PubMed/MEDLINE. Relevant publications were identified using single and/or combined keywords including: osteogenesis imperfecta, genes (such as COL1A1 and COL1A2), animal models, phenotypes (such as osteopenia and femoral bowing), and drug therapies (such as bisphosphonate and denosumab), mesenchymal stem cells, gene therapy, and pluripotent stem cells.</p><p><strong>Results: </strong>This review systematically delineates the molecular pathogenesis of OI, categorizing defects into disrupted collagen biosynthesis, impaired post-translational modification, aberrant procollagen trafficking, and dysfunctional osteoblast differentiation or mineralization pathways. Of note, we highlight the unique genetic landscape and clinical characterization of OI within Asian populations. Furthermore, we evaluate the transition towards precision management. Surgical management of OI has been optimized by telescopic rodding and a multidisplinary approach. Bisphosphonates remain a cornerstone of medical therapy, though responses vary with OI genotypes. Emerging targeted biologics include denosumab, romosozumab, setrusumab, and fresolimumab. Finally, we discuss the transformative potential of cell-based therapies, particularly mesenchymal stem cells. Precision gene editing technologies, such as CRISPR-Cas9, offer a strategy in addressing the root genetic causes of OI.</p><p><strong>Conclusions: </strong>Integrating molecular diagnostics with robust genotype-phenotype correlations is essential for advancing personalized care. Future breakthroughs will rely on the translation of gene and cell therapies to ultimately improve the long-term clinical outcomes for patients with OI.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"982-1011"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149115534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between perinatal asphyxia-induced brain injury, number of enlarged perivascular spaces, and sleep quality in later life.","authors":"Xin-Yu Xue, Li Sun, Min Yu, Mei-Xia Li, Qiu-Yan Tian, Jing Ren, Po Miao, Li-Xiao Xu, Chen-Xi Feng, Mei Li, Min Gong, Ling-Zhi Wang, Hong-Liang Huo, Jian Huang, Wan-Liang Guo, Rong Ju, Tao Pan, Xing Feng, Wen-Hao Zhou, Huai-Yu Li, Bin Sun, Xiao-Feng Yang, Xin Ding","doi":"10.1007/s12519-026-01093-8","DOIUrl":"10.1007/s12519-026-01093-8","url":null,"abstract":"<p><strong>Background: </strong>Perinatal asphyxia (PA) is increasingly recognized as a significant contributor to neonatal brain injury. Identifying reliable biomarkers for assessing the severity of injury is crucial. Enlarged perivascular spaces (EPVSs), which are considered imaging markers of glymphatic dysfunction are reliable indicators of disease severity and prognosis. However, the application of EPVSs among neonates remains unclear. This study aims to investigate whether numbers of EPVSs can serve as a novel biomarker for the severity of PA-induced brain injury (PABI) and the sleep quality in later life.</p><p><strong>Methods: </strong>Neonates (n = 319) with PA were categorized as mild (n = 229) or severe (n = 90). Clinical, amplitude-integrated electroencephalography (aEEG), and cranial magnetic resonance imaging (MRI) data were collected. The sleep quality was assessed using questionnaires via follow-up. Correlation analysis was performed to examine associations between numbers of EPVSs and clinical parameters. Multivariate linear regression analysis was performed to evaluate the independent correlation between numbers of EPVSs and severity of PABI. The correlation between numbers of EPVSs and later sleep quality in infants was also evaluated.</p><p><strong>Results: </strong>There were multiple clinical parameters correlated with numbers of EPVSs. Univariate analysis revealed that physiological status, inflammatory markers, and numbers of EPVSs were related with the severity of PABI. Multivariable regression analysis found that numbers of EPVSs independently related with the severity of PABI [P = 0.0001 in all infants (MRI); P = 0.0248 in mild PA group (MRI); P = 0.0114 in severe PA group (MRI)]. In the severe PA group, numbers of EPVSs were significantly correlated with long-term sleep quality (P = 0.0061, r = 0.3365), a higher number of EPVSs was associated with more severe sleep disturbance.</p><p><strong>Conclusions: </strong>Numbers of EPVSs may serve as a novel imaging biomarker for evaluating the severity of brain injury after PA; this biomarker can predict sleep disorders later in life. Collectively our data suggests that glymphatic dysfunction may contribute to post asphyxia-induced brain injury. Early evaluation of EPVSs could aid in risk stratification and intervention strategies.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"1055-1068"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653852/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and survival of pediatric low-grade gliomas in Switzerland.","authors":"Ladina Greuter, Eleftheria Michalopoulou, Shelagh Redmond, Nicolas V der Weid, Maria Licci, Johanna Wyss, Raphael Guzman, Jehuda Soleman","doi":"10.1007/s12519-026-01085-8","DOIUrl":"10.1007/s12519-026-01085-8","url":null,"abstract":"<p><strong>Background: </strong>Brain tumors are the most common solid cancers occurring in children, with pediatric low-grade gliomas (pLGG) being the most frequent central nervous system (CNS) tumors in children. The overall survival of pLGG is excellent, with a ten-year survival of 85%-96%. Prognostic factors include age, gender, anatomical location, and histological and molecular subtype. Despite the excellent survival rates, children suffering from pLGG often have a diminished quality of life due to functional or neurologic deficits either caused by the primary tumor or as a side effect of their treatment. In this study, we describe the epidemiology of pLGG in Switzerland.</p><p><strong>Methods: </strong>The target population comprised children aged 0-17 years, diagnosed with histologically verified pLGG during 1990-2019 while residing in Switzerland. We retrieved the data from the Swiss Childhood Cancer Registry (ChCR). We calculated crude incidence rates per 100,000 person-years and observed survival (OS) using the Kaplan-Meier estimator (non-parametric univariable analysis). We estimated OS separately according to age histological subgroup and treatment group.</p><p><strong>Results: </strong>We included 591 pLGG during 1990-2019 in Switzerland. Most pLGG were diagnosed at the age of 2-11 years (n = 352, 59.6%). Around half of pLGG were supratentorial located (n = 286, 48.4%), while the other half (n = 266, 45.0%) occurred infratentorial. Most pLGG (82.0%) were World Health Organization (WHO) grade 1. The vast majority of pLGG (n = 501, 84.8%) were treated with surgery, either alone (n = 441, 74.6%) or in combination with other treatments. The lowest 5- and 10-year survival was observed in children who received surgery followed by radiotherapy and/or chemotherapy (40% and 20%). Astrocytoma excluding pilocytic astrocytoma had a significantly lower 5-year, 10-year and total survival (98.8%, 85.8%, and 82.1%) compared to the other histopathological subtypes (P = 0.024).</p><p><strong>Conclusions: </strong>This is the first report on the incidence and survival of children with pLGG in Switzerland. Children with pLGG have an excellent long-term survival rate of over 90%.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"1083-1094"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of a card game-based intervention in alleviating preoperative anxiety in children: a randomized controlled trial.","authors":"Jun-Qing Chen, Ru-Yu Sun, Yi Wang, Nan Lin, Xian Ye, Dan Wang, Xiao-Hua Wu, Fei Qiu, Hong-Zhen Xu, Wei-Fang Zhang","doi":"10.1007/s12519-026-01097-4","DOIUrl":"10.1007/s12519-026-01097-4","url":null,"abstract":"","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"1095-1098"},"PeriodicalIF":7.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149008874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"BMI trajectories from ages 1 to 7 years and associated cardiometabolic risk at age 8 years: distinguishing cumulative and timing-specific effects.","authors":"Ming Gao, Qing-Qing Meng, Shu-Min Zhao, Dan-Tong Zhao, Yi-Juan Qiao, Wei-Qin Li, Jin-Nan Liu, Zhi-Jie Yu, Gang Hu, Jun-Hong Leng, Xi-Lin Yang, Jing Li","doi":"10.1007/s12519-026-01079-6","DOIUrl":"10.1007/s12519-026-01079-6","url":null,"abstract":"<p><strong>Background: </strong>Evidence from repeated early-childhood BMI measurements in Chinese children remains limited. This study aimed to examine associations between body mass index (BMI) trajectories from ages 1 to 7 years and cardiometabolic risk at age 8 in this population, and to further distinguish cumulative and timing-specific effects of early BMI development.</p><p><strong>Methods: </strong>We followed 1072 mother-child pairs from Tianjin, China for 8 years. Height and weight were measured annually between ages 1 and 7 years; blood pressure, fasting glucose, and lipid concentrations were assessed at age 8. Group-based trajectory modeling was used to identify BMI trajectories. Excess BMI-years, adiposity rebound (AR) age, and interval-specific conditional BMI Z-score gain at ages 1-3, 3-5, and 5-7 years were further assessed. Generalized linear and logistic regression models were used to estimate associations with a modified continuous cardiometabolic risk score (modified cMetS) and cardiometabolic risk traits (CRTs) at age 8.</p><p><strong>Results: </strong>Two adverse BMI trajectories were identified: late obesity growth pattern (LOGP) and persistent obesity growth pattern (POGP). Compared with control trajectory, LOGP and POGP were associated with higher modified cMetS in fully adjusted models [LOGP: regression coefficient (β) = 0.88, 95% confidence interval (CI) = 0.53-1.22; POGP: β = 1.59, 95% CI = 0.87-2.31] and higher CRT risk [LOGP: odds ratio (OR) = 1.70, 95% CI = 1.20-2.41; POGP: OR = 3.91, 95% CI = 1.92-7.99]. Among individual CRT components, significant associations were mainly observed for hypertension. Greater excess BMI-years, earlier AR, and greater conditional BMI Z-score gain during ages 3-5 and 5-7 years were also associated with higher modified cMetS and CRT risk.</p><p><strong>Conclusions: </strong>LOGP and POGP in early childhood were associated with increased cardiometabolic risk at age 8. Greater cumulative excess BMI burden, earlier AR, and accelerated BMI gain during specific periods may help identify children at higher risk.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"886-898"},"PeriodicalIF":7.3,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}