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Objective <p>This study aimed to describe four-year body mass index (BMI) trajectories among Chinese university students, evaluate the predictive value of early anthropometric indicators for senior-year BMI, and examine the bidirectional longitudinal associations between BMI and vital capacity using a cross-lagged panel model.</p> Methods <p>A four-year longitudinal cohort study was conducted at a university in Jiangsu Province, China (2021–2025), including 4,422 undergraduate students (3,010 males, 68.1%). Height, weight, and vital capacity were measured annually. Descriptive trajectory analysis, predictive modeling with repeated cross-validation (linear regression, LASSO, random forest with hyperparameter tuning), cross-lagged panel modeling, multiple imputation sensitivity analysis, and formal interaction tests were performed.</p> Results <p>Male BMI increased from 22.49 ± 3.59 to 23.57 ± 4.76&#xa0;kg/m² (mean increase: 1.08&#xa0;kg/m²); female BMI increased from 21.17 ± 2.89 to 21.46 ± 3.06&#xa0;kg/m² (mean increase: 0.29&#xa0;kg/m²). Temporal stability analysis demonstrated that senior-year BMI was near-fully determined by earlier BMI measurements (R² = 0.850 ± 0.037); junior-year BMI alone accounted for 93.6% of variable importance. Adding VC z-scores and sex yielded ΔR² = 0.0004. The cross-lagged panel model (FIML, <i>N</i> = 4,422) revealed strong BMI autoregressive stability (β = 0.86–0.88) and very small cross-lagged paths (all |β| ≤ 0.10). An RI-CLPM was attempted but yielded unstable within-person estimates due to the very high rank-order stability of BMI. Included and excluded participants did not differ significantly in baseline BMI (<i>p</i> = 0.427) or VC z-score (<i>p</i> = 0.718).</p> Conclusions <p>BMI showed strong longitudinal tracking stability across the four university years, with the increase substantially greater in males. Cross-lagged panel modeling with height-and-age-adjusted vital capacity z-scores revealed prospective associations of negligible magnitude (all |β| ≤ 0.10). These findings characterize the natural history of BMI change during the university period and indicate that pulmonary function, as measured by vital capacity, has minimal prospective association with BMI trajectories after accounting for anthropometric confounding.</p>

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Body mass index trajectories and bidirectional longitudinal associations with vital capacity: a four-year longitudinal study of Chinese university students

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Xupeng Zhang,
  • Changnan Xu,
  • MengBiao Cai,
  • Bo Peng,
  • Kebing Yuan

摘要

Objective

This study aimed to describe four-year body mass index (BMI) trajectories among Chinese university students, evaluate the predictive value of early anthropometric indicators for senior-year BMI, and examine the bidirectional longitudinal associations between BMI and vital capacity using a cross-lagged panel model.

Methods

A four-year longitudinal cohort study was conducted at a university in Jiangsu Province, China (2021–2025), including 4,422 undergraduate students (3,010 males, 68.1%). Height, weight, and vital capacity were measured annually. Descriptive trajectory analysis, predictive modeling with repeated cross-validation (linear regression, LASSO, random forest with hyperparameter tuning), cross-lagged panel modeling, multiple imputation sensitivity analysis, and formal interaction tests were performed.

Results

Male BMI increased from 22.49 ± 3.59 to 23.57 ± 4.76 kg/m² (mean increase: 1.08 kg/m²); female BMI increased from 21.17 ± 2.89 to 21.46 ± 3.06 kg/m² (mean increase: 0.29 kg/m²). Temporal stability analysis demonstrated that senior-year BMI was near-fully determined by earlier BMI measurements (R² = 0.850 ± 0.037); junior-year BMI alone accounted for 93.6% of variable importance. Adding VC z-scores and sex yielded ΔR² = 0.0004. The cross-lagged panel model (FIML, N = 4,422) revealed strong BMI autoregressive stability (β = 0.86–0.88) and very small cross-lagged paths (all |β| ≤ 0.10). An RI-CLPM was attempted but yielded unstable within-person estimates due to the very high rank-order stability of BMI. Included and excluded participants did not differ significantly in baseline BMI (p = 0.427) or VC z-score (p = 0.718).

Conclusions

BMI showed strong longitudinal tracking stability across the four university years, with the increase substantially greater in males. Cross-lagged panel modeling with height-and-age-adjusted vital capacity z-scores revealed prospective associations of negligible magnitude (all |β| ≤ 0.10). These findings characterize the natural history of BMI change during the university period and indicate that pulmonary function, as measured by vital capacity, has minimal prospective association with BMI trajectories after accounting for anthropometric confounding.