Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors
Juonala, M and Magnussen, CG and Berenson, GS and Venn, A and Burns, TL and Sabin, MA and Srinivasan, SR and Daniels, SR and Davis, PH and Chen, W and Sun, C and Cheung, M and Viikari, JSA and Dwyer, T and Raitakari, OT, Childhood Adiposity, Adult Adiposity, and Cardiovascular Risk Factors, New England Journal of Medicine, 365, (20) pp. 1876-1885. ISSN 0028-4793 (2011) [Refereed Article]
Obesity in childhood is associated with increased cardiovascular risk. It is uncertain
whether this risk is attenuated in persons who are overweight or obese as children
but not obese as adults.
We analyzed data from four prospective cohort studies that measured childhood and
adult body-mass index (BMI, the weight in kilograms divided by the square of the
height in meters). The mean length of follow-up was 23 years. To define high adiposity
status, international age-specific and sex-specific BMI cutoff points for overweight
and obesity were used for children, and a BMI cutoff point of 30 was used for adults.
Data were available for 6328 subjects. Subjects with consistently high adiposity status
from childhood to adulthood, as compared with persons who had a normal BMI as
children and were nonobese as adults, had an increased risk of type 2 diabetes
(relative risk, 5.4; 95% confidence interval [CI], 3.4 to 8.5), hypertension (relative risk,
2.7; 95% CI, 2.2 to 3.3), elevated low-density lipoprotein cholesterol levels (relative
risk, 1.8; 95% CI, 1.4 to 2.3), reduced high-density lipoprotein cholesterol levels (relative
risk, 2.1; 95% CI, 1.8 to 2.5), elevated triglyceride levels (relative risk, 3.0; 95% CI,
2.4 to 3.8), and carotid-artery atherosclerosis (increased intima¨Cmedia thickness of the
carotid artery) (relative risk, 1.7; 95% CI, 1.4 to 2.2) (P¡Ü0.002 for all comparisons).
Persons who were overweight or obese during childhood but were nonobese as adults
had risks of the outcomes that were similar to those of persons who had a normal
BMI consistently from childhood to adulthood (P>0.20 for all comparisons).
Overweight or obese children who were obese as adults had increased risks of type
2 diabetes, hypertension, dyslipidemia, and carotid-artery atherosclerosis. The risks
of these outcomes among overweight or obese children who became nonobese by
adulthood were similar to those among persons who were never obese. (Funded by
the Academy of Finland and others.)