Elsevier

Atherosclerosis

Volume 185, Issue 2, April 2006, Pages 388-393
Atherosclerosis

Obesity in youth is not an independent predictor of carotid IMT in adulthood: The Cardiovascular Risk in Young Finns Study

https://doi.org/10.1016/j.atherosclerosis.2005.06.016Get rights and content

Abstract

Being obese in childhood may be associated with increased cardiovascular morbidity and mortality in adulthood. We examined the relationship between obesity and overweight identified in youth and carotid artery intima–media thickness assessed in adulthood. As part of the longitudinal Cardiovascular Risk in Young Finns Study, we assessed tracking of body mass index (BMI) from youth (ages 3–18 years) to young adulthood (ages 24–39 years) in a cohort of 2260 subjects. BMI measured in youth was significantly associated with BMI measured in adulthood. The risk of being obese in adulthood (BMI > 30 kg/m2) was increased by three-fold in subjects who had been overweight or obese (BMI > 80th percentile) in childhood (ages 3–9 years) and by four-fold in subjects who had been overweight or obese in adolescence (ages 12–18 years). Age and sex adjusted adult IMT values were comparable in subjects who had been consistently overweight/obese in youth and adulthood and in subjects who became obese in adulthood, 0.642 mm versus 0.634 mm, respectively. IMT values were lower (overall P < 0.0001) and comparable in subjects who had remained consistently non-obese and those who had been obese in youth but had become non-obese in adulthood, 0.610 mm versus 0.627 mm, respectively. We conclude that being obese in youth is associated with increased carotid IMT in adulthood, but this relationship is explained by significant tracking of body mass from youth to adulthood.

Introduction

Obesity is associated with clustering of several risk factors for cardiovascular disease including dyslipidemia, elevated blood pressure and hyperinsulinemia already in children and adolescents [1], [2]. Being obese in early life may be associated with long-term adverse cardiovascular health effects, as the risk of morbidity and mortality from coronary heart disease is increased in adult subjects who have been obese in adolescence [3], [4]. Obesity tracks significantly from childhood to adulthood [5] and this may partly explain the relationship between childhood obesity and later cardiovascular disease.

The thickness of the common carotid intima–media (IMT) measured by ultrasound is a marker of structural subclinical atherosclerosis. Increased IMT correlates with cardiovascular risk factors and predicts future cardiovascular events [6], [7], [8]. We have previously shown in the Young Finns cohort that risk factors identified in adolescence predict increased IMT two decades later in adulthood independently of the adult risk factor status [9]. This suggests that risk factors operating in early life may be associated with permanent damage to the arterial wall [10]. In the present analysis, we have examined the association between childhood/adolescence obesity and adult IMT in detail. In particular, we have assessed how the association between body mass index (BMI) in youth and IMT in adulthood varies according to the age of BMI measurement and how obesity tracking patterns are associated with adult IMT.

Section snippets

Subjects

The Cardiovascular Risk in Young Finns Study is an on-going multicentre follow-up study of atherosclerosis precursors of Finnish children and adolescents. The first cross-sectional survey was conducted in 1980 [11]. Total sample size was 4320 children and adolescents in six age cohorts (aged 3, 6, 9, 12, 15 and 18 years). The subjects were randomly chosen from the national register. A total of 3596 subjects (83.2% of those invited) participated in 1980. In 2001, we re-examined these

Results

BMI measured in youth was significantly associated with BMI measured in adulthood. The correlation coefficients varied between r = 0.30 and 0.65 in the six age groups (all P < 0.001). Tracking was generally similar in both sexes.

The prevalence of adult obesity (BMI >30 kg/m2) was 12.3% (men 13.5%; women 11.4%). The prevalence increased by age, being 7.2% in 24-year olds and 15.9% in 39-year olds. Table 1 shows mean BMI levels in childhood and adulthood and the prevalence of obesity in adulthood

Discussion

Longitudinal studies from childhood to adulthood have suggested that being obese or overweight in early life may be associated with increased atherosclerosis, including increased carotid artery IMT [9], [14] and coronary calcification [15], as well as with increased morbidity and mortality from cardiovascular causes [3], [4]. These findings suggest that obesity may have long-term influences on the development of atherosclerosis. Alternatively, the relationship between childhood obesity and

Acknowledgements

This study was financially supported by the Academy of Finland (Grant No. 53392), the Social Insurance Institution of Finland, Ministry of Education, the Turku University Foundation, Special Federal Grants for the Turku University Hospital, the Juho Vainio Foundation, the Finnish Foundation of Cardiovascular Research, the Emil Aaltonen Foundation, the Finnish Medical Foundation and the Finnish Cultural Foundation.

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