The contribution of childhood obesity to adult carotid intima-media thickness: the Bogalusa Heart Study.
OBJECTIVE
Although obese children are at increased risk for coronary heart disease in later life, it is not clear if the association results from the persistence of childhood obesity into adulthood. We examined the relation of both childhood and adult levels of body mass index (BMI, kg m(-2)) to carotid intima-media thickness (IMT) measured at the (mean) age of 36 years.


METHODS
Prior to the determination of adult IMT, the 1142 participants had been examined 7 (mean) times in the Bogalusa Heart Study.


METHODS
In addition to BMI, levels of lipids, lipoproteins and blood pressure were measured at each examination. Cumulative levels of each risk factor were based on the areas under the individual growth curves calculated using multilevel models for repeated (BMI) measurements. We then examined the relation of these cumulative levels to adult IMT.


RESULTS
Carotid IMT was associated with cumulative levels of BMI in both childhood and adulthood (P<0.001 for each association). Furthermore, the association between childhood BMI and adult IMT persisted, but was reduced, after controlling for adult BMI. Although childhood levels of lipids, lipoproteins and blood pressure were also associated with adult IMT, these associations were not independent of adult levels of these risk factors.


CONCLUSIONS
These results emphasize the adverse effects of elevated childhood BMI levels. In addition to the strong tracking of BMI levels from childhood to adulthood, there appears to be a modest, independent effect of childhood BMI on adult IMT. The prevention of childhood obesity should be emphasized.
Freedman
D S
DS
Division of Nutrition, Physical Activity and Obesity, Centers for Disease Control and Prevention, Atlanta, GA 30341-4133, USA. DFreedman@CDC.gov
Patel
D A
DA
Srinivasan
S R
SR
Chen
W
W
Tang
R
R
Bond
M G
MG
Berenson
G S
GS
D000328:Adult; D050197:Atherosclerosis / Q000209:etiology* / Q000473:pathology; D015992:Body Mass Index; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008055:Lipids / Q000097:blood; D008297:Male; D009765:Obesity / Q000150:complications* / Q000473:pathology / Q000517:prevention & control; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
D008055:Lipids