title: Youth overweight and metabolic disturbances in predicting carotid intima-media thickness, type 2 diabetes, and metabolic syndrome in adulthood: the Cardiovascular Risk in Young Finns study.
abstract: OBJECTIVE
  Our objective was to assess cardiovascular risk and metabolic complications in adulthood in subjects with or without overweight and metabolic disturbances (i.e., elevated blood pressure, glucose, triglycerides, low HDL cholesterol, and high LDL cholesterol) and their combinations as youth.
  
  
  METHODS
  Using data from the population-based Cardiovascular Risk in Young Finns study, we examined the utility of four age- and sex-specific youth phenotypes (group I: normal weight, no metabolic disturbances; group II: normal weight, one or more metabolic disturbances; group III: overweight/obese, no metabolic disturbances; group IV: overweight/obese, one or more metabolic disturbances) in predicting adult high carotid intima-media thickness (IMT), type 2 diabetes mellitus (T2DM), and metabolic syndrome (MetS). The study included 1,617 participants 9-24 years of age at baseline who were followed up 21-25 years later.
  
  
  RESULTS
  IMT (mean ± SEM) was higher among participants in groups II (0.627 ± 0.005 mm, P = 0.05), III (0.647 ± 0.010 mm, P = 0.005), and IV (0.670 ± 0.010 mm, P < 0.0001) compared with group I (0.616 ± 0.003 mm). In addition, subjects in group IV had significantly higher IMT compared with those in group II (P = 0.002). Participants in groups II, III, and IV were at increased risk of the development of MetS in adulthood compared with those in the control group. For group II participants, the difference was attenuated after risk factor adjustments. Additionally, participants in group III and IV were at increased risk of the development of T2DM compared with those in groups I and II.
  
  
  CONCLUSIONS
  While metabolic risk factors associated with overweight increase future risk for MetS, T2DM, and increased IMT, overweight in isolation is also a risk factor. Therefore, overweight should be prevented and treated wherever possible.
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, FinlandDepartment of Medicine, Kymenlaakso Central Hospital, Kotka, Finland jkkosk@utu.fi.
authors.forename: Juha
authors.initials: J
authors.lastname: Koskinen
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, FinlandMenzies Research Institute Tasmania, Hobart, Tasmania, Australia.
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.affiliation: The Royal Children's Hospital, Murdoch Childrens Research Institute, and University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Sabin
authors.affiliation: Department of Clinical Physiology, Tampere University Hospital and University of Tampere, Tampere, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Kähönen
authors.affiliation: Department of Pediatrics, Tampere University Hospital and University of Tampere, Tampere, Finland.
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland.
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.affiliation: Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland.
authors.forename: Leena
authors.initials: L
authors.lastname: Taittonen
authors.affiliation: Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Jokinen
authors.affiliation: Department of Clinical Chemistry, Fimlab Laboratories, Tampere University Hospital and Tampere University School of Medicine, Tampere, Finland.
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
authors.affiliation: Division of Medicine, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.affiliation: Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.affiliation: Division of Medicine, University of Turku and Turku University Hospital, Turku, Finland.
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology; D059168:Carotid Intima-Media Thickness; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000209:etiology; D050171:Dyslipidemias / Q000453:epidemiology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology* / Q000209:etiology; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D012307:Risk Factors; D055815:Young Adult