Infection-Related Hospitalization in Childhood and Adult Metabolic Outcomes.
OBJECTIVE
Identifying childhood determinants of adult cardiometabolic disease would facilitate early-life interventions. There are few longitudinal data on the contribution of childhood infections. Therefore, we investigated whether hospitalization with childhood infection is associated with adult anthropometric and metabolic outcomes in a large, well-phenotyped longitudinal cohort.


METHODS
A total of 1376 subjects from the Cardiovascular Risk in Young Finns Study, aged 3 to 9 years at baseline (1980), who had lifetime data from birth onward on infection-related hospitalization (IRH) had repeated assessments through childhood and adolescence and at least once in adulthood (age 30-45 years in 2001-2011). Early childhood (<5 years), childhood/adolescence (5-18 years), adult (>18 years), and total lifetime IRHs were related to adiposity, BMI, and metabolic syndrome in adulthood. Analyses were adjusted for childhood and adulthood risk factors and potential confounders.


RESULTS
Early-childhood IRH correlated with adverse adult but not childhood metabolic variables: increased BMI (P = .02) and metabolic syndrome (risk ratio: 1.56; 95% confidence interval: 1.03-2.35; P = .03), adjusted for age, gender, birth weight, childhood BMI and other risk factors, and family income. The age at which differences in adult BMI became persistent was related to age of IRH in childhood. The greatest increase in adult BMI occurred in those with >1 childhood IRH.


CONCLUSIONS
Childhood IRH was independently associated with adverse adult metabolic variables. This finding suggests that infections and/or their treatment in childhood may contribute to causal pathways leading to adult cardiometabolic diseases.
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia; Department of Pediatrics, Monash University, Department of Pediatric Infectious Diseases, Monash Children's Hospital, Clayton, Victoria, Australia; david.burgner@mcri.edu.au.
David P
DP
Burgner
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia;
Matthew A
MA
Sabin
Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Menzies Research Institute Tasmania, University of Tasmania, Hobart, Australia;
Costan G
CG
Magnussen
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia; Royal Children's Hospital, Parkville, Victoria, Australia;
Michael
M
Cheung
Departments of Clinical Physiology and.
Mika
M
Kähönen
Department of Clinical Chemistry, Finlab Laboratories, Tampere University Hospital and University of Tampere School of Medicine, Tampere, Finland;
Terho
T
Lehtimäki
Pediatrics, University of Tampere and Tampere University Hospital, Tampere, Finland;
Nina
N
Hutri-Kähönen
Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland;
Eero
E
Jokinen
Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland;
Tomi
T
Laitinen
Department of Pediatrics, University of Oulu, Oulu, and Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland;
Leena
L
Taittonen
Department of Children and Adolescents, Oulu University Hospital, PEDEGO Research Group, and Medical Research Center Oulu, University of Oulu, Oulu, Finland;
Päivi
P
Tossavainen
Oxford Martin School and Nuffield Department of Population Health, Oxford University; Oxford, United Kingdom;
Terence
T
Dwyer
Department of Medicine, University of Turku, and Division of Medicine, Turku University Hospital, Turku, Finland; and.
Jorma S A
JS
Viikari
Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
Olli T
OT
Raitakari
Murdoch Children's Research Institute, Parkville, Victoria, Australia; Department of Medicine, University of Turku, and Division of Medicine, Turku University Hospital, Turku, Finland; and.
Markus
M
Juonala
D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003141:Communicable Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D008875:Middle Aged