title: Childhood Infections, Socioeconomic Status, and Adult Cardiometabolic Risk.
abstract: Socioeconomic disadvantage throughout the life course is associated with increased risk of cardiometabolic diseases, but traditional risk factors do not fully account for the social gradient. We investigated the interactions between low socioeconomic status (SES) and infection in childhood and adverse cardiometabolic parameters in adulthood.
  
  
  
  Participants from the Cardiovascular Risk in Young Finns Study, a cohort well phenotyped for childhood and adulthood cardiometabolic risk factors and socioeconomic parameters, were linked to lifetime hospitalization data from birth onward available from the Finnish National Hospital Registry. In those with complete data, we investigated relationships between infection-related hospitalization in childhood, SES, and childhood and adult cardiometabolic parameters.
  
  
  
  The study cohort consisted of 1015 participants (age range 3-18 years at baseline and 30-45 years at follow-up). In adults who were raised in below-median income families, childhood infection-related hospitalizations (at age 0-5 years) were significantly associated with higher adult BMI (β ± SE comparing those with 0 vs ≥1 hospitalizations 2.4 ± 0.8 kg/m(2), P = .008), waist circumference (7.4 ± 2.3 cm, P = .004), and reduced brachial flow-mediated dilatation (-2.7 ± 0.9%, P = .002). No equivalent associations were observed in participants from higher-SES families.
  
  
  
  Infection was associated with worse cardiovascular risk factor profiles only in those from lower-SES families. Childhood infection may contribute to social gradients observed in adult cardiometabolic disease risk factors. These findings suggest reducing childhood infections, especially in socioeconomic disadvantaged children, may reduce the cardiometabolic disease burden in adults.
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia;
authors.forename: Richard S
authors.initials: RS
authors.lastname: Liu
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia; Department of Pediatrics, Monash University, Clayton, Victoria, Australia; david.burgner@mcri.edu.au.
authors.forename: David P
authors.initials: DP
authors.lastname: Burgner
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia;
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Sabin
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine and Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia;
authors.forename: Costan G
authors.initials: CG
authors.lastname: Magnussen
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia;
authors.forename: Michael
authors.initials: M
authors.lastname: Cheung
authors.affiliation: Departments of Pediatrics, and Clinical Physiology, University of Tampere, Tampere, Finland;
authors.forename: Nina
authors.initials: N
authors.lastname: Hutri-Kähönen
authors.affiliation: Clinical Physiology, University of Tampere, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Tampere, Finland;
authors.forename: Mika
authors.initials: M
authors.lastname: Kähönen
authors.affiliation: Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Tampere, Finland;
authors.forename: Terho
authors.initials: T
authors.lastname: Lehtimäki
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 Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland;
authors.forename: Tomi
authors.initials: T
authors.lastname: Laitinen
authors.affiliation: Department of Pediatrics, University of Oulu, Oulu, and Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland;
authors.forename: Leena
authors.initials: L
authors.lastname: Taittonen
authors.affiliation: Oxford Martin School and Nuffield Department of Population Health, Oxford University, Oxford, United Kingdom;
authors.forename: Terence
authors.initials: T
authors.lastname: Dwyer
authors.affiliation: Department of Medicine, University of Turku, Turku, Finland; Division of Medicine and.
authors.forename: Jorma S A
authors.initials: JS
authors.lastname: Viikari
authors.affiliation: Department of Epidemiology and Public Health, University College London, London, United Kingdom.
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.affiliation: Research Centre of Applied and Preventive Cardiovascular Medicine and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland; and.
authors.forename: Olli T
authors.initials: OT
authors.lastname: Raitakari
authors.affiliation: Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Medicine, University of Turku, Turku, Finland; Division of Medicine and.
authors.forename: Markus
authors.initials: M
authors.lastname: Juonala
mesh_terms: D000293:Adolescent; D000328:Adult; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D054624:Health Status Disparities; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007239:Infections / Q000150:complications*; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D055815:Young Adult