Infection-Related Hospitalization in Childhood and Adult Metabolic Outcomes
David P Burgner1, Matthew A Sabin2, Costan G Magnussen3
1Murdoch 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.
Insights
Hospitalization with childhood infections is linked to higher adult BMI and metabolic syndrome risk. Early or repeated childhood infections may influence long-term cardiometabolic health.
Area of Science:
- Pediatric Health
- Cardiometabolic Disease Research
- Epidemiology
Background:
- Childhood determinants of adult cardiometabolic disease are crucial for early interventions.
- Longitudinal data on childhood infections' contribution to adult disease is limited.
- Investigating childhood infection hospitalization as a risk factor for adult cardiometabolic outcomes is needed.
Purpose of the Study:
- To determine if hospitalization with childhood infection is associated with adult anthropometric and metabolic outcomes.
- To analyze the relationship between infection-related hospitalization (IRH) at different life stages and adult cardiometabolic health.
- To identify potential early-life predictors of adult cardiometabolic disease.
Main Methods:
- Utilized the Cardiovascular Risk in Young Finns Study cohort (n=1376).
- Assessed infection-related hospitalization (IRH) from birth through adulthood (age 30-45).
- Related lifetime and stage-specific IRHs to adult adiposity, BMI, and metabolic syndrome, adjusting for confounders.
Main Results:
- Early-childhood IRH (<5 years) was associated with increased adult BMI (P=.02) and metabolic syndrome (RR=1.56, P=.03).
- The age of IRH correlated with the persistence of adult BMI differences.
- Multiple childhood IRHs (>1) were linked to the greatest increase in adult BMI.
Conclusions:
- Childhood infection hospitalization is an independent predictor of adverse adult metabolic variables.
- Infections and/or their treatments in childhood may play a role in adult cardiometabolic disease development.
- Findings highlight the importance of early-life infection history in long-term health trajectories.
Background And Objectives:
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.
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