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Childhood predictors of cardiovascular disease in adulthood. A systematic review and meta-analysis
O Ajala1, F Mold1, C Boughton2
1Faculty of Health and Medical Sciences, University of Surrey, Surrey, UK.
Insights
Childhood obesity is linked to adult adiposity and cardiovascular issues. Childhood body mass index (BMI) predicts adult dysglycaemia and carotid intima media thickness (CIMT), but shows weak to moderate prediction for hypertension and cardiovascular events.
Area of Science:
- Pediatrics
- Cardiology
- Endocrinology
Background:
- Childhood obesity is a growing concern, often predicting adult adiposity.
- Adult adiposity is linked to earlier onset of cardiovascular diseases and dysglycaemia.
- The predictive role of childhood obesity on these adult conditions requires further investigation.
Purpose of the Study:
- To systematically review studies assessing childhood obesity measures' ability to predict adult dysglycaemia and atherosclerotic cardiovascular disease (ACVD).
- To evaluate the predictive power of childhood body mass index (BMI) and skin fold thickness for specific ACVD markers and events.
Main Methods:
- Systematic review of studies from multiple databases (Web of Science, MEDLINE, PubMed, etc.).
- Included studies measured body mass index (BMI), skin fold thickness, or waist circumference in children.
- 18 studies out of 1,954 met the inclusion criteria.
Main Results:
- Childhood BMI significantly predicted increased carotid intima media thickness (CIMT) (OR, 3.39) and risk of impaired glucose tolerance.
- Childhood BMI showed weak to moderate prediction for ACVD events (OR, 1.04) and hypertension (OR, 1.17).
- Skin fold thickness weakly predicted CIMT in adult females only.
Conclusions:
- Childhood BMI is a significant predictor of adult dysglycaemia and abnormal CIMT.
- The predictive ability of childhood BMI for hypertension and ACVD events is weak to moderate.
- Childhood obesity measures offer valuable insights into future cardiovascular and metabolic health risks.
Abstract:
Childhood obesity predicts the risk of adult adiposity, which is associated with the earlier onset of cardiovascular disease [adult atherosclerotic cardiovascular disease, ACVD: hypertension, increased carotid intima media thickness (CIMT) stroke, ischemic heart disease (IHD)] and dysglycaemia. Because it is not known whether childhood obesity contributes to these diseases, we conducted a systematic review of studies that examine the ability of measures of obesity in childhood to predict dysglycaemia and ACVD. Data sources were Web of Science, MEDLINE, PubMed, CINAHL, Cochrane, SCOPUS, ProQuest and reference lists. Studies measuring body mass index (BMI), skin fold thickness and waist circumference were selected; of 1,954 studies, 18 met study criteria. Childhood BMI predicted CIMT: odds ratio (OR), 3.39 (95% confidence interval (CI), 2.02 to 5.67, P < 0.001) and risk of impaired glucose tolerance in adulthood, but its ability to predict ACVD events (stroke, IHD; OR, 1.04; 95% CI, 1.02 to 1.07; P < 0.001) and hypertension (OR, 1.17, 95% CI 1.06 to 1.27, P = 0.003) was weak-moderate. Body mass index was not predictive of systolic BP (r -0.57, P = 0.08) and weakly predicted diastolic BP (r 0.21, P = 0.002). Skin fold thickness in childhood weakly predicted CIMT in female adults only (rs 0.09, P < 0.05). Childhood BMI predicts the risk of dysglycaemia and abnormal CIMT in adulthood, but its ability to predict hypertension and ACVD events was weak and moderate, respectively. Skin fold thickness was a weak predictor of CIMT in female adults.
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