Two-year change in weight status and high carotid intima-media thickness in Chinese children

No studies have assessed the association between change in weight status and subclinical cardiovascular outcomes in children.

To examine the association of change in weight status over 2 years with carotid intima-media thickness (cIMT) among Chinese children.

A total of 1184 children aged 6-11 years at baseline with complete data were included, and there were 1073 children after excluding those with cIMT ≥ sex- and age-specific 90th percentile values at baseline. Overweight (including obesity) at baseline or follow-up was defined by criteria for overweight and obesity for Chinese school-aged children and adolescents. High cIMT at follow-up was defined as cIMT ≥ age- and sex-specific 90th percentile based on the study population at follow-up.

Compared with children who were in persistent normal-weight group, those in the incident or persistent overweight groups had higher cIMT change (incident overweight: β = 0.0149, p < 0.05; persistent overweight: β = 0.0068, p < 0.05) and had higher odds of high cIMT at follow-up (incident overweight: odds ratio [OR] = 3.58, 95% confidence interval [CI] = 1.34-9.61; persistent overweight: OR = 13.41, 95% CI = 7.58-23.73). In contrast, there was no significant increase in cIMT change (β = 0.0106, p > 0.05) and odds of high cIMT (OR = 2.50, 95% CI = 0.69-9.01) in the resolution group.

Children who developed overweight or maintained overweight over 2 years had increased odds of high cIMT, whereas those able to resolve their overweight status had a similar odds of developing high cIMT in childhood at follow-up. These findings highlight the potential role of managing weight status among children to preserve vascular health.