Obesity in childhood and vascular changes in adulthood: insights into the Cardiovascular Risk in Young Finns Study.

AIMS: Exposure to risk factors in childhood may have long-term influences on vascular structure and function. This paper reviews recent findings from the Cardiovascular Risk in Young Finns Study looking at the relationships between risk factors identified in childhood, including obesity, and arterial structure/function assessed in adulthood.

METHODS: The Young Finns Study is a longitudinal study from childhood to adulthood. The baseline study was carried out in 980 and included 3.596 children and adolescents aged 3-18y. Regular follow-up examinations of this cohort have included comprehensive data collection, including obesity indices (body mass index (BMI, kg/m2) and skinfolds in childhood), serum lipoproteins, insulin, glucose, blood pressure, family risk, lifestyle factors, smoking status, alcohol use, physical activity, psychological factors, diet and socioeconomic status. The latest follow-up was carried out in 2001 (N = 2283, ages 24-39 y). In ddition to the usual protocol, this 21-y follow-up study included ultrasound measurements of carotid artery intima-media hickness (IMT) and carotid artery elasticity.

RESULTS: In this cohort, BMI measured in youth is significantly associated with BMI measured in adulthood. The correlation coefficient for 21-y tracking between childhood and adulthood BMI is r = 0.45 (P<0.0001). In multivariate analysis, childhood LDL-cholesterol, systolic blood pressure, BMI and smoking were all significantly associated with adult IMT. The effects of hildhood LDL-cholesterol and systolic blood pressure remained independently associated with carotid IMT when adjusted for the current risk factor values (P<0.01 for both). However, when adulthood BMI was entered into the model, the effect of childhood BMI became nonsignificant. The age- and sex-adjusted multivariate correlates of carotid artery elasticity included childhood skinfold thickness (sum of biceps, triceps and subscabular) and childhood systolic blood pressure. Childhood systolic lood pressure remained borderline significantly (P= 0.08) associated with carotid elasticity when the effect of current blood pressure was taken into account. However, the effect of childhood skinfold thickness on carotid artery elasticity became nonsignificant (P= 0.16) when adjusted with adult BMI.

CONCLUSIONS: The data from the Cardiovascular Risk in Young Finns Study suggest that obesity indices measured in youth are significantly associated with increased carotid artery IMT and decreased elasticity in adulthood. These relations are, at least, partly explained by significant tracking of obesity from youth to adulthood. These findings emphasize the importance of maintaining ideal weight from youth to adulthood in cardiovascular risk reduction.