The Relationship Between Childhood BMI and Adult Serum Cholesterol, LDL, and Ankle Brachial Index

Objective Effects of childhood overweight may persist into adulthood. We assessed the effect of childhood overweight on cardiovascular disease high risk factor levels in the same participants as adults, after controlling for adult BMI status.

Design A subset of participants in an observational study (Heartwatch) were contacted approximately 26–27 years after initial enrollment to participate in a follow-up study on the long-term effects of childhood overweight. During follow-up, BMI, waist:hip circumference (WHC), blood pressure (BP), serum lipids, and ankle brachial index (ABI) were measured; additional BMI measures throughout childhood were obtained as available from the electronic medical record. Primary outcomes were ABI and serum LDL.

Setting The 1982 Heartwatch study was conducted with children participants living in Marshfield, WI; follow-up included original participants who were re-contacted and agreed to be enrolled.

Participants Participants were a stratified random sample of eligible participants in the original 1982 Heartwatch study. Of the original 3106 participants, 647 adult participants completed follow-up exams.

Results Among males with 1982 BMI ≥ 85^th percentile, adult BMI, WHC, (both p ≤ 0.001), ABI (p = 0.001), total cholesterol (p = 0.01), LDL (p=0.003) and BP (p < 0.02) were higher in 2008–09 as compared to males with 1982 BMI < 85^th percentile. Among females, BMI, BP and WHC (all p < 0.001) were higher in 2008–09. BMI in 1982 and 2008–09 were correlated [r = 0.56 (males); 0.58 (females), p < 0.001]. 2008–09 BMI was more strongly correlated with 2008–09 measures of ABI (r = 0.16, p=0.006, males) and high LDL [r = 0.18, p=0.002 (males); r = 0.11, p=0.046 (females)]. 1982 BMI was not independently associated with ABI or LDL after adjusting for adult BMI.

Conclusion In a cohort studying childhood and adult overweight, childhood BMI was associated with health outcomes relating to cardiovascular disease in adulthood. However, childhood BMI was not independently related to LDL-C or ABI levels in adulthood after accounting for adult BMI. Longitudinal measurements of BMI and other health risk factors were not found to improve accuracy of models for high CVD risk factor levels.