Features of childhood growth, lifestyle and environment associated with a cardiometabolic risk score in young adults

Abstract

Introduction: In young adults, the metabolic syndrome is rare. To better assess the risks for future cardiovascular disease, a cardiometabolic score can be used, ranking the disease risk in each subject. The score is a continuous variable summarising the individual z-scores for waist circumference, blood pressure, blood levels of glucose, triglycerides and HDL-cholesterol. Our main aim was to assess the association between early childhood growth and the cardiometabolic score in young adults. Methods: Study participants were recruited among subjects in the longitudinal population-based GrowUp 1990 Gothenburg study. Those with information on weight and length at birth, as well as weight, height, waist circumference, and parental BMI at ten years of age were invited to participate in a health survey at 18-20 years of age. 513 young adults (female 51%) were included. Multivariable linear stepwise regression analysis was applied. Results: The mean (SD) BMI was 22.2 (3.26) in males and 21.3 (2.69) kg/m² in females; the cardiometabolic score was 0.24 (3.12) and -0.22 (3.18), respectively. A statistically significantly higher score (p<0.001) was seen in individuals with metabolic syndrome, as defined by IDF. After controlling for adult lifestyle features, BMI z-score at ten years of age was significant risk factor in both sexes for an elevated cardiometabolic score in early adulthood, mean(SE) beta 0.47(0.19), p=0.014 in males, 0.82(017) p<0.0001 in females. In males, high maternal BMI and low age at adiposity rebound and in females high birth weight were also associated with a statistically significant risk. Additionally, contraceptive use in females was a risk factor for elevated cardiometabolic score and, in males a high lifestyle related index score showed a protective association with the cardiometabolic score. Conclusion: A high BMI z-score at ten years of age is a risk factor for the cardiometabolic state in young adults, an outcome points to the preventive potential of monitoring BMI in ten-year-old schoolchildren. This finding must however be validated in a new large cohort. Moreover, in young adults in whom metabolic syndrome is rare, a cardiometabolic score seems to be a promising approach and potentially a more powerful tool to detect risks for cardiovascular disease later in life, than using metabolic syndrome categorisation.