Abstract
BackgroundWe have examined the association between adiposity and cardiac structure in adulthood, using a life course approach that takes account of the contribution of adiposity in both childhood and adulthood.MethodsThe Childhood Determinants of Adult Health study (CDAH) is a follow-up study of 8,498 children who participated in the 1985 Australian Schools Health and Fitness Survey (ASHFS). The CDAH follow-up study included 2,410 participants who attended a clinic examination. Of these, 181 underwent cardiac imaging and provided complete data. The measures were taken once when the children were aged 9 to 15 years, and once in adult life, aged 26 to 36 years.ResultsThere was a positive association between adult left ventricular mass (LVM) and childhood body mass index (BMI) in males (regression coefficient (β) 0.41; 95% confidence interval (CI): 0.14 to 0.67; p = 0.003), and females (β = 0.53; 95% CI: 0.34 to 0.72; p < 0.001), and with change in BMI from childhood to adulthood (males: β = 0.27; 95% CI: 0.04 to 0.51; p < 0.001, females: β = 0.39; 95% CI: 0.20 to 0.58; p < 0.001), after adjustment for confounding factors (age, fitness, triglyceride levels and total cholesterol in adulthood). After further adjustment for known potential mediating factors (systolic BP and fasting plasma glucose in adulthood) the relationship of LVM with childhood BMI (males: β = 0.45; 95% CI: 0.19 to 0.71; p = 0.001, females: β = 0.49; 95% CI: 0.29 to 0.68; p < 0.001) and change in BMI (males: β = 0.26; 95% CI: 0.04 to 0.49; p = 0.02, females: β = 0.40; 95% CI: 0.20 to 0.59; p < 0.001) did not change markedly.ConclusionsAdiposity and increased adiposity from childhood to adulthood appear to have a detrimental effect on cardiac structure.
Highlights
We have examined the association between adiposity and cardiac structure in adulthood, using a life course approach that takes account of the contribution of adiposity in both childhood and adulthood
Participants who received echocardiography were similar to those clinic attendees who did not have the examination with respect to body mass index (BMI), total cholesterol, low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), triglycerides, insulin, and glucose, but had higher mean (SD) systolic (121 (13) vs 117 (13)) and diastolic (75 (9) vs 72 (9)) blood pressure, and waist circumference (86.0 (12.5) vs 83.6 (12.3))
For each adiposity measure, (BMI, waist circumference, fat mass and skin fold thickness) there was an indication of higher Left ventricular mass index (LVMI) in those who were overweight in both childhood and adulthood or only overweight in childhood
Summary
We have examined the association between adiposity and cardiac structure in adulthood, using a life course approach that takes account of the contribution of adiposity in both childhood and adulthood. Given that diabetes exerts adverse effects on systolic and diastolic LV function independent of hypertension and coronary artery disease [12,13,14]; that this association is evident well below the threshold for diabetes [15]; and that fitness impacts on cardiac structure [16], assessment of these factors (both confounding and mediating) in early to mid-adulthood is warranted. The Childhood Determinants of Adult Health study (CDAH) is a longitudinal, population-based cohort of young adults followed since childhood in Australia This provides an important opportunity to examine the association between adiposity (potential predictor) and cardiac structure in adulthood (outcome), using a life course approach that takes account of the contribution of adiposity in both childhood and adulthood
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