Paper
International Journal of Obesity (2004) 28, 159–166. doi:10.1038/sj.ijo.0802515 Published online 28 October 2003
The relation of obesity throughout life to carotid intima-media thickness in adulthood: the Bogalusa Heart Study
D S Freedman1, W H Dietz1, R Tang2, G A Mensah3, M G Bond2, E M Urbina4, S Srinivasan5 and G S Berenson5
- 1Division of Nutrition and Physical Activity, Centers for Disease Control and Prevention, Atlanta, GA, USA
- 2Division of Vascular Ultrasound Research, Wake Forest University Baptist Medical Center, Piedmont Plaza Two, Winston-Salem, NC, USA
- 3Cardiovascular Health Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
- 4Tulane University Medical Center, Section of Pediatric Cardiology, New Orleans, LA, USA
- 5Tulane Center for Cardiovascular Health, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA
Correspondence: Dr D Freedman, Rm 5161 Rhodes Bldg, 3005 Chamblee-Tucker Rd, Atlanta, GA 30341-4133, USA. E-mail: DFreedman@CDC.gov
Received 21 May 2003; Revised 7 August 2003; Accepted 5 September 2003; Published online 28 October 2003.
Abstract
OBJECTIVE: Although obese children are at increased risk for coronary heart disease in later life, it is not clear if this association results from the persistence of childhood obesity into adulthood. We examined the relation of adiposity at various ages to the carotid intima-media thickness (IMT) at age 35 y.
DESIGN: Prior to the determination of IMT by B-mode ultrasound, subjects (203 men, 310 women) had, on average, six measurements of body mass index (BMI) and triceps skinfold thickness (TSF) between the ages of 4 and 35 y. Mixed regression models for longitudinal data were used to assess the relation of these characteristics to adult IMT.
RESULTS: Overall, adult IMT was associated with levels of both BMI and TSF (P<0.001), with the magnitudes of the associations with childhood adiposity comparable to those with adult levels of BMI and TSF. Furthermore, adult obesity modified the association between childhood adiposity and IMT: high IMT levels were seen only among overweight (BMI 
95th percentile) children who became obese (BMI 30 kg/m2) adults (P<0.01 for linear trend). In contrast, IMT levels were not elevated among (1) overweight children who were not obese in adulthood, or among (2) thinner children who became obese adults.
CONCLUSIONS: These results emphasize the adverse, cumulative effects of childhood-onset obesity that persists into adulthood. Since many overweight children become obese adults, the prevention of childhood obesity should be emphasized.
Keywords:
atherosclerosis, carotid arteries, children, longitudinal, triceps skinfold thickness, ultrasound, intima-media thickness
