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. 2009 Sep;155(3):S5.e17-26.
doi: 10.1016/j.jpeds.2009.04.044.

Childhood predictors of the metabolic syndrome in middle-aged adults: the Muscatine study

Trudy L Burns  1 , Elena M Letuchy, Richard Paulos, John Witt
Affiliations

Childhood predictors of the metabolic syndrome in middle-aged adults: the Muscatine study

Trudy L Burns et al. J Pediatr. 2009 Sep.

Abstract

Objective: To investigate the association between components of the metabolic syndrome (MetS) measured during childhood/adolescence, and adult MetS.

Study design: This investigation focused on members of the Muscatine Study Longitudinal Adult Cohort. Predictor variables were risk factor measurements obtained between 1970 and 1981 when cohort members participated in school survey examinations. Risk factor measurements obtained between 1982 and 2008 when cohort members participated in follow-up examinations as young and middle-aged adults were used for MetS classification.

Results: 33.0% (29.7% of 474 women; 37.0% of 384 men) of cohort members were classified as having the MetS. The initial MetS classification occurred at ages ranging from 23 to 52 years, with a mean age of 37.2 years (SD = 7.4). Cohort members with the MetS had significantly higher body mass index, systolic blood pressure, and triglycerides at the time they participated in the school survey examinations (P < .0001). Estimated probabilities of remaining MetS free at age 35 for those whose school survey body mass index and triglyceride measurements were both <50th vs >/=75th percentiles were strikingly different (0.94 vs 0.42).

Conclusions: BMI is the strongest childhood predictor of adult MetS. Early identification of at-risk children may reduce the burden of atherosclerotic cardiovascular disease.

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Figures

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Kaplan-Meier plot showing the estimated probability of remaining MetS free for Muscatine Study Longitudinal Adult Cohort members whose body mass index (BMI) load based on school survey examinations was < 50th percentile vs. ≥ 75th percentile. The table displays probability and associated standard error estimates for the two BMI groups at 35 and 45 years of age. Based on the log-rank test there is a significant difference between the curves (p < 0.0001).
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Kaplan-Meier plot showing the estimated probability of remaining MetS free for four groups of Muscatine Study Longitudinal Adult Cohort members: those whose BMI & triglyceride (TRIG) loads were both < 50th percentile; those whose BMI load was < 50th & whose TRIG load was ≥ 75th percentile; those whose BMI load was ≥ 75th & whose TRIG load was < 50th percentile; and those whose BMI & TRIG loads were ≥ 75th percentile. The table displays probability and associated standard error estimates for the four groups at 35 years of age. Based on the log-rank test there is a significant difference among the curves (p < 0.0001).
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Estimated probability of being classified with MetS in the Age 40 subset as a function of school survey BMI and TRIG loads. The 50th percentile of TRIG load corresponds to a load of 0.00, and the 75th percentile to a load of 0.67, and the 90th percentile to a load of 1.28.
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