Are associations of childhood body mass index trajectories with early-onset coronary heart disease modified by parental history of cardiovascular disease?

Background

Although body size in early life indicates later cardiovascular disease (CVD) risks it remains unknown whether parental CVD alters this risk. We examined if parental CVD history modifies the association between offspring childhood body mass index (BMI) trajectories and early-onset coronary heart disease (CHD).

Methods

We included 66,906 females and 71,479 males from the Copenhagen School Health Records Register, born 1952-1996, with weight and height measurements at 6-15 years. Five sex-specific childhood BMI trajectories were examined in relation to register-based CHD diagnoses (≥25 years). Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by ages 25-44, 45-54, and ≥55 years using Cox regression.

Results

During follow-up, 1642 females and 3456 males were diagnosed with CHD. Parental CVD did not modify the associations between childhood BMI trajectory and CHD. In models adjusted for parental CVD, compared with the average BMI trajectory, female offspring with the overweight (HR = 1.65, 95% CI: 1.21-2.26) and obesity (2.28, 1.49-3.49) BMI trajectories had increased hazards of CHD only at 25-44 years. The corresponding estimates for males were 1.70 (1.36-2.12) and 2.23 (1.61-3.09). Among males, associations were evident at 45-54 years, but no associations were found at ≥55 years in either sex.

Conclusions

Individuals with the obesity childhood BMI trajectory had a more than 2-fold increased hazard of early-onset CVD, even when accounting for parental CVD. With the rise in early-onset CVD, our findings highlight excess childhood adiposity as an important contributor to the early disease origins and reinforce the importance of addressing the growing obesity burden of childhood obesity.