Background Cardiometabolic risk increases with increasing body mass index (BMI). The exact mechanism is poorly understood, and traditional risk assessment of young adults with obesity has shown to be ineffective. Greater knowledge about potential new effective biomarkers and the use of advanced cardiac imaging for risk assessment in young adults is, therefore, necessary. Objective This study aims to explore traditional and novel cardiometabolic risk markers across strata of BMI in young adults. Methods Participants (N = 264, 50% women, age 28–30 years) were invited from an ongoing cohort study, based on BMI and sex. BMI‐strata were: BMI <25, 25–30, >30 kg/m2, representing normal weight (NW), overweight (OW), and obesity (OB). Participants underwent cardiac computed tomography to detect coronary artery calcification, measures of body composition, blood pressure measurements, and a comprehensive panel of circulating cardiometabolic risk markers. Results No significant coronary artery calcifications were detected in this study. Minor differences in median levels of traditional risk markers were detected across BMI‐strata, for example, total cholesterol (men‐ NW: 4.7 (4.3–5.1) and OB: 4.8 (4.2–5.6) mmol/L, p = 0.58; women‐ NW: 4.3 (3.9–4.8) and OB: 4.7 (4.2–5.3) mmol/L, p = 0.016), whereas substantial differences were seen in markers of inflammation and glucose metabolism, for example, high sensitive CRP (men‐ NW: 0.6 (0.3–1.1) and OB: 2.8 (1.5–4.0) mg/L, p < 0.001; women‐ NW: 0.7 (0.3–1.7) and OB: 4.0 (2.2–7.8) mg/L, p < 0.001) and insulin (men‐ NW: 47.0 (35.0–59.0) and OB: 113.5 (72.0–151.0) pmol/L, p < 0.001; women‐ NW: 44.0 (35.0–60.0) and OB: 84.5 (60.0–126.0) pmol/L, p < 0.001). Conclusion In young adults, obesity is associated with an early onset insulin resistance and inflammatory response prior to development of coronary artery calcification and deterioration of lipid profiles.

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Background Cardiometabolic health in adulthood is associated with socioeconomic position (SEP) in childhood. Although this has been studied by previous research several questions need to be addressed. E.g. knowledge about the association with timing, extent of the exposure as well as lifestyle and adult SEP, is essential to address the increasing social gradient in cardiometabolic diseases. Methods This study included a sub-sample (N = 264, 50% women, age 28–30) from an ongoing cohort study. We used a combination of national registers, longitudinal questionnaire data and clinical data. We examined the association between childhood SEP and cardiometabolic risk, measured by a score of multiple risk markers in young adulthood. SEP-indicators included mother’s educational level and household income. The association was evaluated by four different life course models; the latent effects model, the pathway model, the cumulative model and the social mobility model. Results We found an inverse association between mother’s educational level and cardiometabolic risk. The association was statistically significant evaluated by the pathway and cumulative life course models, however statistically insignificant evaluated by the latent effects model. No specific association with social mobility was observed. However, high adult educational level seems to have a protecting impact on the association. No association was found between household income and cardiometabolic risk in any of the applied life course models. Conclusion Low childhood SEP, represented by mother’s educational level but not household income, is associated with increased cardiometabolic risk in young adulthood. The accumulation of exposure, lifestyle and adult educational attainment are important for the association. In contrast, intergenerational social mobility does not seem to have a specific impact on the association and we find no evidence for a particular timing in childhood.

Background Low socioeconomic position in childhood is associated with greater cardiometabolic disease risk later in life. The aim of the current study is to examine the mediating impact of mental health on the association between childhood socioeconomic position and cardiometabolic disease risk in young adulthood. Methods We used a combination of national registers, longitudinal questionnaire-data and clinical measurements from a sub-sample (N = 259) of a Danish youth cohort. Childhood socioeconomic position was indicated by the educational level of the mother and the father at age 14. Mental health was measured by four different symptom scales at four age-points (age 15, 18, 21 and 28), and combined into one global score. Cardiometabolic disease risk was measured by nine biomarkers at age 28–30 and combined into one global score by sample-specific z-scores. We conducted analyses within the causal inference framework and evaluated the associations using nested counterfactuals. Results We found an inverse association between childhood socioeconomic position and cardiometabolic disease risk in young adulthood. The proportion of the association which was mediated by mental health was 10 (95% CI: -4; 24) % and 12 (95% CI: -4; 28) % using educational level of the mother and the father as indicator, respectively. Conclusions Accumulated poorer mental health in childhood, youth and early adulthood partially explained the association between low childhood socioeconomic position and increased cardiometabolic disease risk in young adulthood. The results of the causal inference analyses rely on the underlying assumptions and correct depiction of the DAG. Since these are not all testable, we cannot exclude violations that potentially could bias the estimates. If the findings can be replicated, this would support a causal relationship and direct potentials for intervention. However, the findings point to a potential for intervention in young age in order to impede the translation of childhood social stratification into later cardiometabolic disease risk disparities.