Early Childhood Growth and Risk of Adult Cerebrovascular Disease: The NFBC1966

Abstract

Background: Low birth weight is associated with an increased risk of adulthood cerebrovascular disease (CVD). Not much is known about effects of early childhood growth. We studied whether the risk of adult CVD is associated with growth or nutritional factors during early childhood. Methods: Within the Northern Finland Birth Cohort 1966, 11 991 persons were followed from birth to 52 years of age. CVD diagnoses were extracted from national hospital and death registers with diagnostic coding based on the World Health Organization recommendations. Cox proportional hazard models were used to estimate associations of childhood growth variables, growth trajectories (by Latent Class Growth Modeling), and nutritional factors with adult CVD, for example, ischemic and hemorrhagic strokes. The analyses were adjusted for childhood socioeconomic status and birth weight. Results: A total of 453 (3.8%) CVDs were recorded during follow-up. Among females, groups with low early childhood weight and height had an increased risk for adulthood ischemic CVDs, with an adjusted hazard ratio of 1.97 (95% CI, 1.21–3.20) and 2.05 (CI, 1.11–3.81), respectively. In addition, females with body mass index over 1 SD at body mass index rebound had an increased risk for ischemic CVDs (adjusted hazard ratio, 1.90 [CI, 1.19–3.04]) compared with females with body mass index −1 to +1 SD. These associations were not found among males. Conclusions: The findings suggest that timing of weight gain during childhood is of significance for development of CVD risk among females.

miR-21, miR-221, miR-29 and miR-34 are distinguishable molecular features of a metabolically unhealthy phenotype in young adults

“…In addition, the pattern of resistin concentrations in serum is due to their higher levels in both metabolic healthy groups without a direct connection with BMI, suggesting a link between visceral obesity and diabetes in these healthy young individuals [ 43 , 44 ]. Therefore, early parameters detected in these populations could be relevant to determining their metabolic status [ 45 ]. However, a pattern of increased serum resistin levels in metabolic diseases has not previously been reported [ 46 , 47 ].…”

Weighing the Effect of Overweight/Obesity on Stroke Risk

“…In this issue of Stroke , Mikkola et al 1 report on data from the prospective Northern Finland Birth Cohort 1966 study to determine the effect of body mass index (BMI) and its changes in adolescence and young adulthood (measured at ages 14 and 31 years) on ischemic and hemorrhagic stroke occurring in young adulthood (ie, between ages 14 and 54 years). They found that the risks of ischemic stroke were associated with both overweight and obesity in younger women but not in men.…”

“…13 The E-values calculated by Mikkola et al were low to moderate, indicating that little unmeasured confounding would be needed to explain the effect estimates. 1 Assessment of obesity/overweight relies on BMIs. The waist-to-hip ratio reflecting abdominal obesity is a stronger risk factor for stroke compared with BMI and has an even greater effect in young adults.…”

“…The study by Mikkola et al provides additional evidence of an association between overweight/obesity and stroke in young adults; however, several important limitations, some of which they note, should be understood. 1 Adjustment was made for sex, smoking, educational level, age at menarche for women, and parental socioeconomic status for children, but not for other potentially modifiable risk factors such as hypertension, lipid disorders, alcohol consumption, exercise level, diabetes, or drug use, which can be particularly important in younger individuals. 10,11 Although the statistic has limitations, 12 the authors calculated E-values to assess the extent to which unmeasured confounding might explain the observed associations between obesity/overweight and stroke risk.…”

Overweight in Adolescence and Young Adulthood in Association With Adult Cerebrovascular Disease: The NFBC1966 Study

“…In the Northern Finland Birth Cohort 1966, previous research has established that low early childhood weight and height increase the risk of ischemic cerebrovascular disease in adulthood among women, and the timing of weight gain during childhood plays a significant role in the development of cerebrovascular disease risk among women. 12 Sex disparity in cerebrovascular disease occurrence has been well identified. The age-adjusted incidence of cerebrovascular disease is higher in men than in women, except in the elderly, which is mostly a result of longer life expectancies in women.…”