Richard S Liu1, David P Burgner2, Matthew A Sabin1, Costan G Magnussen3, Michael Cheung1, Nina Hutri-Kähönen4, Mika Kähönen5, Terho Lehtimäki6, Eero Jokinen7, Tomi Laitinen8, Leena Taittonen9, Terence Dwyer10, Jorma S A Viikari11, Mika Kivimäki12, Olli T Raitakari13, Markus Juonala14. 1. Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia; 2. Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Pediatrics, University of Melbourne, Parkville, Victoria, Australia; Department of Pediatrics, Monash University, Clayton, Victoria, Australia; david.burgner@mcri.edu.au. 3. Research Centre of Applied and Preventive Cardiovascular Medicine and Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia; 4. Departments of Pediatrics, and Clinical Physiology, University of Tampere, Tampere, Finland; 5. Clinical Physiology, University of Tampere, Tampere, Finland; Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Tampere, Finland; 6. Department of Clinical Chemistry, Fimlab Laboratories and University of Tampere School of Medicine, Tampere, Finland; 7. Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland; 8. Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland; 9. Department of Pediatrics, University of Oulu, Oulu, and Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland; 10. Oxford Martin School and Nuffield Department of Population Health, Oxford University, Oxford, United Kingdom; 11. Department of Medicine, University of Turku, Turku, Finland; Division of Medicine and. 12. Department of Epidemiology and Public Health, University College London, London, United Kingdom. 13. Research Centre of Applied and Preventive Cardiovascular Medicine and Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland; and. 14. Murdoch Childrens Research Institute, Parkville, Victoria, Australia; Department of Medicine, University of Turku, Turku, Finland; Division of Medicine and.
Abstract
BACKGROUND AND OBJECTIVES: Socioeconomic disadvantage throughout the life course is associated with increased risk of cardiometabolic diseases, but traditional risk factors do not fully account for the social gradient. We investigated the interactions between low socioeconomic status (SES) and infection in childhood and adverse cardiometabolic parameters in adulthood. METHODS: Participants from the Cardiovascular Risk in Young Finns Study, a cohort well phenotyped for childhood and adulthood cardiometabolic risk factors and socioeconomic parameters, were linked to lifetime hospitalization data from birth onward available from the Finnish National Hospital Registry. In those with complete data, we investigated relationships between infection-related hospitalization in childhood, SES, and childhood and adult cardiometabolic parameters. RESULTS: The study cohort consisted of 1015 participants (age range 3-18 years at baseline and 30-45 years at follow-up). In adults who were raised in below-median income families, childhood infection-related hospitalizations (at age 0-5 years) were significantly associated with higher adult BMI (β ± SE comparing those with 0 vs ≥1 hospitalizations 2.4 ± 0.8 kg/m(2), P = .008), waist circumference (7.4 ± 2.3 cm, P = .004), and reduced brachial flow-mediated dilatation (-2.7 ± 0.9%, P = .002). No equivalent associations were observed in participants from higher-SES families. CONCLUSIONS: Infection was associated with worse cardiovascular risk factor profiles only in those from lower-SES families. Childhood infection may contribute to social gradients observed in adult cardiometabolic disease risk factors. These findings suggest reducing childhood infections, especially in socioeconomic disadvantaged children, may reduce the cardiometabolic disease burden in adults.
BACKGROUND AND OBJECTIVES: Socioeconomic disadvantage throughout the life course is associated with increased risk of cardiometabolic diseases, but traditional risk factors do not fully account for the social gradient. We investigated the interactions between low socioeconomic status (SES) and infection in childhood and adverse cardiometabolic parameters in adulthood. METHODS: Participants from the Cardiovascular Risk in Young Finns Study, a cohort well phenotyped for childhood and adulthood cardiometabolic risk factors and socioeconomic parameters, were linked to lifetime hospitalization data from birth onward available from the Finnish National Hospital Registry. In those with complete data, we investigated relationships between infection-related hospitalization in childhood, SES, and childhood and adult cardiometabolic parameters. RESULTS: The study cohort consisted of 1015 participants (age range 3-18 years at baseline and 30-45 years at follow-up). In adults who were raised in below-median income families, childhood infection-related hospitalizations (at age 0-5 years) were significantly associated with higher adult BMI (β ± SE comparing those with 0 vs ≥1 hospitalizations 2.4 ± 0.8 kg/m(2), P = .008), waist circumference (7.4 ± 2.3 cm, P = .004), and reduced brachial flow-mediated dilatation (-2.7 ± 0.9%, P = .002). No equivalent associations were observed in participants from higher-SES families. CONCLUSIONS: Infection was associated with worse cardiovascular risk factor profiles only in those from lower-SES families. Childhood infection may contribute to social gradients observed in adult cardiometabolic disease risk factors. These findings suggest reducing childhood infections, especially in socioeconomic disadvantaged children, may reduce the cardiometabolic disease burden in adults.
Authors: Richard S Liu; Allison E Aiello; Fiona K Mensah; Constantine E Gasser; Kuna Rueb; Billie Cordell; Markus Juonala; Melissa Wake; David P Burgner Journal: J Epidemiol Community Health Date: 2017-05-10 Impact factor: 3.710
Authors: Tomi T Laitinen; Elina Puolakka; Saku Ruohonen; Costan G Magnussen; Kylie J Smith; Jorma S A Viikari; Olli J Heinonen; Noora Kartiosuo; Nina Hutri-Kähönen; Mika Kähönen; Eero Jokinen; Tomi P Laitinen; Päivi Tossavainen; Laura Pulkki-Råback; Marko Elovainio; Olli T Raitakari; Katja Pahkala; Markus Juonala Journal: JAMA Pediatr Date: 2017-08-01 Impact factor: 16.193
Authors: Pirkko J Pussinen; Susanna Paju; Jaana Koponen; Jorma S A Viikari; Leena Taittonen; Tomi Laitinen; David P Burgner; Mika Kähönen; Nina Hutri-Kähönen; Olli T Raitakari; Markus Juonala Journal: JAMA Netw Open Date: 2019-04-05
Authors: Patricia Rarau; Justin Pulford; Hebe Gouda; Suparat Phuanukoonon; Chris Bullen; Robert Scragg; Bang Nguyen Pham; Barbara McPake; Brian Oldenburg Journal: PLoS One Date: 2019-01-23 Impact factor: 3.240