Associations Of Childhood Obesity With Cardiometabolic Risk Factors By Era Of Birth: The I3c Consortium

Introduction: The prevalence of childhood obesity has increased dramatically over the past several decades, but it is unclear whether children and adolescents with obesity are experiencing more or fewer cardiometabolic risks from obesity now compared with several decades ago. This study leverages data from over 2600 children and adolescents with obesity born from 1951-1996 to determine whether relationships of obesity with cardiometabolic risk have changed over time. Methods: The first study visit, age 3-19, was used to classify individuals by era of birth (quartiles: 1951-1963, 1964-1969, 1970-1974, 1975-1996), weight status (obesity defined as BMI>CDC 95 th %ile and <120% of the 95 th %ile), high BP (SBP or DBP>95 th %ile), high total cholesterol (TC>170 mg/dl), high LDL-C (>110 mg/dl), high triglycerides (TG>100 mg/dl), high glucose (>100 mg/dl), and low HDL-C (<40 mg/dl males, <50 mg/dl females). Participants with obesity (excluding severe obesity) were included in this analysis. Logistic regressions were adjusted for age, sex, race and study cohort to calculate odds ratios relative to the most recent era of birth (1975-1996). Results: The prevalence of childhood obesity increased from 6.1% in the earliest birth era to 7.7% in the most recent (p<0.0001). The adjusted odds of children with obesity having high TC (p<0.0001), high TG (p<0.0001), and high BP (p=0.003) were half as likely among children born between 1964-69 or 1970-74, compared with the most recent birth era (Table). The odds of children with obesity having high LDL (p=0.59), low HDL (p=0.17) or high glucose (0.33) did not differ across birth eras. Conclusions: Childhood obesity in more recent decades has not only become more prevalent, but is associated with greater risks of high TC, high TG and high BP. However, the risks of high LDL, low HDL and high glucose have not significantly changed among children with obesity who were born between 1951 and 1996. Thus, comparisons of children or adolescents with obesity across eras should consider these differing risk profiles.