Long-term cardiometabolic health is significantly influenced by the change in body mass index (BMI) from infancy to adulthood. Cardiovascular-kidney-metabolic syndrome, a collection of interconnected disorders involving cardiac dysfunction, renal impairment, and metabolic changes, is more common in those who maintain or gain excess weight as they age. Monitoring BMI trajectories reveals the long-term effects of childhood obesity on midlife health outcomes and provides important insight into early risk buildup.
Knowing how changes in weight status affect CKM syndrome might assist identify susceptible populations sooner and direct preventive measures meant to lessen the burden of a chronic illness. Thus, this study looked at the relationships between midlife CKM syndrome and its components and BMI transitions from childhood to adulthood.
1,997 individuals between the ages of 6 and 18 were tracked for 36 years into midlife (mean age 48.12 years) using data from the Hanzhong Adolescent Hypertension Study. Based on BMI changes from childhood to midlife, the participants were divided into 4 groups: control, incident, chronic, and resolution.
Cardiovascular illness, chronic renal disease, and metabolic abnormalities characterized the early (stages 0–1), middle (stages 2), and advanced (stages 3–4) stages of chronic kidney disease (CKM). The relationships between BMI transitions and CKM outcomes were evaluated using multivariable regression models.
When compared to those with consistently normal BMI, individuals who went from having a normal childhood BMI to being overweight as adults were more likely to have intermediate (odds ratio [OR] 5.19 [95% CI 3.15–8.53]) and advanced CKM stages (OR 6.70 [95% CI 3.96–11.33]).
If an increased childhood BMI was addressed by adulthood, these risks were reduced. Compared to people with consistently normal BMI, those with normal childhood BMI but overweight adulthood had increased odds of metabolic abnormalities, albuminuria, subclinical renal impairment, and left ventricular diastolic dysfunction.
If a high childhood BMI became normal by maturity, these risks decreased. Overall, increased chances of higher CKM stages in midlife are linked to the shift from normal childhood BMI to overweight in adulthood. On the other hand, people whose high childhood BMI was addressed by adulthood show comparable risk to people whose BMI is consistently normal.
Reference:
Wang, Y., Yang, Y., Chen, J., Du, M.-F., Sun, Y., Wang, D., Jia, H., Hu, G.-L., Man, Z.-Y., Zhang, T., Zuo, S.-H., Chu, C., Chang, M.-K., Niu, Z.-J., Xiong, Y., Li, H., Yao, S., Chen, L., Ren, J., … Mu, J.-J. (2025). Transition of BMI status from childhood to adulthood and cardiovascular-kidney-metabolic syndrome in midlife: A 36-year cohort study. Diabetes Care, 48(12), 2045–2053. https://doi.org/10.2337/dca25-0027
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