Infection-Related Hospitalization in Childhood and Adult Metabolic Outcomes.
Burgner DP., Sabin MA., Magnussen CG., Cheung M., Kähönen M., Lehtimäki T., Hutri-Kähönen N., Jokinen E., Laitinen T., Taittonen L., Tossavainen P., Dwyer T., Viikari JS., Raitakari OT., Juonala M.
BACKGROUND AND OBJECTIVES: Identifying childhood determinants of adult cardiometabolic disease would facilitate early-life interventions. There are few longitudinal data on the contribution of childhood infections. Therefore, we investigated whether hospitalization with childhood infection is associated with adult anthropometric and metabolic outcomes in a large, well-phenotyped longitudinal cohort. METHODS: A total of 1376 subjects from the Cardiovascular Risk in Young Finns Study, aged 3 to 9 years at baseline (1980), who had lifetime data from birth onward on infection-related hospitalization (IRH) had repeated assessments through childhood and adolescence and at least once in adulthood (age 30-45 years in 2001-2011). Early childhood (<5 years), childhood/adolescence (5-18 years), adult (>18 years), and total lifetime IRHs were related to adiposity, BMI, and metabolic syndrome in adulthood. Analyses were adjusted for childhood and adulthood risk factors and potential confounders. RESULTS: Early-childhood IRH correlated with adverse adult but not childhood metabolic variables: increased BMI (P = .02) and metabolic syndrome (risk ratio: 1.56; 95% confidence interval: 1.03-2.35; P = .03), adjusted for age, gender, birth weight, childhood BMI and other risk factors, and family income. The age at which differences in adult BMI became persistent was related to age of IRH in childhood. The greatest increase in adult BMI occurred in those with >1 childhood IRH. CONCLUSIONS: Childhood IRH was independently associated with adverse adult metabolic variables. This finding suggests that infections and/or their treatment in childhood may contribute to causal pathways leading to adult cardiometabolic diseases.