What is the clinical evidence from this study?

Study design: Meta-Analysis. Population: Coronary heart disease (n=5538319). Intervention: Body mass index (BMI) and height during childhood and adolescence. Primary outcome: Adult coronary heart disease (CHD) (HR 1.12, 95% CI 1.01-1.25).

What does this research mean for the field?

Childhood and adolescent body mass index is positively associated with the risk of adult coronary heart disease, whereas childhood and adolescent height is inversely associated with this risk. Novelty: ClaimNovelty.SYNTHESIS. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 7, 2021

Associations between body mass index and height during childhood and adolescence and the risk of coronary heart disease in adulthood: A systematic review and meta‐analysis

Key Result

Child and adolescent BMI was positively associated with adult CHD (HR 1.12; 95% CI 1.01-1.25 per SD), whereas height was inversely associated with CHD (HR 0.87; 95% CI 0.81-0.93 per SD).

Study Design

Type

Meta-Analysis (n=5,538,319)

Structured PICO

Does body mass index and height during childhood and adolescence affect the risk of coronary heart disease in adulthood?

Population

5,538,319 individuals from 22 studies on BMI and 5 studies on height, assessing exposures at ages 2-19 years.

Intervention

Higher body mass index (BMI) and height during childhood and adolescence (ages 2-19 years)

Comparator

Lower body mass index (BMI) and height (assessed per standard deviation and categorically)

Outcome

Adult coronary heart disease (CHD)hard clinical

Higher BMI in youth is associated with an increased risk of adult coronary heart disease, whereas greater height in youth is associated with a decreased risk.

Main Result

Effect estimate: HR 1.12 (95% CI 1.01-1.25)

Limitations

Insufficient studies on height precluded subgroup analyses
Heterogeneity was generally high in all analyses

Abstract

Body mass index (BMI) at child and adolescent ages is positively associated with adult coronary heart disease (CHD) whereas height at these ages may be inversely associated with CHD. However, potential effects of age, sex, and socioeconomic status on associations between BMI and CHD are less investigated. We conducted a systematic review and meta-analysis of BMI and height at ages 2-19 years in relation to adult CHD and examined effects of age, sex, socioeconomic status, and other factors. Twenty-two studies on BMI and five on height were included, comprising 5,538,319 individuals and 69,830 CHD events. Random effects meta-analyses were conducted. Child and adolescent BMI were positively associated with CHD (hazard ratio = 1.12; 95% confidence interval CI 1.01, 1.25 per standard deviation SD), and categorical analyses supported these findings. The associations did not significantly differ by age, sex, or by adjustment for socioeconomic status. Child and adolescent height were inversely associated with CHD (hazard ratio = 0.87; 95% CI 0.81, 0.93 per SD), and categorical analyses agreed. Insufficient studies on height precluded subgroup analyses. Heterogeneity was generally high in all analyses. We found that BMI in youth is positively associated with adult CHD regardless of sex or adjustment for socioeconomic status whereas height is inversely associated with later risk of CHD.

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