What question did this study set out to answer?

This research aims to understand how changes in body mass index (BMI) from childhood to adulthood influence cardiovascular-kidney-metabolic (CKM) syndrome in midlife.

February 6, 2026

Transition of body mass index status from childhood to adulthood and cardiovascular-kidney-metabolic syndrome in midlife: a 36-year prospective cohort study

Key Points

This research aims to understand how changes in body mass index (BMI) from childhood to adulthood influence cardiovascular-kidney-metabolic (CKM) syndrome in midlife.
Utilized data from the Adolescent Hypertension Study cohort spanning 36 years.
Categorized participants based on BMI transitions: control, incident, persistent, and resolution.
Evaluated CKM outcomes defined by cardiovascular disease, chronic kidney disease, and metabolic disorders.
Employed multivariate regression models to analyze relationships between BMI transitions and CKM outcomes.
Individuals moving from normal childhood BMI to overweight in adulthood had significantly increased risk of advanced CKM stages (OR=1.56).
The risk associated with transitioning from high childhood BMI was lower if the high BMI resolved by adulthood (OR=1.19).
Specific CKM risks included increased left ventricular diastolic dysfunction and albuminuria for those overweight in adulthood, compared to persistently normal BMI.

Abstract

Abstract Background Poor cardiovascular-kidney-metabolic (CKM) health is associated with increased morbidity and premature mortality, with adiposity as a key driver. Purpose This study investigated whether body mass index (BMI) transitions from childhood to adulthood affected CKM syndrome and its components in midlife. Methods Using data from the cohort of Adolescent Hypertension Study, 1,624 participants aged 6–18 years were followed for 36 years (1987–2023). Participants were categorized into four groups based on BMI transitions from childhood to midlife: control, incident, persistent, and resolution. CKM stages ranged from early (stages 0–1), intermediate (stage 2) to advanced stage (stages 3–4), defined by cardiovascular disease, chronic kidney disease, and metabolic disorders. Multivariate regression models were used to assess associations between BMI transitions and CKM outcomes. Results Individuals transitioning from normal childhood BMI to overweight in adulthood had higher risks of advanced CKM stages compared to those with persistently normal BMI (OR=1.56, 95% CI: 1.18–2.07). However, the risk was attenuated if childhood high BMI resolved by adulthood (OR=1.19, 95% CI: 0.70–2.04). For specific CKM components, individuals with normal childhood weight but overweight in adulthood showed higher risks of left ventricular diastolic dysfunction, hypertrophy, albuminuria, and metabolic abnormalities compared to those with persistently normal BMI. These risks were reduced if childhood high BMI was resolved by adulthood. Conclusions Transitioning from normal childhood weight to overweight in adulthood increased the risks of advanced CKM stages and components in midlife. However, normalizing childhood overweight by adulthood mitigated these risks, underscoring the importance of early-life weight management for long-term CKM health.Flowchart of the study population Central Illustration

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