Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis.

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childhood obesity 741 adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data
childhood obesity 1122 case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity , as defined by the original study authors, (4) English-language articles, (5) studies published up to
childhood obesity 2269 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.11; 95% CI: 0.07, 0.14), DBP (Zr = 0.11;
childhood obesity 2843 items that placed them at an increased risk for bias.ConclusionsThe results of this study suggest that childhood obesity may be a risk factor for selected adult CVD risk factors. However, a need exists for additional, higher-quality
childhood obesity 4549 of both childhood and adolescent obesity and adult CVD, studies examining the relationship between childhood obesity and adult CVD have yielded conflicting results [[8], [10]–[13]]. This is important given that adult
childhood obesity 4928 chance of becoming overweight or obese adults [[16]–[18]]. Unfortunately, it remains unclear whether childhood obesity is an independent risk factor for adult CVD risk factors or whether childhood obesity persists as adult
childhood obesity 5014 unclear whether childhood obesity is an independent risk factor for adult CVD risk factors or whether childhood obesity persists as adult obesity and indirectly increases the risk of adult CVD [[19], [20]].Recent systematic
childhood obesity 5182 the risk of adult CVD [[19], [20]].Recent systematic reviews suggest that the relationship between childhood obesity and adult high BP or poor lipid profile is weak, possibly because the results are confounded by adult
childhood obesity 5647 search revealed four systematic reviews and one meta-analysis conducted on the relationship between childhood obesity and adult CVD risk factors [[13], [21]–[24]] (Additional file 2a). The four systematic reviews published
childhood obesity 5907 provided qualitative evidence but did not provide any quantitative evidence on the association between childhood obesity and adult CVD risk factors (BP and lipid profile). While one meta-analysis was conducted four years
childhood obesity 6202 thereby possibly biasing results. Moreover, this meta-analysis did not calculate the association between childhood obesity and adult total cholesterol (TC) as well as between childhood obesity and adult non-high-density lipoprotein
childhood obesity 6272 calculate the association between childhood obesity and adult total cholesterol (TC) as well as between childhood obesity and adult non-high-density lipoprotein cholesterol (non-HDL) levels. This is important since non-HDL
childhood obesity 8521 findings provide support for an updated systematic review with meta-analysis on the relationship between childhood obesity and selected adult CVD risk factors, i.e., BP, lipids, and lipoproteins.Systematic reviews with meta-analysis
childhood obesity 9106 systematic reviews [[13], [21]–[23]] and one meta-analysis [[24]] have examined the association between childhood obesity and adult CVD, the investigative team is not aware of any current and thorough systematic review with
childhood obesity 9279 any current and thorough systematic review with meta-analysis on this topic. Furthermore, given that childhood obesity as an independent risk factor for CVD in adults is not well-established, the aim of this study was to
childhood obesity 9525 review and meta-analysis to critically evaluate the available evidence regarding the association between childhood obesity and select adult CVD risk factors: (1) resting SBP, (2) resting DBP, (3) TC, (4) HDL, (5) LDL, (6) non-HDL,
childhood obesity 17622 The a priori plan was to use risk ratio (RR) as our ES in order to examine the association between childhood obesity and selected adult CVD risk factors. However, because most studies reported a correlation between two
childhood obesity 18841 provided were excluded from the meta-analysis.Pooling of ES’sResults for the association between childhood obesity and selected CVD risk factors (SBP, DBP, TC, HDL, LDL, non-HDL, and TG) were pooled separately using
childhood obesity 22444 (6) subject characteristics (sex, race/ethnicity), (7) studies that examined the association between childhood obesity and CVD risk factors while controlling or not controlling for adult adiposity, (8) time to follow up,
childhood obesity 31595 sub-scapular skinfold thickness measures only [[73]]. Most studies did not use a cut-off point to define childhood obesity , but rather, used childhood BMI as a continuous variable.Sixteen studies examined the association between
childhood obesity 31719 rather, used childhood BMI as a continuous variable.Sixteen studies examined the association between childhood obesity and adult SBP [[4], [64], [66]–[69], [71]–[73], [75]–[79], [82], [85]], 14 examined the association
childhood obesity 31851 [[4], [64], [66]–[69], [71]–[73], [75]–[79], [82], [85]], 14 examined the association between childhood obesity and adult DBP [[4], [64], [67]–[69], [71], [72], [75]–[79], [82], [85]], 8 examined the association
childhood obesity 31981 DBP [[4], [64], [67]–[69], [71], [72], [75]–[79], [82], [85]], 8 examined the association between childhood obesity and adult TC [[4], [64], [67], [79], [81], [83]–[85]], 5 examined the association between childhood
childhood obesity 32091 obesity and adult TC [[4], [64], [67], [79], [81], [83]–[85]], 5 examined the association between childhood obesity and adult LDL [[4], [78], [81], [83], [85]], 8 examined the association between childhood obesity and
childhood obesity 32189 between childhood obesity and adult LDL [[4], [78], [81], [83], [85]], 8 examined the association between childhood obesity and adult HDL [[4], [67], [68], [78], [81]–[83], [85]], and 9 examined the association between childhood
childhood obesity 32304 obesity and adult HDL [[4], [67], [68], [78], [81]–[83], [85]], and 9 examined the association between childhood obesity and adult TG [[4], [67], [68], [71], [78], [81], [82], [84], [85]]. However, data from one study that
childhood obesity 33084 the same reason [[70]]. Of the 21 studies, only six (28.6%) included data on the association between childhood obesity and adult CVD risk factors while adjusting for adult BMI [[4], [65], [74], [76], [78], [85]]. Two of
childhood obesity 37579 http://strobe-statement.org/index.php?id=available-checklistsPrimary outcomesThe results of the random-effects meta-analysis for the association between childhood obesity and adult CVD risk factors are presented in Tables 2 and 3 while forest plots displaying the effect
childhood obesity 38005 Additional file 7. Exploratory random-effects meta-regression analyses for the association between childhood obesity and adult CVD risk factors and selected covariates (categorical and continuous) in which adequate data
childhood obesity 41207 (non-overlapping 95% CI)**statistically significant at p < 0.10Fig. 3Forest plot for the association between childhood obesity and adult SBP. Legend: The common metric for the effect size for each study is the Fisher’s r to z
childhood obesity 42015 study using more than one exposure definition was combinedFig. 4Forest plot for the association between childhood obesity and adult SBP (adjusted for adult BMI). Legend: The common metric for the effect size for each study
childhood obesity 42959 combined, or one study using more than one exposure definitionFig. 5Forest plot for the association between childhood obesity and adult DBP. Legend: The common metric for the effect size for each study is the Fisher’s r to z
childhood obesity 43754 combined, or one study using more than one exposure definitionFig. 6Forest plot for the association between childhood obesity and adult DBP (adjusted for adult BMI). Legend: The common metric for the effect size for each study
childhood obesity 44574 combined, or one study using more than one exposure definitionFig. 7Forest plot for the association between childhood obesity and adult TC. Legend: The common metric for the effect size for each study is the Fisher’s r to z
childhood obesity 45368 combined, or one study using more than one exposure definitionFig. 8Forest plot for the association between childhood obesity and adult TC (adjusted for adult BMI). Legend: The common metric for the effect size for each study
childhood obesity 46187 combined, or one study using more than one exposure definitionFig. 9Forest plot for the association between childhood obesity and adult LDL. Legend: The common metric for the effect size for each study is the Fisher’s r to z
childhood obesity 46983 or one study using more than one exposure definitionFig. 10Forest plot for the association between childhood obesity and adult LDL (adjusted for adult BMI). Legend: The common metric for the effect size for each study
childhood obesity 47804 or one study using more than one exposure definitionFig. 11Forest plot for the association between childhood obesity and adult HDL. Legend: The common metric for the effect size for each study is the Fisher’s r to z
childhood obesity 48600 or one study using more than one exposure definitionFig. 12Forest plot for the association between childhood obesity and adult HDL (adjusted for adult BMI). Legend: The common metric for the effect size for each study
childhood obesity 49421 or one study using more than one exposure definitionFig. 13Forest plot for the association between childhood obesity and adult TG. Legend: The common metric for the effect size for each study is the Fisher’s r to z
childhood obesity 50216 or one study using more than one exposure definitionFig. 14Forest plot for the association between childhood obesity and adult TG (adjusted for adult BMI). Legend: The common metric for the effect size for each study
childhood obesity 51945 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult SBP) and baseline age (β = 0.01, p = 0.01; I2 reduced from 91% to 88%) only.Systolic
childhood obesity 52991 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult SBP for studies that adjusted for adult BMI) and follow-up age (β = −0.005, p = 0.002;
childhood obesity 54224 evidence for an association between pooled ES (Fisher’s r to z score) for the association between childhood obesity and adult DBP and baseline age (β = 0.01, p = 0.01; I2 reduced from 90% to 87%).Diastolic blood
childhood obesity 55456 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult DBP for studies that adjusted for adult BMI) and follow-up age (β = −0.006, p < 0.0001;
childhood obesity 56761 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TC) and follow-up age (β = −0.004, p = 0.04; I2 reduced from 91% to 76%), length of
childhood obesity 58074 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TC for studies that adjusted for adult BMI) and baseline age (β = −0.01, p < 0.0001;
childhood obesity 59328 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult LDL) and follow-up age (β = −0.005, p = 0.0001; I2 reduced from 94% to 39%), length
childhood obesity 60543 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult LDL for studies that adjusted for adult BMI) and sex. Because of insufficient data, none of
childhood obesity 61716 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult HDL) and all the covariates examined.High-density lipoprotein (adjusted for adult adiposity)When
childhood obesity 62889 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult HDL for studies that adjusted for adult BMI) and follow-up age (β = −0.007, p = 0.004;
childhood obesity 64244 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TG) and follow-up age (β = −0.009, p < 0.0001; I2 reduced from 83% to 5%), length of
childhood obesity 65487 evidence for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TG for studies that adjusted for adult BMI) and follow-up age (β = 0.006, p = 0.05; I2
childhood obesity 66040 outcomes using only BMI as the exposure showed similar findings (Table 3). The findings suggest that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.10; 95% CI: 0.06, 0.13), DBP (Zr = 0.11;
childhood obesity 66490 conduct a systematic review and meta-analysis of studies that have examined the association between childhood obesity and adult CVD risk factors (SBP, DBP, TC, HDL, LDL, non-HDL, and TG). The overall unadjusted findings
childhood obesity 66623 risk factors (SBP, DBP, TC, HDL, LDL, non-HDL, and TG). The overall unadjusted findings suggest that childhood obesity is significantly and positively associated with adult SBP, DBP and TG and significantly and negatively
childhood obesity 67331 that the association was significant and negative for SBP, DBP, and LDL while the associations between childhood obesity and adult HDL and TG became non-significant when adult BMI was accounted for. However, it is important
childhood obesity 70998 HDL.More specifically, results from our meta-regression analyses revealed that the association between childhood obesity and adult SBP and DBP increases as the baseline age increases. For TC, HDL, and LDL the association
childhood obesity 71414 percent of low risk of bias increased. For studies that adjusted for adult BMI, the association between childhood obesity and adult TC increased as baseline age increased. For SBP, DBP, and HDL the association decreased as
childhood obesity 71924 the percent of low risk of bias increased. However, one unusual finding was the association between childhood obesity and adult TG (adjusted for adult BMI) that increased with the increase in the follow-up age/length of
childhood obesity 72736 [21]–[23]] published on this topic from 2010 to 2012 provided evidence on the association between childhood obesity and adult CVD risk factors (BP and lipid profile). While one study conducted quantitative analyses,
childhood obesity 73060 meta-analysis [[24]]. The systematic review by Lloyd and colleagues [[21]] found little evidence that childhood obesity is an independent risk factor for adult SBP and DBP. Their study concluded that the relationships observed
childhood obesity 73564 findings. A second systematic review by Lloyd and colleagues [[13]] also found little evidence that childhood obesity is an independent risk factor adult TC, LDL, HDL, and TG. They found that the association between childhood
childhood obesity 74594 colleagues also suggested that since adult BMI is on the causal pathway for the association between childhood obesity and adult disease, adjusting for adult BMI has methodological limitations. One of the main limitations
childhood obesity 76449 (YFS). The results from this pooled, random-effects analysis showed a significant association between childhood obesity in predicting the following adult CVD outcomes using risk ratios: HT = 2.1 (95% CI: 1.8, 2.5), LDL = 1.6
childhood obesity 76725 CI: 1.5, 1.9), and TG = 1.8 (95% CI: 1.5, 2.2). The direction of effect for the association between childhood obesity and adult CVD risk factors in the current meta-analysis is consistent with the previous work by Juonala
childhood obesity 79977 included information on loss to follow-up. Fourth, only one study reported on the association between childhood obesity and adult non-HDL. This is important since non-HDL has been shown to be better predictor than LDL for
childhood obesity 83531 systematic review with meta-analysis has relevant implications for practice. Overall, it appears that childhood obesity is positively associated with adult SBP, DBP, and TG and negatively associated with adult HDL. Although
childhood obesity 83862 (i.e. temporality, biological plausibility, coherence, experimental evidence, and analogy) suggest childhood obesity as a plausible risk factor for adult CVD risk factors [[96]]. Given the former, prevention of childhood
childhood obesity 83974 obesity as a plausible risk factor for adult CVD risk factors [[96]]. Given the former, prevention of childhood obesity should remain a priority for public health interventions for preventing negative health outcomes during
childhood obesity 85621 In addition, we also used SBP and DBP instead of HT to examine for independent associations between childhood obesity and components of HT (i.e. SBP and DBP). Lastly, we performed meta-regression analysis on covariates
childhood obesity 88299 could be tested in future original studies [[97]].ConclusionThe results of this study suggest that childhood obesity may be a risk factor for selected adult cardiovascular disease risk factors. However, a need exists
childhood obesity 88823 2:This file provides the previous systematic reviews and meta-analysis examining the association between childhood obesity and selected adult CVD risk factors including AMSTAR assessment of the previous systematic reviews and
metabolic syndrome 4037 necessarily limited to, high blood pressure (BP), poor lipid profile, impaired glucose tolerance, and metabolic syndrome [[7]–[9]]. Importantly, data shows that these risk factors are amplified in the presence of pediatric
metabolic syndrome 22696 (10) age categories of children, (11) comorbid conditions for both the child and the adult (diabetes, metabolic syndrome , etc.), (12) lipid lowering medication, (13) hypertensive medication, (14) family history of CVD, (15)
metabolic syndrome 34843 disease [[64]], coronary heart disease [[65]], diabetes, insulin or glucose levels [[4], [68], [78]], metabolic syndrome [[69]], medication for heart diseases [[76]], medication for hypertension [[68], [76]] [[74]] and uric
obesity 34 Title: BMC Public HealthChildhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysisAmna UmerGeorge
obesity 353 8/2017Publication date (pmc-release): 8/2017Publication date (collection): /2017AbstractBackgroundOverweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease
obesity 618 adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship
obesity 751 individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data
obesity 1132 (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity , as defined by the original study authors, (4) English-language articles, (5) studies published up to
obesity 2279 included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.11; 95% CI: 0.07, 0.14), DBP (Zr = 0.11;
obesity 2853 placed them at an increased risk for bias.ConclusionsThe results of this study suggest that childhood obesity may be a risk factor for selected adult CVD risk factors. However, a need exists for additional, higher-quality
obesity 3376 (10.1186/s12889-017-4691-z) contains supplementary material, which is available to authorized users.BackgroundOverweight and obesity during childhood and adolescence is a major public health problem. One of the important health implications
obesity 3520 a major public health problem. One of the important health implications of childhood and adolescent obesity includes the development of cardiovascular disease (CVD) risk factors during childhood and adolescence
obesity 4160 [[7]–[9]]. Importantly, data shows that these risk factors are amplified in the presence of pediatric obesity , referred to by Ford et al. as ‘obesity-associated risk factors for CVD’ [[8], [9]]. Most notably,
obesity 4202 these risk factors are amplified in the presence of pediatric obesity, referred to by Ford et al. as ‘ obesity -associated risk factors for CVD’ [[8], [9]]. Most notably, a population-based study estimated that
obesity 4483 at least one risk factor for CVD [[1]]. Despite the high prevalence of both childhood and adolescent obesity and adult CVD, studies examining the relationship between childhood obesity and adult CVD have yielded
obesity 4559 childhood and adolescent obesity and adult CVD, studies examining the relationship between childhood obesity and adult CVD have yielded conflicting results [[8], [10]–[13]]. This is important given that adult
obesity 4938 becoming overweight or obese adults [[16]–[18]]. Unfortunately, it remains unclear whether childhood obesity is an independent risk factor for adult CVD risk factors or whether childhood obesity persists as adult
obesity 5024 whether childhood obesity is an independent risk factor for adult CVD risk factors or whether childhood obesity persists as adult obesity and indirectly increases the risk of adult CVD [[19], [20]].Recent systematic
obesity 5050 an independent risk factor for adult CVD risk factors or whether childhood obesity persists as adult obesity and indirectly increases the risk of adult CVD [[19], [20]].Recent systematic reviews suggest that the
obesity 5192 of adult CVD [[19], [20]].Recent systematic reviews suggest that the relationship between childhood obesity and adult high BP or poor lipid profile is weak, possibly because the results are confounded by adult
obesity 5302 and adult high BP or poor lipid profile is weak, possibly because the results are confounded by adult obesity [[13], [21]]. In an effort to find previously published systematic reviews and meta-analyses on this
obesity 5657 revealed four systematic reviews and one meta-analysis conducted on the relationship between childhood obesity and adult CVD risk factors [[13], [21]–[24]] (Additional file 2a). The four systematic reviews published
obesity 5917 qualitative evidence but did not provide any quantitative evidence on the association between childhood obesity and adult CVD risk factors (BP and lipid profile). While one meta-analysis was conducted four years
obesity 6212 possibly biasing results. Moreover, this meta-analysis did not calculate the association between childhood obesity and adult total cholesterol (TC) as well as between childhood obesity and adult non-high-density lipoprotein
obesity 6282 association between childhood obesity and adult total cholesterol (TC) as well as between childhood obesity and adult non-high-density lipoprotein cholesterol (non-HDL) levels. This is important since non-HDL
obesity 8531 provide support for an updated systematic review with meta-analysis on the relationship between childhood obesity and selected adult CVD risk factors, i.e., BP, lipids, and lipoproteins.Systematic reviews with meta-analysis
obesity 9116 reviews [[13], [21]–[23]] and one meta-analysis [[24]] have examined the association between childhood obesity and adult CVD, the investigative team is not aware of any current and thorough systematic review with
obesity 9289 and thorough systematic review with meta-analysis on this topic. Furthermore, given that childhood obesity as an independent risk factor for CVD in adults is not well-established, the aim of this study was to
obesity 9535 meta-analysis to critically evaluate the available evidence regarding the association between childhood obesity and select adult CVD risk factors: (1) resting SBP, (2) resting DBP, (3) TC, (4) HDL, (5) LDL, (6) non-HDL,
obesity 9767 secondary aim of the study was to examine whether this association persists after adjusting for adult obesity .MethodsThis study was conducted and reported according to the Cochrane Collaboration’s recommendations
obesity 10651 collected on the same individual over time, (3) main exposure variable of the child’s overweight and obesity status (BMI age-and sex-specific percentiles, percent body fat, fat mass, waist circumference (WC),
obesity 10903 skin fold thickness, body weight, BMI z-score, BMI or other measures used to assess overweight and obesity in populations) [[37]], (4) studies available in English-language, (5) studies published up to June,
obesity 12999 the different electronic database searches [[42]]. The PubMed search string used was as follows:“( obesity OR obese OR overweight OR fat OR adipos* OR “body mass index” OR BMI) AND (child* or adolesc*) AND
obesity 17632 priori plan was to use risk ratio (RR) as our ES in order to examine the association between childhood obesity and selected adult CVD risk factors. However, because most studies reported a correlation between two
obesity 18851 were excluded from the meta-analysis.Pooling of ES’sResults for the association between childhood obesity and selected CVD risk factors (SBP, DBP, TC, HDL, LDL, non-HDL, and TG) were pooled separately using
obesity 22454 characteristics (sex, race/ethnicity), (7) studies that examined the association between childhood obesity and CVD risk factors while controlling or not controlling for adult adiposity, (8) time to follow up,
obesity 31605 skinfold thickness measures only [[73]]. Most studies did not use a cut-off point to define childhood obesity , but rather, used childhood BMI as a continuous variable.Sixteen studies examined the association between
obesity 31729 used childhood BMI as a continuous variable.Sixteen studies examined the association between childhood obesity and adult SBP [[4], [64], [66]–[69], [71]–[73], [75]–[79], [82], [85]], 14 examined the association
obesity 31861 [64], [66]–[69], [71]–[73], [75]–[79], [82], [85]], 14 examined the association between childhood obesity and adult DBP [[4], [64], [67]–[69], [71], [72], [75]–[79], [82], [85]], 8 examined the association
obesity 31991 [64], [67]–[69], [71], [72], [75]–[79], [82], [85]], 8 examined the association between childhood obesity and adult TC [[4], [64], [67], [79], [81], [83]–[85]], 5 examined the association between childhood
obesity 32101 and adult TC [[4], [64], [67], [79], [81], [83]–[85]], 5 examined the association between childhood obesity and adult LDL [[4], [78], [81], [83], [85]], 8 examined the association between childhood obesity and
obesity 32199 childhood obesity and adult LDL [[4], [78], [81], [83], [85]], 8 examined the association between childhood obesity and adult HDL [[4], [67], [68], [78], [81]–[83], [85]], and 9 examined the association between childhood
obesity 32314 adult HDL [[4], [67], [68], [78], [81]–[83], [85]], and 9 examined the association between childhood obesity and adult TG [[4], [67], [68], [71], [78], [81], [82], [84], [85]]. However, data from one study that
obesity 33094 reason [[70]]. Of the 21 studies, only six (28.6%) included data on the association between childhood obesity and adult CVD risk factors while adjusting for adult BMI [[4], [65], [74], [76], [78], [85]]. Two of
obesity 37589 http://strobe-statement.org/index.php?id=available-checklistsPrimary outcomesThe results of the random-effects meta-analysis for the association between childhood obesity and adult CVD risk factors are presented in Tables 2 and 3 while forest plots displaying the effect
obesity 38015 Additional file 7. Exploratory random-effects meta-regression analyses for the association between childhood obesity and adult CVD risk factors and selected covariates (categorical and continuous) in which adequate data
obesity 41217 CI)**statistically significant at p < 0.10Fig. 3Forest plot for the association between childhood obesity and adult SBP. Legend: The common metric for the effect size for each study is the Fisher’s r to z
obesity 42025 more than one exposure definition was combinedFig. 4Forest plot for the association between childhood obesity and adult SBP (adjusted for adult BMI). Legend: The common metric for the effect size for each study
obesity 42969 study using more than one exposure definitionFig. 5Forest plot for the association between childhood obesity and adult DBP. Legend: The common metric for the effect size for each study is the Fisher’s r to z
obesity 43764 study using more than one exposure definitionFig. 6Forest plot for the association between childhood obesity and adult DBP (adjusted for adult BMI). Legend: The common metric for the effect size for each study
obesity 44584 study using more than one exposure definitionFig. 7Forest plot for the association between childhood obesity and adult TC. Legend: The common metric for the effect size for each study is the Fisher’s r to z
obesity 45378 study using more than one exposure definitionFig. 8Forest plot for the association between childhood obesity and adult TC (adjusted for adult BMI). Legend: The common metric for the effect size for each study
obesity 46197 study using more than one exposure definitionFig. 9Forest plot for the association between childhood obesity and adult LDL. Legend: The common metric for the effect size for each study is the Fisher’s r to z
obesity 46993 study using more than one exposure definitionFig. 10Forest plot for the association between childhood obesity and adult LDL (adjusted for adult BMI). Legend: The common metric for the effect size for each study
obesity 47814 study using more than one exposure definitionFig. 11Forest plot for the association between childhood obesity and adult HDL. Legend: The common metric for the effect size for each study is the Fisher’s r to z
obesity 48610 study using more than one exposure definitionFig. 12Forest plot for the association between childhood obesity and adult HDL (adjusted for adult BMI). Legend: The common metric for the effect size for each study
obesity 49431 study using more than one exposure definitionFig. 13Forest plot for the association between childhood obesity and adult TG. Legend: The common metric for the effect size for each study is the Fisher’s r to z
obesity 50226 study using more than one exposure definitionFig. 14Forest plot for the association between childhood obesity and adult TG (adjusted for adult BMI). Legend: The common metric for the effect size for each study
obesity 51955 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult SBP) and baseline age (β = 0.01, p = 0.01; I2 reduced from 91% to 88%) only.Systolic
obesity 53001 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult SBP for studies that adjusted for adult BMI) and follow-up age (β = −0.005, p = 0.002;
obesity 54234 for an association between pooled ES (Fisher’s r to z score) for the association between childhood obesity and adult DBP and baseline age (β = 0.01, p = 0.01; I2 reduced from 90% to 87%).Diastolic blood
obesity 55466 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult DBP for studies that adjusted for adult BMI) and follow-up age (β = −0.006, p < 0.0001;
obesity 56771 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TC) and follow-up age (β = −0.004, p = 0.04; I2 reduced from 91% to 76%), length of
obesity 58084 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TC for studies that adjusted for adult BMI) and baseline age (β = −0.01, p < 0.0001;
obesity 59338 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult LDL) and follow-up age (β = −0.005, p = 0.0001; I2 reduced from 94% to 39%), length
obesity 60553 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult LDL for studies that adjusted for adult BMI) and sex. Because of insufficient data, none of
obesity 61726 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult HDL) and all the covariates examined.High-density lipoprotein (adjusted for adult adiposity)When
obesity 62899 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult HDL for studies that adjusted for adult BMI) and follow-up age (β = −0.007, p = 0.004;
obesity 64254 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TG) and follow-up age (β = −0.009, p < 0.0001; I2 reduced from 83% to 5%), length of
obesity 65497 for an association between pooled ES (Fisher’s r to z score for the association between childhood obesity and adult TG for studies that adjusted for adult BMI) and follow-up age (β = 0.006, p = 0.05; I2
obesity 66050 using only BMI as the exposure showed similar findings (Table 3). The findings suggest that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.10; 95% CI: 0.06, 0.13), DBP (Zr = 0.11;
obesity 66500 systematic review and meta-analysis of studies that have examined the association between childhood obesity and adult CVD risk factors (SBP, DBP, TC, HDL, LDL, non-HDL, and TG). The overall unadjusted findings
obesity 66633 factors (SBP, DBP, TC, HDL, LDL, non-HDL, and TG). The overall unadjusted findings suggest that childhood obesity is significantly and positively associated with adult SBP, DBP and TG and significantly and negatively
obesity 67190 meta-analysis), and (4) non-significant small study effects.When examining studies that adjusted for adult obesity , the overall findings suggest that the association was significant and negative for SBP, DBP, and LDL
obesity 67341 association was significant and negative for SBP, DBP, and LDL while the associations between childhood obesity and adult HDL and TG became non-significant when adult BMI was accounted for. However, it is important
obesity 71008 specifically, results from our meta-regression analyses revealed that the association between childhood obesity and adult SBP and DBP increases as the baseline age increases. For TC, HDL, and LDL the association
obesity 71424 risk of bias increased. For studies that adjusted for adult BMI, the association between childhood obesity and adult TC increased as baseline age increased. For SBP, DBP, and HDL the association decreased as
obesity 71934 percent of low risk of bias increased. However, one unusual finding was the association between childhood obesity and adult TG (adjusted for adult BMI) that increased with the increase in the follow-up age/length of
obesity 72746 [21]–[23]] published on this topic from 2010 to 2012 provided evidence on the association between childhood obesity and adult CVD risk factors (BP and lipid profile). While one study conducted quantitative analyses,
obesity 73070 meta-analysis [[24]]. The systematic review by Lloyd and colleagues [[21]] found little evidence that childhood obesity is an independent risk factor for adult SBP and DBP. Their study concluded that the relationships observed
obesity 73574 A second systematic review by Lloyd and colleagues [[13]] also found little evidence that childhood obesity is an independent risk factor adult TC, LDL, HDL, and TG. They found that the association between childhood
obesity 74604 also suggested that since adult BMI is on the causal pathway for the association between childhood obesity and adult disease, adjusting for adult BMI has methodological limitations. One of the main limitations
obesity 76459 results from this pooled, random-effects analysis showed a significant association between childhood obesity in predicting the following adult CVD outcomes using risk ratios: HT = 2.1 (95% CI: 1.8, 2.5), LDL = 1.6
obesity 76735 1.9), and TG = 1.8 (95% CI: 1.5, 2.2). The direction of effect for the association between childhood obesity and adult CVD risk factors in the current meta-analysis is consistent with the previous work by Juonala
obesity 76958 [[24]]. They also found a statistically significant association with HT even after adjustment for adult obesity (relative risk, 1.5; 95% CI: 1.1, 2.1; P = 0.009) [[24]]. For dyslipidemias, the effect of childhood
obesity 77129 dyslipidemias, the effect of childhood adiposity was reduced and became non-significant when adult obesity was taken into account. The results of our meta-analysis are consistent with the pooled results for
obesity 79987 information on loss to follow-up. Fourth, only one study reported on the association between childhood obesity and adult non-HDL. This is important since non-HDL has been shown to be better predictor than LDL for
obesity 82550 additional markers for adiposity, for example percent body fat, in addition to BMI. Additional use of an obesity index using age- and sex-specific thresholds might also provide more valid information regarding the
obesity 82670 age- and sex-specific thresholds might also provide more valid information regarding the effects of obesity on adult CVD. Tenth, the negative associations in the adjusted analysis for all outcomes, and a positive
obesity 83541 review with meta-analysis has relevant implications for practice. Overall, it appears that childhood obesity is positively associated with adult SBP, DBP, and TG and negatively associated with adult HDL. Although
obesity 83872 temporality, biological plausibility, coherence, experimental evidence, and analogy) suggest childhood obesity as a plausible risk factor for adult CVD risk factors [[96]]. Given the former, prevention of childhood
obesity 83984 plausible risk factor for adult CVD risk factors [[96]]. Given the former, prevention of childhood obesity should remain a priority for public health interventions for preventing negative health outcomes during
obesity 84146 interventions for preventing negative health outcomes during childhood as well as reducing the burden of adult obesity . Furthermore, this study provides important information to support the notion that obese children who
obesity 85631 addition, we also used SBP and DBP instead of HT to examine for independent associations between childhood obesity and components of HT (i.e. SBP and DBP). Lastly, we performed meta-regression analysis on covariates
obesity 88309 tested in future original studies [[97]].ConclusionThe results of this study suggest that childhood obesity may be a risk factor for selected adult cardiovascular disease risk factors. However, a need exists
obesity 88833 provides the previous systematic reviews and meta-analysis examining the association between childhood obesity and selected adult CVD risk factors including AMSTAR assessment of the previous systematic reviews and

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