Gene-by-age effects on BMI from birth to adulthood: the Fels Longitudinal Study.

OBJECTIVES: Genome wide association studies have shown 32 loci to influence BMI in European-American adults but replication in other studies is inconsistent and may be attributed to gene-by-age effects. The aims of this study were to determine if the influence of the summed risk score of these 32 loci (GRS) on BMI differed across age from birth to 40 years, and to determine if additive genetic effects other than those in the GRS differed by age. METHODS: Serial measures of BMI were calculated at 0, 1, 3, 6, 9, 12, 18, and 28 months, and 4, 7, 11, 15, 19, 23, 30, and 40 years for 1,176 (605 females, 571 males) European-American participants in the Fels Longitudinal Study. SOLAR was used for genetic analyses. RESULTS: GRS was significant (P < 0.05) at ages: 6, 9 months, 4-15 years, and 23-40 years. Remaining additive genetic effects independently influenced BMI (P < 5.3 × 10(-5) , 0.40 < h(2) < 0.76). Some genetic correlations between ages were not significant. Differential GRS effects did not retain significance after multiple comparisons adjustments. CONCLUSIONS: While well-known BMI variants do not appear to have significant differential effects, other additive genes differ over the lifespan.

Associations between trunk, leg and total body adiposity with arterial stiffness.

BACKGROUND: Obesity and arterial stiffness are associated, but fat distribution patterns may be more strongly related to arterial stiffness than general obesity because of the possible increased inflammation associated with increased abdominal adiposity. The aims of this study were to examine whether fat patterning is associated with arterial stiffness, and determine whether these associations are mediated by low-grade inflammation. METHODS: Adult participants from the Fels Longitudinal Study (228 males and 254 females) were assessed for brachial-ankle pulse wave velocity (BaPWV) to determine arterial stiffness. Dual energy X-ray absorptiometry was used to estimate fat percentage of the trunk and legs (e.g., TRUNKFAT% and LEGFAT%). High-sensitivity C-reactive protein (hs-CRP) levels were assayed as a general marker of inflammation. General linear regression analyses were used. RESULTS: BaPWV was positively associated with TRUNKFAT% (r = 0.44 in men and r = 0.38 in women), whereas it was inversely related to LEGFAT% (r = -0.40 in men and r = -0.39 in women). In multiple regression analyses, each SD increase in TRUNKFAT% was associated with an ~1.03 m/s increase in BaPWV in both men and women. Each SD increase in LEGFAT% was related to a similar magnitude of decrease (1.03 m/s) in BaPWV in both sexes. The relationships of TRUNKFAT% and LEGFAT% with BaPWV were attenuated slightly when including hs-CRP in the models, but remained significant. CONCLUSIONS: We found that trunk and leg fat are related to BaPWV in opposite directions when total body adiposity was accounted for. However, the associations between regional fat patterning and arterial stiffness did not appear to be mediated by low-grade inflammation.

A changing pattern of childhood BMI growth during the 20th century: 70 y of data from the Fels Longitudinal Study.

BACKGROUND: The BMI distribution shifted upward in the United States between the 1960s and the 1990s, but little is known about secular trends in the pattern of BMI growth, particularly earlier in the century and early in childhood. OBJECTIVE: The objective was to examine differences in BMI growth in children born in 1929-1999. DESIGN: BMI curves from ages 2 to 18 y were produced for 855 European-American children in the Fels Longitudinal Study born in 1929-1953, 1954-1972, and 1973-1999. Age (A(min)) and BMI (BMI(min)) at adiposity rebound and age (AV(max)), BMI (BMIV(max)), and velocity (V(max)) at maximum velocity were derived; multivariable regression was used to examine whether maternal BMI, infant weight gain, and other covariates mediated the cohort effects on these traits. RESULTS: BMI curves showed that children born in 1973-1999 had the lowest BMI values until age 5 y but had the largest values from age 8 y onward. In adjusted models, boys and girls born in 1973-1999 had a 0.15-kg/m(2) per year faster V(max) and a 1-kg/m(2) higher BMIV(max) than did children of the same sex born in 1929-1953, and girls had a 0.8-y earlier A(min) (P < 0.01). Maternal BMI and infant weight gain were associated with an obesity-prone pattern of BMI growth but did not account for the observed trends. CONCLUSIONS: Shifts in the BMI growth rate around the time of pubertal initiation were apparent starting after 1973. The BMI growth curve did not increase monotonically over time; rather, children born during the obesity epidemic were characterized by lower BMI values before the adiposity rebound and by rapid subsequent BMI gain.

Cortical bone health shows significant linkage to chromosomes 2p, 3p, and 17q in 10-year-old children.

Genes play an important role in lifelong skeletal health. Genes that influence bone building during childhood have the potential to affect bone health not only throughout childhood but also into adulthood. Given that peak bone mass is a significant predictor of adult fracture risk, it is imperative that the genetic underpinnings of the normal pediatric skeleton are uncovered. In a sample of 600 10-year-old children from 144 families in the Fels Longitudinal Study, we examined radiographic cortical bone measures of the second metacarpal. Morphometic measurements included bone width, medial and lateral cortical thicknesses, and the calculated cortical index representing the amount of cortex relative to bone width. We then conducted genome-wide linkage analysis on these traits in 440 genotyped individuals using the SOLAR analytic platform. Significant quantitative trait loci (QTL) were identified for bone traits on three separate chromosomes. A QTL for medial cortical thickness was localized to chromosome 2p25.2. A QTL for lateral cortical thickness was localized to chromosomal region 3p26.1-3p25.3. Finally, a QTL detected for cortical index was localized to the 17q21.2 chromosomal region. Each region contains plausible candidate genes for pediatric skeletal health, some of which confirm findings from studies of adulthood bone, and for others represent novel candidate genes for skeletal health.

Secular trends in blood pressure during early-to-middle adulthood: the Fels Longitudinal Study.

BACKGROUND: Some studies have shown a decline in blood pressure (BP) over the second half of the twentieth century. However, the increasing prevalence of obesity may have opposite effects on recent cohorts. METHOD: Using serial BP data from the Fels Longitudinal Study, we examined secular trends in mean BP, the rate of change in BP with age (slopes), and the influence of obesity (i.e., BMI) and height on these trends during young-to-middle adulthood. The study sample consisted of 970 adults, aged 18-40 years, who were born between 1920 and 1979. Participants were grouped into birth decade cohorts and had up to 11 serial measurements of SBP, DBP, and BMI. Sex-stratified mixed longitudinal analyses were used to identify cohort effects on mean BP at ages 19, 29, and 39 years, and on the rate of change in BP with age. RESULTS: For both sexes, mean SBP did not vary significantly by birth cohort, before and after adjusting for height and BMI. Mean DBP exhibited a U-shaped secular trend even after adjusting for BMI and height that was influenced by age-by-cohort effects. By age 39 years, those born most recently had the highest mean DBP. CONCLUSION: There were cohort effects on the rate of change in DBP with age, but not on rate of SBP change. The most recent cohorts had higher rates of DBP change with age compared to the earlier cohorts. The secular trend was partially influenced by the trends in BMI.

A genome-wide linkage scan for quantitative trait loci influencing the craniofacial complex in humans (Homo sapiens sapiens).

The genetic architecture of the craniofacial complex has been the subject of intense scrutiny because of the high frequency of congenital malformations. Numerous animal models have been used to document the early development of the craniofacial complex, but few studies have focused directly on the genetic underpinnings of normal variation in the human craniofacial complex. This study examines 80 quantitative traits derived from lateral cephalographs of 981 participants in the Fels Longitudinal Study, Wright State University, Dayton, Ohio. Quantitative genetic analyses were conducted using the Sequential Oligogenic Linkage Analysis Routines analytic platform, a maximum-likelihood variance components method that incorporates all familial information for parameter estimation. Heritability estimates were significant and of moderate to high magnitude for all craniofacial traits. Additionally, significant quantitative trait loci (QTL) were identified for 10 traits from the three developmental components (basicranium, splanchnocranium, and neurocranium) of the craniofacial complex. These QTL were found on chromosomes 3, 6, 11, 12, and 14. This study of the genetic architecture of the craniofacial complex elucidates fundamental information of the genetic architecture of the craniofacial complex in humans.

Significant associations of age, menopausal status and lifestyle factors with visceral adiposity in African-American and European-American women.

BACKGROUND: Elevated visceral adiposity is strongly predictive of cardiometabolic disease, but, due to the high cost of biomedical imaging, assessment of factors contributing to normal variation in visceral (VAT) and subcutaneous (SAT) adipose tissue partitioning in large cohorts of healthy individuals are few, particularly in ethnic and racial minority populations. OBJECTIVE: To describe age, menopausal status, smoking and physical activity differences in VAT and abdominal subcutaneous adipose tissue (ASAT) mass in African-American (AA) and European-American (EA) women. METHODS: Magnetic resonance imaging measures of VAT and ASAT mass and VAT% (VAT/VAT+ASAT, %) were obtained from a cross-sectional sample of 617 EA and 111 AA non-diabetic women aged 18-80 years. Multivariate linear regression was used to test independent effects of the covariates. RESULTS: VAT and VAT% were higher in EA than AA women (p < 0.01). Differences in VAT, ASAT and VAT% across age groups began in early adulthood in both ethnic groups, but the association of age with VAT% was stronger in EA women (p for interaction = 0.03). Current smokers had higher VAT and VAT% (p < 0.01) and lower TBF than non-smokers. Frequent participation in sports activities was associated with ∼30% lower VAT in older (>55 years) as well as younger ( < 40 years) women (p < 0.0001). CONCLUSION: Greater allocation of abdominal adipose tissue into the visceral compartment occurs in EA than AA women and in older than younger women. Avoidance of cigarette smoking and frequent participation in sports activities may partially counteract this deleterious phenomenon of ageing.

Bayesian longitudinal plateau model of adult grip strength.

OBJECTIVES: This article illustrates the use of applied Bayesian statistical methods in modeling the trajectory of adult grip strength and in evaluating potential risk factors that may influence that trajectory. METHODS: The data consist of from 1 to 11 repeated grip strength measurements from each of 498 men and 533 women age 18-96 years in the Fels Longitudinal Study (Roche AF. 1992. Growth, maturation and body composition: the Fels longitudinal study 1929-1991. Cambridge: Cambridge University Press). In this analysis, the Bayesian framework was particularly useful for fitting a nonlinear mixed effects plateau model with two unknown change points and for the joint modeling of a time-varying covariate. Multiple imputation (MI) was used to handle missing values with posterior inferences appropriately adjusted to account for between-imputation variability. RESULTS: On average, men and women attain peak grip strength at the same age (36 years), women begin to decline in grip strength sooner (age 50 years for women and 56 years for men), and men lose grip strength at a faster rate relative to their peak; there is an increasing secular trend in peak grip strength that is not attributable to concurrent secular trends in body size, and the grip strength trajectory varies with birth weight (men only), smoking (men only), alcohol consumption (men and women), and sports activity (women only). CONCLUSIONS: Longitudinal data analysis requires handling not only serial correlation but often also time-varying covariates, missing data, and unknown change points. Bayesian methods, combined with MI, are useful in handling these issues.

Genetic analysis of self-reported physical activity and adiposity: the Southwest Ohio Family Study.

OBJECTIVE: Physical inactivity poses a major risk for obesity and chronic disease, and is influenced by both genetic and environmental factors. However, the genetic association between physical activity (PA) level and obesity is not well characterized. Our aims were to: (i) estimate the extent of additive genetic influences on physical activity while adjusting for household effects; and (ii) determine whether physical activity and adiposity measures share common genetic effects. SUBJECTS: The sample included 521 (42 % male) adult relatives, 18-86 years of age, from five large families in the Southwest Ohio Family Study. DESIGN: Sport, leisure and work PA were self-reported (Baecke Questionnaire of Habitual Physical Activity). Total body and trunk adiposity, including percentage body fat (%BF), were measured using dual-energy X-ray absorptiometry. Abdominal visceral and subcutaneous adipose tissue mass were measured using MRI. RESULTS: Heritabilities for adiposity and PA traits, and the genetic, household and environmental correlations among them, were estimated using maximum likelihood variance components methods. Significant genetic effects (P < 0.05) were found for sport (h2 = 0.26) and leisure PA (h2 = 0.17). Significant (P < 0.05) household effects existed for leisure PA (c2 = 0.25). Sport PA had a negative genetic correlation with central adiposity measurements adjusted for height (rhoG > |-0.40|). Sport and leisure PA had negative genetic correlations with %BF (rhoG > |-0.46|). CONCLUSIONS: The results suggest that the association of sport and leisure PA with lower adiposity is due, in part, to a common genetic inheritance of both reduced adiposity and the predisposition to engage in more physical activity.

Visceral adiposity and its anatomical distribution as predictors of the metabolic syndrome and cardiometabolic risk factor levels.

BACKGROUND: Despite the recognition that central obesity plays a critical role in chronic disease, few large-scale imaging studies have documented human variation in abdominal adipose tissue patterning. OBJECTIVE: We aimed to compare the associations between abdominal subcutaneous adipose tissue (ASAT) and visceral abdominal tissue (VAT), which were measured at different locations across the abdomen, and the presence of the metabolic syndrome (MS; National Cholesterol Education Program Adult Treatment Panel III definition) and individual cardiometabolic risk factors. DESIGN: This study included 713 non-Hispanic whites aged 18-86 y, in whom VAT and ASAT were assessed by using multiple-image magnetic resonance imaging. The anatomical position of the magnetic resonance image containing the maximum VAT area for each subject was used as a measure of VAT patterning. Multivariate linear and logistic regression analyses were used to examine the relation of VAT, ASAT, and VAT patterning to cardiometabolic risk. RESULTS: VAT mass was a stronger predictor of the MS than was ASAT mass, but ASAT mass (and other measures of subcutaneous adiposity) had signification interactions with VAT mass, whereby elevated ASAT reduced the probability of MS among men with high VAT (P = 0.0008). There was variation across image locations in the association of VAT area with the MS in men, and magnetic resonance images located 4-8 cm above L4-L5 provided the strongest correlations between VAT area and cardiometabolic risk factors. Subjects whose maximum VAT area was higher in the abdomen had higher LDL-cholesterol concentrations (R(2) = 0.07, P < 0.0001), independent of age and adiposity. CONCLUSION: Further studies are needed to confirm the effects of VAT patterning on cardiometabolic risk.

Genetic architecture of knee radiographic joint space in healthy young adults.

Evidence of a significant genetic component to the age-related degenerative joint disease osteoarthritis has been established, but the nature of genetic influences on normal joint morphology in healthy individuals remains unclear. Following up on our previous findings on the influence of body habitus on phenotypic variation in knee joint space [Duren et al., Human Biology 78:353-364 (2006)], the objective of the current study was to estimate the heritability of radiographic joint space in the knees of healthy young adults from a community-based sample of families. A sample of 253 subjects (mean age = 18.02 years) from 87 randomly ascertained nuclear and extended families was examined. Joint width (JW) and minimum joint space in the medial (MJS) and lateral (LJS) knee compartments were measured. A maximum-likelihood variance components method was used to estimate the heritability of MJS, LJS, and JW. Covariate effects of age, sex, age-by-sex interactions, stature, weight, and BMI were simultaneously estimated. Genetic correlation analyses were then conducted to examine relationships between trait pairs. MJS, LJS, and JW were each significantly heritable (p < 0.001), with heritabilities of 0.52, 0.53, and 0.63, respectively. The genetic correlation between MJS and LJS was not significantly different from 1. Genetic correlations between each joint space measure and JW were not significantly different from 0. This study demonstrates a significant genetic component to radiographic knee joint space during young adulthood in healthy subjects. This suggests that there are specific but as yet unidentified genes that influence the morphology of healthy articular cartilage, the target tissue of osteoarthritis. Genetic correlation analyses indicate complete pleiotropy between MJS and LJS but genetic independence of joint space and JW.

Childhood obesity predicts adult metabolic syndrome: the Fels Longitudinal Study.

OBJECTIVES: To determine the age of significant divergence in body mass index (BMI) and waist circumference in adults with and without the metabolic syndrome, and to provide age- and sex-specific childhood values that predict adult metabolic syndrome. STUDY DESIGN: Part 1 of this study is a retrospective cohort study of 92 men and 59 women (mean age, 51 years) who had metabolic syndrome and 154 randomly selected adults matched for age and sex who did not have the syndrome. Part 2 is a study of predictive accuracy in a validation sample of 743 participants. RESULTS: The first appearance of differences between adults with and without metabolic syndrome occurred at ages 8 and 13 for BMI and 6 and 13 for waist circumference in boys and girls, respectively. Odds ratios (ORs) for the metabolic syndrome at 30 years and older ranged from 1.4 to 1.9 across age groups in boys and from 0.8 to 2.8 across age groups in girls if BMI exceeded criterion values in childhood. The corresponding ORs for waist circumference ranged from 2.5 to 31.4 in boys and 1.7 to 2.5 in girls. These ORs increased with the number of examinations. CONCLUSIONS: Children with BMI and waist circumference values exceeding the established criterion values are at increased risk for the adult metabolic syndrome.

Presentation, heritability, and genome-wide linkage analysis of the midchildhood growth spurt in healthy children from the Fels Longitudinal Study.

Growth is a complex process composed of distinct phases over the course of childhood. Although the pubertal growth spurt has received the most attention from auxologists and pediatricians, the midchildhood growth spurt has been less well studied. The midchildhood growth spurt refers to a relatively small increase in growth velocity observed in some, but not necessarily all, children in early to middle childhood. If present, the midchildhood growth spurt typically occurs sometime between the ages of 4 and 8 years, well before the onset of the far more pronounced pubertal growth spurt. In this study we used a triple logistic curve-fitting method to fit individual growth curves to serial stature data from 579 healthy participants in the Fels Longitudinal Study, 479 of whom have been genotyped for about 400 short tandem repeat (STR) markers spanning the genome. We categorized individuals according to the presence or absence of a midchildhood growth spurt and then conducted heritability and genome-wide linkage analyses on the dichotomous trait. In the total sample of 579 individuals, 336 (58%) were found to have evidence of having had a midchildhood growth spurt. There was a marked sex difference in presence of the midchildhood growth spurt, however, with 232 of the 293 males (79%) having had a midchildhood growth spurt but just 104 of the 286 females (36%) having had one. Presence of a midchildhood growth spurt was found to have a significant heritability of 0.37 +/- 0.14 (p = 0.003). Two quantitative trait loci with suggestive LOD scores were found: one at 12 cM on chromosome 17p13.2 (LOD = 2.13) between markers D17S831 and D17S938 and one at 85 cM on chromosome 12q14 (LOD = 2.06) between markers D12S83 and D12S326.

Body composition methods: comparisons and interpretation.

The incidence of obesity in the United States and other developed countries is epidemic. Because the prevalence of comorbidities to obesity, such as type 2 diabetes, has also increased, it is clear there is a great need to monitor and treat obesity and its comorbidities. Body composition assessments vary in precision and in the target tissue of interest. The most common assessments are anthropometric and include weight, stature, abdominal circumference, and skinfold measurements. More complex methods include bioelectrical impedance, dual-energy X-ray absorptiometry, body density, and total body water estimates. There is no single universally recommended method for body composition assessment in the obese, but each modality has benefits and drawbacks. We present here the most common methods and provide guidelines by way of examples to assist the clinician/researcher in choosing methods appropriate to their situation.

Genetic and environmental influences on infant weight and weight change: the Fels Longitudinal Study.

Despite significant progress in understanding the mechanisms by which the prenatal/maternal environment can alter development and adult health, genetic influences on normal variation in growth are little understood. This work examines genetic and nongenetic contributions to body weight and weight change during infancy and the relationships between weight change and adult body composition. The dataset included 501 white infants in 164 nuclear and extended families in the Fels Longitudinal Study, each with 10 serial measures of weight from birth to age 3 years and 232 with body composition data in mid-adulthood. Heritability and covariate effects on weight and weight z-score change from birth to 2 years of age were estimated using a maximum likelihood variance decomposition method. Additive genetic effects explained a high proportion of the variance in infant weight status (h2=0.61-0.95), and change in weight z-score (h2=0.56-0.82). Covariate effects explained 27% of the phenotypic variance at 0-1 month of age and declined in effect to 6.9% of phenotypic variance by 36 months. Significant sex, gestational age, birth order, birth year, and maternal body mass index effects were also identified. For both sexes, a significant increase in weight z-score (>2 SD units) (upward centile crossing) was associated with greater adulthood stature, fat mass, and percent body fat than decrease or stability in weight z-score. Understanding genetic influences on growth rate in a well-nourished, nutritionally stable population may help us interpret the causes and consequences of centile crossing in nutritionally compromised contexts.

Genetic factors in physical growth and development and their relationship to subsequent health outcomes.

Normal physical growth during childhood is influenced by both genetic and environmental factors. However, few studies have examined whether there are shared genetic effects between aspects of child growth and later health outcomes. In this study, we estimate the influence of genetic factors on growth in stature during childhood and determine whether there are pleiotropic effects of genes influencing both childhood growth and later adult health outcomes using familial data. Serial stature data (i.e., birth through adulthood) from participants in the Fels Longitudinal Study were used to derive stature growth parameters. Adult health outcome data for each participant were available for at least one visit after age 30 years. Maximum likelihood-based variance component methods were used to determine the heritability of each parameter and to examine the relationships between growth parameters and adult health outcomes by estimating genetic correlations between the traits. Heritability estimates for the growth parameters are generally high and statistically significant ranging in magnitude from 0.65-0.98. Heritabilities for adult health outcomes are also significant ranging from 0.31-0.98. Results of the phenotypic correlation analysis show that stature growth parameters are significantly related to several adult health outcomes including stature, weight, BMI, systolic and diastolic blood pressure, percent body fat, fat-free mass, skeletal muscle mass in the arms and legs, and total body bone mass. Results of the genetic correlation analysis reveal some evidence of common genetic pathways underlying certain aspects of growth and adult health outcomes including body composition and blood pressure variables.

Sex differences in young adulthood metabolic syndrome and physical activity: the Fels longitudinal study.

OBJECTIVE: To evaluate the effects of habitual physical activity (PA) on the metabolic syndrome (MS) in young adult men and women. RESEARCH METHODS AND PROCEDURES: Cross-sectional PA data were utilized from 249 women and 237 men, aged 18-40 years in the Fels Longitudinal Study. MS components--abdominal circumference (AC), triglycerides (TG), HDL, blood pressure (BP), and fasting glucose (FG)--were dichotomized according to the National Cholesterol Education Program's Adult Treatment Panel III revised criteria. Leisure, sport, work, and total PA scores were calculated using the Baecke Questionnaire of Habitual Physical Activity. Multiple logistic regression modeling assessed the effects of PA, age, smoking, and BMI on MS status. RESULTS: 26.9% of men and 19.3% of women had MS. For men, MS risk was reduced with increases in both total PA [OR = 0.65 (95% CI: 0.47, 0.90)] and sport PA [OR = 0.40 (95% CI: 0.23, 0.70)]. AC, TG, and HDL values also improved with total and sport PA. Among women, the risk for MS was marginally reduced by total PA [OR = 0.72 (95% CI: 0.50, 1.02)] and HDL levels were increased by both total PA [OR = 0.79 (95% CI: 0.63, 0.98)] and sport PA [OR = 0.54 (95% CI: 0.35, 0.84)]. DISCUSSION: Increased total and sport PA reduces risk for the MS in young men, though not as clearly in young women.

Approximation of total visceral adipose tissue with a single magnetic resonance image.

BACKGROUND: A single axial image measured between the 4th and 5th lumbar vertebrae (L4-L5) is most frequently chosen to approximate total abdominal visceral adipose tissue (VAT) volume, but growing evidence suggests that this measurement site is not ideal. OBJECTIVE: The objective was to determine the single magnetic resonance (MR) image that best approximates the total VAT volume in a biracial sample of healthy subjects. DESIGN: We used contiguous abdominal MR images to measure VAT area and summed them to determine total VAT volume. The sample included 820 healthy men and women (n = 692 whites, 128 blacks) aged 18-88 y. RESULTS: A range of MR images had equally high correlations with total VAT in each race and sex group. The image 6 cm above L4-L5 (L4-L5 + 6) was within the best equivalent range for all race and sex groups. The L4-L5 + 6 image crossed the L3 vertebra in 85% of subjects and crossed the L2-L3 intervertebral space or the L2 vertebra for 15% of subjects. Linear regression models indicated that the L4-L5 + 6 image explained 97% of the variance in total abdominal VAT volume, and additional covariates did not increase the R(2) value significantly. The L4-L5 image explained 83% of the variance in VAT volume, and the covariates accounted for an additional 7% of the variance. Rank-order values for VAT can change if total VAT volume is approximated by a single image area. Whereas 25% of subjects changed rank by >or=10% with the L4-L5 image, only 3% changed rank to that degree with the L4-L5 + 6 image. CONCLUSIONS: A single MR image located approximately at the L3 vertebra can accurately estimate total VAT volume in blacks and whites of both sexes.

Systolic blood pressure in childhood predicts hypertension and metabolic syndrome later in life.

OBJECTIVE: The goal was to link hypertension and the metabolic syndrome in adulthood directly to blood pressures measured decades earlier for the same individuals as children and to establish criterion values for blood pressure that predict hypertension and the metabolic syndrome later in life. METHODS: We analyzed serial data for 240 men and 253 women in the Fels Longitudinal Study. We derived age- and gender-specific childhood blood pressures that predict hypertension and the metabolic syndrome in adulthood, and we validated these criterion values in a larger sample. RESULTS: Blood pressure diverged between adults with and without the metabolic syndrome beginning at age 5 for boys and age 8 for girls. The odds ratios for developing hypertension at > or = 30 years of age ranged from 1.1 for 14- to 18-year-old boys to 3.8 for 5- to 7-year-old boys and from 2.7 for 8- to 13-year-old girls to 4.5 for 5- to 7-year-old girls, if their blood pressure exceeded criterion values at a single examination in childhood. The corresponding odds ratios for the metabolic syndrome, with or without hypertension, ranged from 1.2 for 14- to 18-year-old boys to 2.6 for 8- to 13-year-old boys and from 1.5 for 14- to 18-year-old girls to 3.1 for 5- to 7-year-old girls. The relative risk of adult hypertension ranged from 1.5 to 3.8 for boys and from 1.5 to 4.7 for girls, and that of the metabolic syndrome ranged from 1.1 to 1.8 for boys and from 1.2 to 5.6 for girls. These relative risks varied directly with the number of examinations at which systolic blood pressure exceeded criterion values. CONCLUSION: Children with systolic blood pressures above the criterion values established in this longitudinal study are at increased risk of hypertension and the metabolic syndrome later in life.