Methods:

Data from four prospective cohort studies that measured childhood and adult body mass index (BMI) were used for the present study. The studies used for this analysis included two from the United States: the Bogalusa Heart Study and the Muscatine Study. One study was from Australia: the Childhood Determinants of Adult Health (CDAH) study. The other one was from Finland: Cardiovascular Risk in Young Finns Study. The mean length of follow-up was 23 years. International age- and sex-specific BMI cutoff points for overweight and obesity were used for children, and a BMI cutoff point of 30 kg/m² was used for adults. The primary outcomes of interest were type 2 diabetes (DM), hypertension (HTN), dyslipidemia, and carotid intima-media thickness (IMT). Subjects were classified as having DM, if they had a fasting plasma glucose level of 7 mmol/L (126 mg/L) or higher, reported the use of oral glucose-lowering medication or insulin, but had not reported having type 1 diabetes, or had received a diagnosis of type 2 diabetes from a physician. Dyslipidemia was defined, according to National Cholesterol Education Program guidelines, as low-density lipoprotein (LDL) cholesterol levels of 160 mg/dl (4.14 mmol/L) or higher, high-density lipoprotein (HDL) cholesterol levels of <40 mg/dl (1.03 mmol/L), and triglyceride levels of 200 mg/dl (2.26 mmol/L) or higher. Subjects who were taking lipid-lowering medication were also classified as having dyslipidemia. High-risk IMT in adulthood was defined as an IMT ≥ the 90th percentile for age, sex, race, study year, and cohort-specific values.