Background: Data are limited regarding the association of
cumulative burden and trajectory of body mass index (BMI) from early
life with adult lipid disorders. Methods: The study cohort
consisted of 5195 adults who had BMI repeatedly measured 4 to 21 times
from childhood and had blood lipid measurements of low-density
lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol
(HDL-C), and triglycerides (TG) and information on lipid-lowering
medications in the last adult survey. The area under the curve (AUC) was
calculated as a measure of long-term burden (total AUC) and trends
(incremental AUC) of BMI. Results: Participants with
dyslipidemia, high LDL-C, low HDL-C and high TG had consistently and
significantly higher BMI levels from childhood to adulthood compared to
those with normal lipid levels. After adjusting for age, race, sex, and
cohort, increased risk of adult dyslipidemia was significantly
associated with higher values of childhood BMI, adulthood BMI, total AUC
and incremental AUC, with odds ratio (95% confidence interval) = 1.22
(1.15-1.29), 1.85 (1.74-1.97), 1.61 (1.52-1.71), and 1.59 (1.50-1.69),
respectively, and p < 0.001 for all. The association patterns were similar in most race-sex subgroups. Conclusions:
Adults with dyslipidemia versus normal lipid levels have consistently
higher levels and distinct life-course trajectories of BMI, suggesting
that the impact of excessive body weight on dyslipidemia originates in
early life.