A1 Refereed original research article in a scientific journal
Earliest age to detect lifetime cardiometabolic health stratification in children; 
Authors: Mäkinen, Ville-Petteri; Kähönen, Mika; Lehtimäki, Terho; Hutri, Nina; Rönnemaa, Tapani; Viikari, Jorma; Pahkala, Katja; Rovio, Suvi; Niinikoski, Harri; Mykkänen, Juha; Raitakari, Olli; Ala-Korpela, Mika
Publisher: Elsevier BV
Publication year: 2026
Journal: Atherosclerosis
Article number: 120833
Volume: 419
ISSN: 0021-9150
eISSN: 1879-1484
DOI: https://doi.org/10.1016/j.atherosclerosis.2026.120833
Publication's open availability at the time of reporting: Open Access
Publication channel's open availability : Partially Open Access publication channel
Web address : https://doi.org/10.1016/j.atherosclerosis.2026.120833
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/526933471
Self-archived copy's licence: CC BY
Self-archived copy's version: Publisher`s PDF
Background and aims: Cardiovascular risk factors such as overweight and high cholesterol in childhood are predictive of high disease risk in adulthood. However, the optimal timing and scope of early prevention remains uncertain due to sparse data. Our aim was to identify the earliest age at which adult-like cardiometabolic stratification emerges in population-based time-series of the first five decades of life.
Methods: Children born in 1962-1992 were included from three European cohorts (local community samples). Suitable measurement series of weight, height and lipoprotein lipids were analyzed for 5683 participants (ages 0-49 years, follow-ups 10-31 years depending on cohort). Longitudinal tracking was quantified by autocorrelation (R2) over the same individuals between two visits at least a decade apart. The pattern of R2 as a function of age at the first visit was examined to identify the earliest age when adult-like plateau was reached.
Results: Autocorrelation of body mass index was low in children under four (R2 ≤12%), but reached adult levels at age nine (R2 = 51% for 10-year follow-up and R2 = 27% for 31-year follow-up). Lipoprotein lipids did not exhibit a reduction in autocorrelation at young ages. For circulating cholesterol, 10-year autocorrelation at 15 months of age was R2 = 30%.
Conclusions: Adult-like cardiometabolic stratification is detectable in young children, but accuracy (without extreme indication) may be too low for personalized risk prediction. Consequently, we emphasize broad preventative programs that extend into adulthood to reduce the overall prevalence of cardiometabolic risk factors in the population.
Keywords:
body mass index, cholesterol, Lipids, metabolic health, paediatric cohort
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Funding information in the publication:
VPM was supported by the University of Oulu Profi8 Health Dimensions programme and Research Council of Finland Decision #365202. This study was also supported by a research grant from the Sigrid Jusélius Foundation, the Finnish Foundation for Cardiovascular Research, and the Research Council of Finland (grant #357183). The UK Medical Research Council and Wellcome (Grant ref: MR/Z505924/1) and the University of Bristol provide core support for ALSPAC. A comprehensive list of grants funding is available on the ALSPAC website (URL: http://www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). Genome-wide genotyping data was generated by Sample Logistics and Genotyping Facilities at Wellcome Sanger Institute and LabCorp (Laboratory Corporation of America) using support from 23andMe. Specific grants that apply here include 076467/Z/05/Z, CS/15/6/31468, 086676/Z/08/Z, PG106/145 and R01 DK077659. This publication is the work of the authors and V–P Mäkinen will serve as the guarantor for the contents of this paper. The Young Finns Study has been financially supported by the Academy of Finland: grants 356405, 322098, 286284, 134309 (Eye), 126925, 121584, 124282, 129378 (Salve), 117797 (Gendi), and 141071 (Skidi); the Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals (grant X51001); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation for Cardiovascular Research; Finnish Cultural Foundation; The Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; Yrjö Jahnsson Foundation; Signe and Ane Gyllenberg Foundation; Diabetes Research Foundation of Finnish Diabetes Association; EU Horizon 2020 (grant 755320 for TAXINOMISIS and grant 848146 for To Aition); European Research Council (grant 742927 for MULTIEPIGEN project); Tampere University Hospital Supporting Foundation; Finnish Society of Clinical Chemistry; the Cancer Foundation Finland; pBETTER4U_EU (Preventing obesity through Biologically and bEhaviorally Tailored inTERventions for you; project number: 101080117); CVDLink (EU grant nro. 101137278) and the Jane and Aatos Erkko Foundation.
