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Background <p>Childhood adiposity is associated with adverse cardiovascular changes, yet the longitudinal relationships of general and regional body fat mass with cardiovascular structure and function in children remain incompletely understood. Furthermore, whether these associations are partially mediated by traditional cardiometabolic risk factors is unclear. Therefore, this study aimed to investigate these longitudinal associations in Chinese children and to assess the potential mediating role of cardiometabolic risk factors.</p> Methods <p>A total of 1064 children aged 10–15&#xa0;years from the Huantai Childhood Cardiovascular Health Cohort Study with complete baseline and 2-year follow-up data were included. Multivariable linear regression models and mediation analyses were performed to examine the associations.</p> Results <p>Children with elevated baseline fat mass percentage (FMP) exhibited higher left ventricular (LV) measures at follow-up, including LV end-diastolic internal dimension (<i>β</i> = 2.10, 95% CI = 1.69, 2.50), LV posterior wall thickness (<i>β</i> = 0.35, 95% CI = 0.29, 0.41), interventricular septal thickness (<i>β</i> = 0.29, 95% CI = 0.23, 0.35), LV end-diastolic volume (<i>β</i> = 10.13, 95% CI = 8.07, 12.19), LV end-systolic internal dimension (<i>β</i> = 0.80, 95% CI = 0.45, 1.15), and LV mass index (<i>β</i> = 3.90, 95% CI = 3.28, 4.51). Elevated FMP was also associated with differences in LV function, indicated by higher LV ejection fraction (<i>β</i> = 0.99, 95% CI = 0.27, 1.71) and a lower early-to-late mitral flow velocity ratio (<i>β</i> = − 0.10, 95% CI = − 0.18, − 0.03). Higher vascular metrics were also observed, including higher levels of carotid intima-media thickness (<i>β</i> = 0.03, 95% CI = 0.02, 0.04), ankle-brachial index (<i>β</i> = 0.02, 95% CI = 0.01, 0.03), and pulse pressure index (<i>β</i> = 0.02, 95% CI = 0.01, 0.03). Similar patterns were observed for elevated fat mass index, visceral fat mass, and subcutaneous fat mass. Mediation analyses indicated that these associations may be partly accounted for cardiometabolic factors such as systolic and diastolic blood pressure, high-density lipoprotein cholesterol, and insulin resistance (measured by the homeostatic model assessment).</p> Conclusions <p>Higher levels of general and regional body fat mass during childhood are associated with less favorable cardiovascular structure and function over a 2-year period, and these associations may be partly explained by metabolic risk factors.</p>

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Longitudinal associations between body fat mass and cardiovascular outcomes among Chinese children: mediation by cardiometabolic risk factors

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  • 发表日期：

    2026年3月16日

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  • Hui Yang,
  • Qin Liu,
  • Qian Zhang,
  • Min Zhao,
  • Bo Xi

摘要

Background

Childhood adiposity is associated with adverse cardiovascular changes, yet the longitudinal relationships of general and regional body fat mass with cardiovascular structure and function in children remain incompletely understood. Furthermore, whether these associations are partially mediated by traditional cardiometabolic risk factors is unclear. Therefore, this study aimed to investigate these longitudinal associations in Chinese children and to assess the potential mediating role of cardiometabolic risk factors.

Methods

A total of 1064 children aged 10–15 years from the Huantai Childhood Cardiovascular Health Cohort Study with complete baseline and 2-year follow-up data were included. Multivariable linear regression models and mediation analyses were performed to examine the associations.

Results

Children with elevated baseline fat mass percentage (FMP) exhibited higher left ventricular (LV) measures at follow-up, including LV end-diastolic internal dimension (β = 2.10, 95% CI = 1.69, 2.50), LV posterior wall thickness (β = 0.35, 95% CI = 0.29, 0.41), interventricular septal thickness (β = 0.29, 95% CI = 0.23, 0.35), LV end-diastolic volume (β = 10.13, 95% CI = 8.07, 12.19), LV end-systolic internal dimension (β = 0.80, 95% CI = 0.45, 1.15), and LV mass index (β = 3.90, 95% CI = 3.28, 4.51). Elevated FMP was also associated with differences in LV function, indicated by higher LV ejection fraction (β = 0.99, 95% CI = 0.27, 1.71) and a lower early-to-late mitral flow velocity ratio (β = − 0.10, 95% CI = − 0.18, − 0.03). Higher vascular metrics were also observed, including higher levels of carotid intima-media thickness (β = 0.03, 95% CI = 0.02, 0.04), ankle-brachial index (β = 0.02, 95% CI = 0.01, 0.03), and pulse pressure index (β = 0.02, 95% CI = 0.01, 0.03). Similar patterns were observed for elevated fat mass index, visceral fat mass, and subcutaneous fat mass. Mediation analyses indicated that these associations may be partly accounted for cardiometabolic factors such as systolic and diastolic blood pressure, high-density lipoprotein cholesterol, and insulin resistance (measured by the homeostatic model assessment).

Conclusions

Higher levels of general and regional body fat mass during childhood are associated with less favorable cardiovascular structure and function over a 2-year period, and these associations may be partly explained by metabolic risk factors.