Associations of mental health with cardiovascular risk phenotypes and adiposity in adolescence: A cross-sectional community-based study

Kate Lycett; Clare McNamara; Fiona K Mensah; David Burgner; Jessica A Kerr; Josh Muller; Melissa Wake

doi:10.1111/jpc.13943

Associations of mental health with cardiovascular risk phenotypes and adiposity in adolescence: A cross-sectional community-based study

J Paediatr Child Health. 2018 Jun;54(6):677-684. doi: 10.1111/jpc.13943. Epub 2018 May 20.

Authors

Kate Lycett^{1

2}, Clare McNamara^{1

2}, Fiona K Mensah^{2

3

4}, David Burgner^{2

5

6}, Jessica A Kerr^{1

2}, Josh Muller¹, Melissa Wake^{1

2

7}

Affiliations

¹ Community Health Services Research, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
² Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
³ Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
⁴ Clinical Epidemiology and Biostatistics Unit, Royal Children's Hospital, Melbourne, Victoria, Australia.
⁵ Infection and Immunity, Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
⁶ Department of Paediatrics, Monash University, Melbourne, Victoria, Australia.
⁷ Department of Paediatrics, Liggins Institute, University of Auckland, Auckland, New Zealand.

PMID: 29779266
DOI: 10.1111/jpc.13943

Abstract

Aim: Cardiovascular disease and mental illness commonly co-occur in later life, but it is unknown how early these associations arise. We aimed to determine the extent to which: (i) childhood mental health is associated with functional and structural cardiovascular risk phenotypes and adiposity in late childhood/adolescence, and (ii) associations between mental health and cardiovascular phenotypes may be explained by differential body mass index.

Methods: This cross-sectional study drew on three longitudinal community-based cohort studies (two enriched for overweight/obesity) in metropolitan Melbourne, Australia, with harmonized follow-up in 2014. Mental health exposures included emotional and behavioural problems (Strength and Difficulties Questionnaire) and psychosocial health and general well-being (Pediatric Quality of Life Inventory (PedsQL)), which were assessed by self- and parent-proxy report. Cardiovascular risk phenotypes and adiposity measures included mean arterial pressure, pulse wave velocity, carotid artery intima-media thickness, retinal arterioleto-venule ratio, waist circumference, % body fat, and BMI z-score. We used multivariable linear regression models, adjusting for age, sex and neighbourhood disadvantage, to examine associations.

Results: Of the 364 participants (mean age 14.7, standard deviation 2.0, years), 30% were overweight and 16% obese. All adiposity indicators were positively associated with higher behavioural/emotional problems and poorer psychosocial health and negatively associated with better ratings of positive general well-being, as reported by parents and children (all P ≤ 0.03). However, there was little evidence that cardiovascular functional or structural phenotypes varied by mental health.

Conclusions: By late childhood/adolescence, mental health is strongly associated with adiposity but not with cardiovascular structure or function. This suggests that the known relationship between these constructs may not develop until early or mid-adulthood.

Keywords: adolescent; cardiovascular diseases; cardiovascular system; child; mental health; obesity.

MeSH terms

Adiposity*
Adolescent
Cardiovascular Diseases*
Child
Cross-Sectional Studies
Female
Humans
Male
Mental Health*
Obesity
Phenotype*
Self Report
Victoria