Tracking of clustered cardiovascular disease risk factors from childhood to adolescence

Pediatr Res. 2013 Feb;73(2):245-9. doi: 10.1038/pr.2012.158. Epub 2012 Nov 19.


Background: Clustering of cardiovascular disease (CVD) risk factors has been found in children as young as 9 y of age. However, the stability of this clustering over the course of childhood has yet to be determined. The purpose of this study was to determine the tracking of clustered CVD risk from young school age through adolescence and to examine differences in tracking between levels of overweight/obesity and cardiorespiratory fitness (VO(2peak)).

Methods: Beginning at 6 y, children (n = 434) were measured three times in 7 y. Anthropometrics, blood pressure, and VO(2peak) were measured. Fasting blood samples were analyzed for CVD risk factors. A clustered risk score (z-score) was constructed by adding sex-specific z-scores for blood pressure, homeostatic model assessment (HOMA-IR), triglyceride (TG), skinfolds, and negative values of high-density lipoprotein cholesterol (HDLc) and VO(2peak).

Results: Significant tracking coefficients were found between clustered z-score at all time intervals (r = 0.514, 0.559, and 0.381 between ages 6-9, 9-13, and 6-13 y, respectively, all P < 0.0001). Tracking was higher for low-fit children, whereas no clear pattern was found for different levels of body fat.

Conclusion: We found that clustered z-score is a fairly stable characteristic through childhood. Implementation of preventive strategies could therefore start at early school age.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity
  • Adolescent
  • Age Factors
  • Biomarkers / blood
  • Blood Pressure
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / physiopathology
  • Child
  • Cluster Analysis
  • Denmark / epidemiology
  • Humans
  • Logistic Models
  • Obesity / epidemiology
  • Obesity / physiopathology
  • Odds Ratio
  • Overweight / blood
  • Overweight / epidemiology*
  • Overweight / physiopathology
  • Oxygen Consumption
  • Physical Fitness*
  • Risk Assessment
  • Risk Factors
  • Skinfold Thickness


  • Biomarkers