Association between Number of Siblings and Cardiovascular Risk Factors in Childhood and in Adulthood: The Cardiovascular Risk in Young Finns Study

Jukka Pihlman; Costan G Magnussen; Suvi P Rovio; Katja Pahkala; Eero Jokinen; Tomi P Laitinen; Nina Hutri-Kähönen; Päivi Tossavainen; Leena Taittonen; Mika Kähönen; Jorma S A Viikari; Olli T Raitakari; Markus Juonala; Joel Nuotio

doi:10.1016/j.jpeds.2021.05.058

Association between Number of Siblings and Cardiovascular Risk Factors in Childhood and in Adulthood: The Cardiovascular Risk in Young Finns Study

J Pediatr. 2021 Oct:237:87-95.e1. doi: 10.1016/j.jpeds.2021.05.058. Epub 2021 Jun 1.

Authors

Affiliations

¹ Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland. Electronic address: jttpih@utu.fi.
² Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
³ Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
⁴ Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Paavo Nurmi Center, Sports and Exercise Medicine Unit, Department of Physical Activity and Health, University of Turku, Turku, Finland.
⁵ Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland.
⁶ Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland.
⁷ Department of Pediatrics, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
⁸ Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.
⁹ Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland; Vaasa Central Hospital, Vaasa, Finland.
¹⁰ Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
¹¹ Department of Internal Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland.
¹² Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland.
¹³ Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland; Center for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland; Heart Center, Turku University Hospital and University of Turku, Turku, Finland.

PMID: 34087153
DOI: 10.1016/j.jpeds.2021.05.058

Abstract

Objective: To determine the association of number of siblings on cardiovascular risk factors in childhood and in adulthood.

Study design: In total, 3554 participants (51% female) from the Cardiovascular Risk in Young Finns Study with cardiovascular disease risk factor data at baseline 1980 (age 3-18 years) and 2491 participants with longitudinal risk factor data at the 2011 follow-up. Participants were categorized by number of siblings at baseline (0, 1, or more than 1). Risk factors (body mass index, physical activity, hypertension, dyslipidemia, and overweight, and metabolic syndrome) in childhood and in adulthood were used as outcomes. Analyses were adjusted for age and sex.

Results: In childhood, participants without siblings had higher body mass index (18.2 kg/m², 95% CI 18.0-18.3) than those with 1 sibling (17.9 kg/m², 95% CI 17.8-18.0) or more than 1 sibling (17.8 kg/m², 95% CI 17.7-17.9). Childhood physical activity index was lower among participants without siblings (SD -0.08, 95% CI -0.16-0.00) compared with participants with 1 sibling (SD 0.06, 95%CI 0.01-0.11) or more than 1 sibling (SD -0.02, 95% CI -0.07-0.03). OR for adulthood hypertension was lower among participants with 1 sibling (OR 0.73, 95% CI 0.54-0.98) and more than 1 sibling (OR 0.71, 95% CI 0.52-0.97) compared with participants with no siblings. OR for obesity was lower among participants with 1 sibling (OR 0.72, 95% CI 0.54-0.95) and more than 1 sibling (OR 0.75, 95% CI 0.56-1.01) compared with those with no siblings.

Conclusions: Children without siblings had poorer cardiovascular risk factor levels in childhood and in adulthood. The number of siblings could help identify individuals at increased risk that might benefit from early intervention.

Keywords: birth order; cardiovascular disease; family size; risk factor.

Publication types

Multicenter Study
Observational Study

MeSH terms

Adolescent
Adult
Cardiovascular Diseases / diagnosis
Cardiovascular Diseases / epidemiology
Cardiovascular Diseases / etiology*
Child
Child, Preschool
Female
Finland / epidemiology
Heart Disease Risk Factors*
Humans
Linear Models
Logistic Models
Longitudinal Studies
Male
Siblings*