Abstract
Background: Revealing how increasing weight at adolescence versus adulthood contributes to risk of coronary heart (CHD) disease can elucidate its short-term and cumulative effects on the natural history of the disease in early adulthood.
Methods: Using the MELANY cohort we utilized data of 37,673 male teenagers at a mean age of 17 years who were followed until the age of 42 (650,000 person-years of follow-up). Body-mass index (BMI) was obtained at baseline with additional blood analyses, physical examination and medical and lifestyle information which was repeatedly collected during the follow-up period. Primary outcome was the incidence of coronary atherosclerosis diagnosed as at least 50% stenosis of at least a single coronary artery as demonstrated by coronary angiography.
Results: Within a median 17 years of follow-up of 37,674 men, we documented 327 incident cases of CHD. In a multivariate model adjusted for classical risk factors, age 17 BMI>20.9 Kg/m2 was a significant predictor of CHD (HR=2.83; 95%CI:1.39–5.74 for the extreme deciles). BMI at age 17 remained an independent risk factor for CHD even following further adjustment for BMI at adulthood (age 30 years). Consistent were findings with BMI as continuous variables (βBMI−17=1.36;p=0.004, βBMI−30=1.21;p=0.029, p-interaction=0.048).
Conclusions: Both high-normal BMI at adolescence (age 17) and at age 30 are associated with CHD among young men. This suggests a long-term cumulative effect of elevated BMI (already above 21 Kg/m2) in the pathogenesis of CHD at early adulthood.
Methods: Using the MELANY cohort we utilized data of 37,673 male teenagers at a mean age of 17 years who were followed until the age of 42 (650,000 person-years of follow-up). Body-mass index (BMI) was obtained at baseline with additional blood analyses, physical examination and medical and lifestyle information which was repeatedly collected during the follow-up period. Primary outcome was the incidence of coronary atherosclerosis diagnosed as at least 50% stenosis of at least a single coronary artery as demonstrated by coronary angiography.
Results: Within a median 17 years of follow-up of 37,674 men, we documented 327 incident cases of CHD. In a multivariate model adjusted for classical risk factors, age 17 BMI>20.9 Kg/m2 was a significant predictor of CHD (HR=2.83; 95%CI:1.39–5.74 for the extreme deciles). BMI at age 17 remained an independent risk factor for CHD even following further adjustment for BMI at adulthood (age 30 years). Consistent were findings with BMI as continuous variables (βBMI−17=1.36;p=0.004, βBMI−30=1.21;p=0.029, p-interaction=0.048).
Conclusions: Both high-normal BMI at adolescence (age 17) and at age 30 are associated with CHD among young men. This suggests a long-term cumulative effect of elevated BMI (already above 21 Kg/m2) in the pathogenesis of CHD at early adulthood.
| Original language | English GB |
|---|---|
| Journal | Circulation |
| Volume | 122 |
| Issue number | 21 |
| State | Published - 23 Nov 2010 |
Keywords
- Obesity
- Coronary heart disease
