Dynamics of Body Mass Index from Adolescence to Adulthood and Risk of Diabetes Versus Coronary Heart Disease

Amir Tirosh, Iris Shai, Arnon Afek, Gal Dubnov-Raz, Nir Ayalon, Barak Gordon, Estela Derazne, Dorit Tzur, Ari Shamiss, Shlomo Vinker, Assaf Rudich

Research output: Contribution to journalMeeting Abstract

Abstract

The relationship between changes in body mass index (BMI) from adolescence to adulthood and the risk of obesity-related diseases in young adulthood is unclear.Apparently healthy 37,674 young men were followed prospectively for incidence of angiography-proven CHD and type 2 diabetes through the Israeli-army examination center.Height and weight were measured at age-17 and repeatedly during adulthood.Mean age-17 (adolescence) BMI ranged between 17.3kg/m2 (fi rst decile) to 27.6kg/m2 (top decile). During ∼650,000 person-years of follow-up (17.4 years) we documented 1,173 incident cases of type 2 diabetes and 327 incident cases of CHD. In a multiv ariat e model adjus t ed for age, f amily his tor y, blood pr es sur e, life-style parameters, and blood biomarkers, increased adolescence BMI was a signifi cant predictor of diabetes (HR=2.76;95%CI:2.11-3.58; extreme deciles), and angiography-proven CHD (HR=5.43;95%CI:2.77-10.62; extreme deciles). Further adjustment to BMI at early adulthood completely attenuated the association between adolescence BMI and diabetes (HR=1.01;95%CI:0.75-1.37), but not with CHD (HR=6.85;95%CI:3.30-14.21). Consistent were fi ndings with adjusting both BMI values as continuous predictor variables (Diabetes: βBMI-17=1.05;p= 0.28, βBMI-30=1.12;p=0.003, p-interaction=0.885; CHD: βBMI-17=1.36;p= 0.004, βBMI-30=1.21;p=0.029, p-interaction=0.048). In a multivariate model, adjusted for age-17 BMI, each incremental unit of BMI gain between adolescence and adulthood was associated with 8% increase in diabetes risk (HR=1.08 (95%CI;1.06-1.11) but not with CHD (HR=1.01(95%CI;0.97-1.05)).In conclusion, diabetes risk mainly associates with more recent weight gain and with increased BMI closer to the time of diagnosis, whereas a longer ‘BMI memory’ exists for CHD risk. Increased BMI at adolescence, well within the currently-considered normal range, constitutes a signifi cant risk factor for CHD at early adulthood.
Original languageEnglish GB
Pages (from-to)A71-A71
JournalDiabetes
Volume60
DOIs
StatePublished - 1 Jul 2011

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