Adolescent BMI predicts future cardiovascular risk

The emerging pandemic of obesity is threatening to reverse the reduction in cardiovascular mortality and morbidity that has occurred during the latter half of the 20th century. While adult obesity is clearly related to cardiovascular risk, the association of BMI in adolescence with future adult cardiovascular disease has not been completely delineated.

Using data from the Staff Periodic Examination Center of the Israeli Army Medical Corps, the authors assessed the height and weight of 37 674 apparently healthy young men, starting at age 17, and repeated this assessment every 3–5 years for a median period of 16.9 years. During this time participants were followed up for incident angiography-proven coronary heart disease and type II diabetes. During approximately 650 000 person-years of follow-up, 1173 incident cases of type II diabetes and 327 of coronary heart disease were documented. Dividing the cohort into deciles, in multivariate analysis, elevated adolescent BMI was a significant predictor of both diabetes (HR for the highest vs the lowest decile, 2.76; 95% CI 2.11 to 3.58) and angiography-proven coronary heart disease (HR=5.43; 95% CI 2.77 to 10.62). However, after adjustment of the BMI values as continuous variables in multivariate models, only elevated BMI in adulthood was significantly associated with diabetes (b=1.115, p=0.003; p=0.89 for interaction) while BMI in both adolescence and adulthood continued to be associated with coronary disease (p=0.048 for interaction).