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Change in body mass index from adolescence to young adulthood and increased carotid intima-media thickness at 28 years of age: The Atherosclerosis Risk in Young Adults study

Abstract

Obesity has become a major health problem in Western societies by increasing the risk of atherosclerosis and cardiovascular disease. Although data on tracking of body mass index (BMI) are available, little is known about the impact of weight change over time on the development of vascular damage.

OBJECTIVE: To evaluate the relationship between adolescent BMI as well as change in BMI from adolescence into young adulthood and cardiovascular risk, as estimated by common carotid intima-media thickness (CIMT).

DESIGN: Cohort study.

SUBJECTS: A total of 750 healthy young adults, aged 27–30 y, who attended secondary school in Utrecht, the Netherlands.

MEASUREMENTS: Data on adolescent weight, height, blood pressure and puberty stage were available from the original school health records of the Municipal Health Service. At young adulthood, a questionnaire on cardiovascular risk factors was completed and fasting blood sample was drawn and common CIMT was measured.

RESULTS: One standard deviation (s.d.) increase in adolescent BMI was associated with 2.3 μm [95% confidence interval (CI): 1.3; 3.3] increase in mean common CIMT in young adults after adjustment for gender, adolescent age, adolescent blood pressure, puberty stage and lumen diameter. Further adjustment for adult cardiovascular risk factors did not change the relationship (linear regression coefficient=2.1 μm/s.d.; 95% CI: 1.0; 3.1). Adjustment for adult BMI attenuated the association (linear regression coefficient=0.9 μm/s.d.; 95% CI: −0.3; 2.2) as the majority of overweight and obese adolescents remained overweight or became obese young adults. Subjects who remained in the upper BMI distribution from adolescence into young adulthood had a significantly higher common CIMT compared to those who showed relative weight loss over time (mean difference 14.7 μm; P<0.001). These latter showed similar CIMT values as individuals with constant low BMI.

CONCLUSION: Adolescent BMI predicts cardiovascular risk, as estimated by common CIMT in young adulthood. Individuals who experience the largest increase in BMI and those who remain overweight over time have the thickest common CIMT.

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References

  1. Flegal KM, Carroll MD, Kuczmarski RJ, Johnson CL . Overweight and obesity in the United States: prevalence and trends, 1960–1994. Int J Obes Relat Metab Disord 1998; 22: 39–47.

    Article  CAS  Google Scholar 

  2. Lahti-Koski M, Jousilahti P, Pietinen P . Secular trends in body mass index by birth cohort in eastern Finland from 1972 to 1997. Int J Obes Relat Metab Disord 2001; 25: 727–734.

    Article  CAS  Google Scholar 

  3. Thomsen BL, Ekstrom CT, Sorensen TI . Development of the obesity epidemic in Denmark: cohort, time and age effects among boys born 1930–1975. Int J Obes Relat Metab Disord 1999; 23: 693–701.

    Article  CAS  Google Scholar 

  4. Chinn S, Hughes JM, Rona RJ . Trends in growth and obesity in ethnic groups in Britain. Arch Dis Child 1998; 78: 513–517.

    Article  CAS  Google Scholar 

  5. Seidell JC, Verschuren WM, Kromhout D . Prevalence and trends of obesity in The Netherlands 1987–1991. Int J Obes Relat Metab Disord 1995; 19: 924–927.

    CAS  Google Scholar 

  6. Hulens M, Beunen G, Claessens AL, Lefevre J, Thomis M, Philippaerts R, Borms J, Vrijens J, Lysens R, Vansant G . Trends in BMI among Belgian children, adolescents and adults from 1969 to 1996. Int J Obes Relat Metab Disord 2001; 25: 395–399.

    Article  CAS  Google Scholar 

  7. Sakamoto N, Wansorn S, Tontisirin K, Marui E . A social epidemiologic study of obesity among preschool children in Thailand. Int J Obes Relat Metab Disord 2001; 25: 389–394.

    Article  CAS  Google Scholar 

  8. Wang Y, Ge K, Popkin BM . Tracking of body mass index from childhood to adolescence: a 6-y follow-up study in China. Am J Clin Nutr 2000; 72: 1018–1024.

    Article  CAS  Google Scholar 

  9. Sowers JR . Obesity and cardiovascular disease. Clin Chem 1998; 44: 1821–1825.

    CAS  PubMed  Google Scholar 

  10. Abate N . Obesity and cardiovascular disease. Pathogenetic role of the metabolic syndrome and therapeutic implications. J Diabetes Complications 2000; 14: 154–174.

    Article  CAS  Google Scholar 

  11. Berenson GS, Srinivasan SR, Bao W, Newman III WP, Tracy RE, Wattigney WA . Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med 1998; 338: 1650–1656.

    Article  CAS  Google Scholar 

  12. Chambless LE, Folsom AR, Clegg LX, Sharrett AR, Shahar E, Nieto FJ, Rosamond WD, Evans G . Carotid wall thickness is predictive of incident clinical stroke: the Atherosclerosis Risk in Communities (ARIC) study. Am J Epidemiol 2000; 151: 478–487.

    Article  CAS  Google Scholar 

  13. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE . Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 1997; 96: 1432–1437.

    Article  CAS  Google Scholar 

  14. Davis PH, Dawson JD, Mahoney LT, Lauer RM . Increased carotid intimal-medial thickness and coronary calcification are related in young and middle-aged adults. The Muscatine study. Circulation 1999; 100: 838–842.

    Article  CAS  Google Scholar 

  15. Tuzcu EM, Kapadia SR, Tutar E, Ziada KM, Hobbs RE, McCarthy PM, Young JB, Nissen SE . High prevalence of coronary atherosclerosis in asymptomatic teenagers and young adults: evidence from intravascular ultrasound. Circulation 2001; 103: 2705–2710.

    Article  CAS  Google Scholar 

  16. Homma S, Hirose N, Ishida H, Ishii T, Araki G . Carotid plaque and intima-media thickness assessed by b-mode ultrasonography in subjects ranging from young adults to centenarians. Stroke 2001; 32: 830–835.

    Article  CAS  Google Scholar 

  17. Bots ML, Hofman A, De Jong PT, Grobbee DE . Common carotid intima-media thickness as an indicator of atherosclerosis at other sites of the carotid artery. The Rotterdam Study. Ann Epidemiol 1996; 6: 147–153.

    Article  CAS  Google Scholar 

  18. Parsons TJ, Power C, Logan S, Summerbell CD . Childhood predictors of adult obesity: a systematic review. Int J Obes Relat Metab Disord 1999; 23 (Suppl 8): S1–S107.

    PubMed  Google Scholar 

  19. Pietilainen KH, Kaprio J, Rasanen M, Winter T, Rissanen A, Rose RJ . Tracking of body size from birth to late adolescence: contributions of birth length, birth weight, duration of gestation, parents' body size, and twinship. Am J Epidemiol 2001; 154: 21–29.

    Article  CAS  Google Scholar 

  20. Srinivasan SR, Bao W, Wattigney WA, Berenson GS . Adolescent overweight is associated with adult overweight and related multiple cardiovascular risk factors: the Bogalusa Heart Study. Metabolism 1996; 45: 235–240.

    Article  CAS  Google Scholar 

  21. Laitinen J, Power C, Jarvelin MR . Family social class, maternal body mass index, childhood body mass index, and age at menarche as predictors of adult obesity. Am J Clin Nutr 2001; 74: 287–294.

    Article  CAS  Google Scholar 

  22. Guo SS, Roche AF, Chumlea WC, Gardner JD, Siervogel RM . The predictive value of childhood body mass index values for overweight at age 35 y. Am J Clin Nutr 1994; 59: 810–819.

    Article  CAS  Google Scholar 

  23. Aristimuno GG, Foster TA, Voors AW, Srinivasan SR, Berenson GS . Influence of persistent obesity in children on cardiovascular risk factors: the Bogalusa Heart Study. Circulation 1984; 69: 895–904.

    Article  CAS  Google Scholar 

  24. Wattigney WA, Harsha DW, Srinivasan SR, Webber LS, Berenson GS . Increasing impact of obesity on serum lipids and lipoproteins in young adults. The Bogalusa Heart Study. Arch Intern Med 1991; 151: 2017–2022.

    Article  CAS  Google Scholar 

  25. Freedman DS, Srinivasan SR, Burke GL, Shear CL, Smoak CG, Harsha DW, Webber LS, Berenson GS . Relation of body fat distribution to hyperinsulinemia in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr 1987; 46: 403–410.

    Article  CAS  Google Scholar 

  26. Gunnell DJ, Frankel SJ, Nanchahal K, Peters TJ, Davey SG . Childhood obesity and adult cardiovascular mortality: a 57-y follow-up study based on the Boyd Orr cohort. Am J Clin Nutr 1998; 67: 1111–1118.

    Article  CAS  Google Scholar 

  27. Must A, Jacques PF, Dallal GE, Bajema CJ, Dietz WH . Long-term morbidity and mortality of overweight adolescents. A follow-up of the Harvard Growth Study of 1922 to 1935. N Engl J Med 1992; 327: 1350–1355.

    Article  CAS  Google Scholar 

  28. Nieto FJ, Szklo M, Comstock GW . Childhood weight and growth rate as predictors of adult mortality. Am J Epidemiol 1992; 136: 201–213.

    Article  CAS  Google Scholar 

  29. Davis PH, Dawson JD, Riley WA, Lauer RM . Carotid intimal-medial thickness is related to cardiovascular risk factors measured from childhood through middle age: The Muscatine Study. Circulation 2001; 104: 2815–2819.

    Article  CAS  Google Scholar 

  30. Friedewald WT, Levy RI, Fredrickson DS . Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972; 18: 499–502.

    CAS  Google Scholar 

  31. Wendelhag I, Gustavsson T, Suurkula M, Berglund G, Wikstrand J . Ultrasound measurement of wall thickness in the carotid artery: fundamental principles and description of a computerized analysing system. Clin Physiol 1991; 11: 565–577.

    Article  CAS  Google Scholar 

  32. Troiano RP, Flegal KM . Overweight prevalence among youth in the United States: why so many different numbers? Int J Obes Relat Metab Disord 1999; 23 (Suppl 2): S22–S27.

    Article  Google Scholar 

  33. Glagov S, Zarins C, Giddens DP, Ku DN . Hemodynamics and atherosclerosis. Insights and perspectives gained from studies of human arteries. Arch Pathol Lab Med 1988; 112: 1018–1031.

    CAS  PubMed  Google Scholar 

  34. Mahoney LT, Burns TL, Stanford W, Thompson BH, Witt JD, Rost CA, Lauer RM . Usefulness of the Framingham risk score and body mass index to predict early coronary artery calcium in young adults (Muscatine Study). Am J Cardiol 2001; 88: 509–515.

    Article  CAS  Google Scholar 

  35. Sanchez A, Barth JD, Zhang L . The carotid artery wall thickness in teenagers is related to their diet and the typical risk factors of heart disease among adults. Atherosclerosis 2000; 152: 265–266.

    Article  CAS  Google Scholar 

  36. Tounian P, Aggoun Y, Dubern B, Varille V, Guy-Grand B, Sidi D, Girardet JP, Bonnet D . Presence of increased stiffness of the common carotid artery and endothelial dysfunction in severely obese children: a prospective study. Lancet 2001; 358: 1400–1404.

    Article  CAS  Google Scholar 

  37. Prati P, Vanuzzo D, Casaroli M, Di Chiara A, De Biasi F, Feruglio GA, Touboul PJ . Prevalence and determinants of carotid atherosclerosis in a general population. Stroke 1992; 23: 1705–1711.

    Article  CAS  Google Scholar 

  38. Kuller L, Borhani N, Furberg C, Gardin J, Manolio T, O'Leary D, Psaty B, Robbins J . Prevalence of subclinical atherosclerosis and cardiovascular disease and association with risk factors in the Cardiovascular Health Study. Am J Epidemiol 1994; 139: 1164–1179.

    Article  CAS  Google Scholar 

  39. Heiss G, Sharrett AR, Barnes R, Chambless LE, Szklo M, Alzola C . Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC study. Am J Epidemiol 1991; 134: 250–256.

    Article  CAS  Google Scholar 

  40. Joensuu T, Salonen R, Winblad I, Korpela H, Salonen JT . Determinants of femoral and carotid artery atherosclerosis. J Intern Med 1994; 236: 79–84.

    Article  CAS  Google Scholar 

  41. Salonen R, Salonen JT . Determinants of carotid intima-media thickness: a population-based ultrasonography study in eastern Finnish men. J Intern Med 1991; 229: 225–231.

    Article  CAS  Google Scholar 

  42. Stevens J, Tyroler HA, Cai J, Paton CC, Folsom AR, Tell GS, Schreiner PJ, Chambless LE . Body weight change and carotid artery wall thickness. The Atherosclerosis Risk in Communities (ARIC) Study. Am J Epidemiol 1998; 147: 563–573.

    Article  CAS  Google Scholar 

  43. Lakka TA, Lakka HM, Salonen R, Kaplan GA, Salonen JT . Abdominal obesity is associated with accelerated progression of carotid atherosclerosis in men. Atherosclerosis 2001; 154: 497–504.

    Article  CAS  Google Scholar 

  44. Van Gaal LF, Wauters MA, De Leeuw IH . The beneficial effects of modest weight loss on cardiovascular risk factors. Int J Obes Relat Metab Disord 1997; 21 (Suppl 1): S5–S9.

    Google Scholar 

  45. Hecker KD, Kris-Etherton PM, Zhao G, Coval S, St Jeor S . Impact of body weight and weight loss on cardiovascular risk factors. Curr Atheroscler Rep 1999; 1: 236–242.

    Article  CAS  Google Scholar 

  46. Sothern MS, Despinasse B, Brown R, Suskind RM, Udall Jr JN, Blecker U . Lipid profiles of obese children and adolescents before and after significant weight loss: differences according to sex. South Med J 2000; 93: 278–282.

    Article  CAS  Google Scholar 

  47. Sudi KM, Gallistl S, Borkenstein MH, Payerl D, Aigner R, Moller R, Tafeit E . Effects of weight loss on leptin, sex hormones, and measures of adiposity in obese children. Endocrine 2001; 14: 429–435.

    Article  CAS  Google Scholar 

  48. Karason K, Wikstrand J, Sjostrom L, Wendelhag I . Weight loss and progression of early atherosclerosis in the carotid artery: a four-year controlled study of obese subjects. Int J Obes Relat Metab Disord 1999; 23: 948–956.

    Article  CAS  Google Scholar 

  49. Markus RA, Mack WJ, Azen SP, Hodis HN . Influence of lifestyle modification on atherosclerotic progression determined by ultrasonographic change in the common carotid intima-media thickness. Am J Clin Nutr 1997; 65: 1000–1004.

    Article  CAS  Google Scholar 

  50. Mavri A, Stegnar M, Sentocnik JT, Videcnik V . Impact of weight reduction on early carotid atherosclerosis in obese premenopausal women. Obes Res 2001; 9; 511–516.

    Article  CAS  Google Scholar 

  51. Kushner R . The treatment of obesity. A call for prudence and professionalism. Arch Intern Med 1997; 157: 602–604.

    Article  CAS  Google Scholar 

  52. Korkeila M, Rissanen A, Kaprio J, Sorensen TI, Koskenvuo M . Weight-loss attempts and risk of major weight gain: a prospective study in Finnish adults. Am J Clin Nutr 1999; 70: 965–975.

    Article  CAS  Google Scholar 

  53. Williamson DF, Serdula MK, Anda RF, Levy A, Byers T . Weight loss attempts in adults: goals, duration, and rate of weight loss. Am J Public Health 1992; 82: 1251–1257.

    Article  CAS  Google Scholar 

  54. Haus G, Hoerr SL, Mavis B, Robison J . Key modifiable factors in weight maintenance: fat intake, exercise, and weight cycling. J Am Diet Assoc 1994; 94: 409–413.

    Article  CAS  Google Scholar 

  55. Epstein LH, Valoski AM, Kalarchian MA, McCurley J . Do children lose and maintain weight easier than adults: a comparison of child and parent weight changes from six months to ten years. Obes Res 1995; 3: 411–417.

    Article  CAS  Google Scholar 

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Acknowledgements

We gratefully thank all participants for their time; AAA Bak for her logistic support during enrolment; R Meijer for teaching the acquisition method of CIMT; Marjon vd Meer, Janneke vd Brink and Yvonne Azzara for their contribution in the fieldwork; Hanneke den Breeijen, Carla Tims, Rugter Petersen, Frank Leus and Ronald van Lom for data processing.

The study was funded by the Health Research and Development Council of the Netherlands (ZON-MW), The Hague, the Netherlands.

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Correspondence to M L Bots.

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Oren, A., Vos, L., Uiterwaal, C. et al. Change in body mass index from adolescence to young adulthood and increased carotid intima-media thickness at 28 years of age: The Atherosclerosis Risk in Young Adults study. Int J Obes 27, 1383–1390 (2003). https://doi.org/10.1038/sj.ijo.0802404

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