Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife
Abstract Context Most studies linking long-term consequences of adolescent underweight and obesity are limited to men. Objective To assess the sex-specific association of adolescent BMI with cardiovascular- and non-cardiovascular-related mortality in young adulthood and midlife. Setting A nationwide...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-06-01
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| Series: | Cardiovascular Diabetology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12933-018-0727-7 |
| _version_ | 1818966599964557312 |
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| author | Ariel Furer Arnon Afek Omri Orr Liron Gershovitz Moran Landau Rabbi Estela Derazne Orit Pinhas-Hamiel Noam Fink Adi Leiba Amir Tirosh Jeremy D. Kark Gilad Twig |
| author_facet | Ariel Furer Arnon Afek Omri Orr Liron Gershovitz Moran Landau Rabbi Estela Derazne Orit Pinhas-Hamiel Noam Fink Adi Leiba Amir Tirosh Jeremy D. Kark Gilad Twig |
| author_sort | Ariel Furer |
| collection | DOAJ |
| description | Abstract Context Most studies linking long-term consequences of adolescent underweight and obesity are limited to men. Objective To assess the sex-specific association of adolescent BMI with cardiovascular- and non-cardiovascular-related mortality in young adulthood and midlife. Setting A nationwide cohort. Participants 927,868 women, 1,366,271 men. Interventions Medical examination data at age 17, including BMI, were linked to the national death registry. Main outcomes Death attributed to cardiovascular (CVD) and non-CVD causes. Results During 17,346,230 women-years and 28,367,431 men-years of follow-up, there were 451 and 3208 CVD deaths, respectively, and 6235 and 22,223 non-CVD deaths, respectively. Compared to low-normal BMI (18.5–22.0 kg/m2), underweight women had a lower adjusted risk for CVD mortality (Cox hazard ratio (HR) = 0.68; 95% CI 0.46–0.98) in contrast to underweight men (HR = 0.99; 0.88–1.13). The latter were at higher risk for non-CVD mortality (HR = 1.04; 1.00–1.09), unlike underweight women (HR = 1.01; 0.93–1.10). Findings, which persisted when the study sample was limited to those with unimpaired health, were accentuated for the obese with ≥ 30 years follow-up. Both sexes exhibited similarly higher risk estimates already in the high-normal BMI range (22.0 ≤ BMI < 25.0 kg/m2) with overall no interaction between sex and BMI (p = 0.62). Adjusted spline models suggested lower BMI values for minimal mortality risk among women (16.8 and 18.2 kg/m2) than men (18.8 and 20.0 kg/m2), for CVD and non-CVD death, respectively. Conclusions Underweight adolescent females have favorable cardiovascular outcomes in adulthood. Otherwise the risk patterns were similar between the sexes. The optimal BMI value for women and men with respect to future CVD outcomes is within or below the currently accepted low-normal BMI range. |
| first_indexed | 2024-12-20T13:35:28Z |
| format | Article |
| id | doaj.art-e34647d2bf8c4c72b3c280fbd9215496 |
| institution | Directory Open Access Journal |
| issn | 1475-2840 |
| language | English |
| last_indexed | 2024-12-20T13:35:28Z |
| publishDate | 2018-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Cardiovascular Diabetology |
| spelling | doaj.art-e34647d2bf8c4c72b3c280fbd92154962022-12-21T19:38:58ZengBMCCardiovascular Diabetology1475-28402018-06-0117111010.1186/s12933-018-0727-7Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlifeAriel Furer0Arnon Afek1Omri Orr2Liron Gershovitz3Moran Landau Rabbi4Estela Derazne5Orit Pinhas-Hamiel6Noam Fink7Adi Leiba8Amir Tirosh9Jeremy D. Kark10Gilad Twig11The Israel Defense Forces Medical CorpsThe Sackler School of Medicine, Tel Aviv UniversityThe Israel Defense Forces Medical CorpsThe Israel Defense Forces Medical CorpsThe Israel Defense Forces Medical CorpsThe Sackler School of Medicine, Tel Aviv UniversityThe Sackler School of Medicine, Tel Aviv UniversityThe Israel Defense Forces Medical CorpsThe Israel Defense Forces Medical CorpsThe Sackler School of Medicine, Tel Aviv UniversityHebrew University-Hadassah School of Public Health and Community MedicineThe Israel Defense Forces Medical CorpsAbstract Context Most studies linking long-term consequences of adolescent underweight and obesity are limited to men. Objective To assess the sex-specific association of adolescent BMI with cardiovascular- and non-cardiovascular-related mortality in young adulthood and midlife. Setting A nationwide cohort. Participants 927,868 women, 1,366,271 men. Interventions Medical examination data at age 17, including BMI, were linked to the national death registry. Main outcomes Death attributed to cardiovascular (CVD) and non-CVD causes. Results During 17,346,230 women-years and 28,367,431 men-years of follow-up, there were 451 and 3208 CVD deaths, respectively, and 6235 and 22,223 non-CVD deaths, respectively. Compared to low-normal BMI (18.5–22.0 kg/m2), underweight women had a lower adjusted risk for CVD mortality (Cox hazard ratio (HR) = 0.68; 95% CI 0.46–0.98) in contrast to underweight men (HR = 0.99; 0.88–1.13). The latter were at higher risk for non-CVD mortality (HR = 1.04; 1.00–1.09), unlike underweight women (HR = 1.01; 0.93–1.10). Findings, which persisted when the study sample was limited to those with unimpaired health, were accentuated for the obese with ≥ 30 years follow-up. Both sexes exhibited similarly higher risk estimates already in the high-normal BMI range (22.0 ≤ BMI < 25.0 kg/m2) with overall no interaction between sex and BMI (p = 0.62). Adjusted spline models suggested lower BMI values for minimal mortality risk among women (16.8 and 18.2 kg/m2) than men (18.8 and 20.0 kg/m2), for CVD and non-CVD death, respectively. Conclusions Underweight adolescent females have favorable cardiovascular outcomes in adulthood. Otherwise the risk patterns were similar between the sexes. The optimal BMI value for women and men with respect to future CVD outcomes is within or below the currently accepted low-normal BMI range.http://link.springer.com/article/10.1186/s12933-018-0727-7AdolescenceBody mass indexCohort studyObesityCardiovascular deathSex |
| spellingShingle | Ariel Furer Arnon Afek Omri Orr Liron Gershovitz Moran Landau Rabbi Estela Derazne Orit Pinhas-Hamiel Noam Fink Adi Leiba Amir Tirosh Jeremy D. Kark Gilad Twig Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife Cardiovascular Diabetology Adolescence Body mass index Cohort study Obesity Cardiovascular death Sex |
| title | Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife |
| title_full | Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife |
| title_fullStr | Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife |
| title_full_unstemmed | Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife |
| title_short | Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife |
| title_sort | sex specific associations between adolescent categories of bmi with cardiovascular and non cardiovascular mortality in midlife |
| topic | Adolescence Body mass index Cohort study Obesity Cardiovascular death Sex |
| url | http://link.springer.com/article/10.1186/s12933-018-0727-7 |
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