Adiposity during adolescence and carotid intima-media thickness in adulthood: Results from the 1993 Pelotas Birth Cohort

Ana Maria Baptista Menezes,Cristiano Tschiedel Belem Da Silva,Fernando César Wehrmeister,Paula Duarte Oliveira,Isabel O Oliveira,Helen Gonçalves,Maria Cecilia F Assunção,Fabiano De Castro Justo,Fernando C Barros

doi:10.1016/j.atherosclerosis.2016.10.026

Abstract

Background and aimsAlthough several studies have examined the association between adiposity and cardiovascular risk markers, few have explored the issue prospectively in young populations. We sought to test whether higher levels of body mass index (BMI) and subscapular skinfold at different stages of adolescence were associated with carotid intima-media thickness (cIMT) in young adulthood. MethodsIn a prospective cohort, we assessed BMI and subscapular skinfold at 11, 15 and 18 years and measured cIMT at 18 years in 3264 individuals. Traditional cardiovascular risk factors and fat mass-mediating effects on cIMT were also assessed. ResultsBoth BMI and subscapular skinfolds were significantly associated with higher cIMT in a cummulative fashion: after controlling for confounders, males and females who persisted overweight/obese at all three assessments, had a mean higher cIMT (5.2 and 3.1 μm, respectively) compared to males and females with normal/healthy BMI at each evaluation (p < 0.001). Moreover, male and females that presented increased fatness in all assessments had a similar pattern of higher cIMT compared to normal/healthy fatness/skinfold at 18 years (mean cIMT 4.6 and 3.0 μm for males and females, respectively; p < 0.001). Associations between adiposity and cIMT were both direct and indirect. Indirect effects were chiefly mediated by fat mass and diastolic blood pressure. ConclusionsOur results suggest adiposity exerts direct and indirect effects during adolescence that result in higher cIMT in young adulthood.

Highlights

Overweight and obesity are two essential public health issues worldwide, including both developed and developing countries [1]
body mass index (BMI) was similar among sexes at each age, with an increase from 11 to 18 years of around 25% for both sexes; mean subscapular skinfolds was higher among girls compared to boys at each age, increasing 2/3 from 11 to 18 years in females; in the three follow-up visits, boys were much more active than girls
This study reports that higher levels of adiposity during adolescence have a positive, cumulative association with carotid intima-media thickness (cIMT) in young adults followed since birth from a representative sample in Latin America

Summary

Introduction

Overweight and obesity are two essential public health issues worldwide, including both developed and developing countries [1]. Rates are alarming in developing countries, such as Brazil, where overweight and obesity in adolescents may reach 23 and 7%, respectively [3]. Several studies have examined the association between adiposity and cardiovascular risk markers, few have explored the issue prospectively in young populations. We sought to test whether higher levels of body mass index (BMI) and subscapular skinfold at different stages of adolescence were associated with carotid intima-media thickness (cIMT) in young adulthood. Results: Both BMI and subscapular skinfolds were significantly associated with higher cIMT in a cummulative fashion: after controlling for confounders, males and females who persisted overweight/obese at all three assessments, had a mean higher cIMT (5.2 and 3.1 mm, respectively) compared to males and females with normal/healthy BMI at each evaluation (p < 0.001). Male and females that presented increased fatness in all assessments had a similar pattern of higher cIMT compared to normal/

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Results

Conclusion