BMI increase through puberty and adolescence is associated with risk of adult stroke.

Claes Ohlsson,Maria Bygdell,Jenny M Kindblom,Annika Rosengren,Christina Jern,Arvid Sondén

doi:10.1212/wnl.0000000000004158

Claes Ohlsson, Maria Bygdell + Show 4 more

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https://doi.org/10.1212/wnl.0000000000004158

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Abstract

Objective:To evaluate the contribution of prepubertal childhood body mass index (BMI) and BMI change through puberty and adolescence, 2 distinct developmental BMI parameters, for risk of adult stroke in men.Methods:In this population-based study in Gothenburg, Sweden, men born in 1945–1961 with information on both childhood BMI at age 8 and BMI change through puberty and adolescence (BMI at age 20–BMI at age 8) were followed until December 2013 (n = 37,669). Information on stroke events was retrieved from high-quality national registers (918 first stroke events, 672 ischemic stroke events [IS], 207 intracerebral hemorrhage events [ICH]).Results:BMI increase through puberty and adolescence (hazard ratio [HR] 1.21 per SD increase; 95% confidence interval [CI] 1.14–1.28), but not childhood BMI, was independently associated with risk of adult stroke. Subanalyses revealed that BMI increase through puberty and adolescence was associated with both IS (HR per SD increase 1.19; 95% CI 1.11–1.28) and ICH (HR per SD increase 1.29; 95% CI 1.15–1.46). High BMI increase during puberty was strongly associated with increased risk of adult hypertension (odds ratio per SD increase 1.35; 95% CI 1.32–1.39).Conclusions:BMI increase through puberty and adolescence is associated with risk of adult IS and ICH in men. We propose that greater BMI increases during puberty contribute to increased risk of adult stroke at least partly via increased blood pressure.

Highlights

In this population-based study in Gothenburg, Sweden, men born in 1945–1961 with information on both childhood body mass index (BMI) at age 8 and BMI change through puberty and adolescence (BMI at age 20–BMI at age 8) were followed until December 2013 (n 5 37,669)
In combined analysis including both BMI change through puberty and adolescence and young adult BMI, only BMI increase through puberty and adolescence was associated with risk of adult stroke, demonstrating that BMI increase through puberty and adolescence is an independent risk marker of stroke
We demonstrate that BMI increase through puberty and adolescence, but not childhood BMI, is associated with risk of adult stroke and that this is observed both for ischemic stroke (IS) and intracerebral hemorrhage (ICH)

Summary

Methods

In this population-based study in Gothenburg, Sweden, men born in 1945–1961 with information on both childhood BMI at age 8 and BMI change through puberty and adolescence (BMI at age 20–BMI at age 8) were followed until December 2013 (n 5 37,669). Information on stroke events was retrieved from high-quality national registers (918 first stroke events, 672 ischemic stroke events [IS], 207 intracerebral hemorrhage events [ICH]). We collected birthweight as well as directly measured height and weight from centrally archived School Health Care (SHC) records for all men born 1945 to 1961 in Gothenburg, Sweden (see e-Methods at Neurology.org). We collected height and weight at young adult age from military conscription tests. The study cohort was linked to high-quality national disease registers using personal identity numbers (PINs) from the included participants.

Results

Discussion

Conclusion