Elevated adolescent BMI may predict diabetes in adults

Tirosh A. N Engl J Med. 2011;364:1315-1325.

Individuals with elevated adolescent BMI were at a nearly threefold increased risk for developing diabetes as adults, according to study results.

The prospective study involved 37,674 young men who were apparently healthy. The men were followed for incident angiography-proven CHD and diabetes during 650,000 person-years of follow-up (mean follow-up, 17.4 years). Height and weight measurements were taken at regular intervals starting at age 17 years.

There were 1,173 incident cases of type 2 diabetes and 327 cases of CHD reported.

A multivariate analysis accounted for age, family history, BP, lifestyle factors and biomarkers in blood.

Results indicated that elevated adolescent BMI — the mean range of which, for the first through last deciles, was 17.3 to 27.6 — was significantly linked to diabetes (HR for the highest vs. the lowest decile, 2.76; 95% CI, 2.11-3.58). Elevated adolescent BMI was also associated with angiography-proven CHD (HR=5.43; 95% CI, 2.77-10.62).

The link between BMI and diabetes disappeared when the participants reached adulthood (HR=1.01; 95% CI, 0.75-1.37). However, adult BMI was associated with CHD (HR=6.85; 95% CI, 3.30-14.21).

Results of a further adjustment in which BMI was evaluated as a continuous variable indicated that adult BMI was the only factor significantly associated with diabetes (P=.003).

Angiography-proven coronary heart disease was independently linked to BMI in adolescence (P=.004) and adulthood (P=.03).

“An elevated BMI in adolescence — one that is well within the range currently considered to be normal — constitutes a substantial risk factor for obesity-related disorders in midlife,” the researchers wrote.

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