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Early mortality among young adults linked to cardiometabolic risk factors
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Among those aged 12 to 39 years, smoking, adiposity and hyperglycemia were associated with an overall increased risk for mortality before aged 55 years, whereas elevated blood pressure was linked to an increased risk for mortality from endogenous causes.
As the prevalence of overweight and obesity in the United States has increased in the past 20 years, particularly among adolescents and young adults, survey data indicate that there have also been changes in BP, lipids, smoking and glucose levels among these two groups. Although the incidence of these cardiometabolic risk factors has generally declined among middle-aged and older adults, the repercussions of the increased frequency of these risk factors in young age groups have not been determined.
“Although these risk factors have been associated with earlier onset of many chronic diseases, including diabetes, hypertension and cardiovascular disease, most of the studies showing such associations have focused on adults 40 years or older, and relatively few have examined the relationship between these risk factors and risk for early death among adolescents and young adults,” Sharon H. Saydah, PhD, of the CDC, and colleagues wrote.
To assess the risk for mortality associated with cardiometabolic risk factors in these younger age groups, Saydah and colleagues evaluated 9,245 participants from the third National Health and Nutrition Examination Survey who were aged 12 to 39 years at the time of their involvement in the survey.
Risk factors consisted of three measures of adiposity, HbA1c, cholesterol levels, BP, self-reported smoking status and cotinine level.
Saydah and colleagues determined death before age 55 years (n=298) through linkage to the National Death Index through 2006. The researchers also used proportional hazards models, with age as the time scale, to evaluate the risk for death before age 55 years after adjusting for sex, race/ethnicity and presence of comorbid conditions.
According to study results, current smokers were at 86% elevated risk for early death than those classified as never-smokers, and participants with a waist-to-height ratio >.0.65 were at 139% greater risk than those with a waist-to-height ratio <0.5. In addition, participants with an HbA1c level >6.5% were at 281% greater risk than participants with an HbA1c <5.7%.
The researchers found that neither high-density lipoprotein nor non–high-density lipoprotein cholesterol measures were connected with elevated risk for early mortality.
“Although it is well established that many early deaths, especially among teenagers and young adults, are caused by injuries, the extent to which risk factors for disease are also associated with early deaths has not been well studied,” Saydah and colleagues wrote. “Our findings suggest that, at least in the United States, certain cardiometabolic risk factors also contribute substantially to the overall risk for early death and to the social loss that such deaths entail.”
Disclosure: The researchers reported no relevant financial disclosures.
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