Overweight as a child, young adult increases risk for venous thromboembolic events

For men, having overweight during childhood and young adulthood was a strong determinant for experiencing venous thromboembolic events later in life, according to the results of a study published in the Journal of Internal Medicine.

About one in three thromboembolic (TE) events are linked to obesity, Lina Lilja, a doctoral student in the department of internal medicine and clinical nutrition at the University of Gothenburg in Sweden, and colleagues wrote. However, it was previously unknown how much elevated BMI during specific periods of childhood and puberty contribute to this phenomenon.

“Elevated BMI in childhood, adolescence and adulthood is a global challenge, and the rise in the prevalence of obesity has been shown to be steeper among children and youths than in adults,” they wrote. “Extended follow-up and large statistical power are needed to evaluate the consequences of overweight and obesity during childhood and adolescence, and such studies have therefore been difficult to perform.”

The researchers studied data from 37,672 men who were enrolled in the BMI Epidemiology Study Gothenburg, including information regarding height and weight in childhood and as young adults, and BMI change upon reaching puberty. They tracked data on outcomes from Swedish national registers.

Lilja and colleagues found that childhood overweight was a moderate determinant and overweight during young adulthood was a strong determinant for experiencing venous thromboembolism (VTE) later in adulthood. They wrote that VTE was associated with both BMI at age 8 years (HR = 1.06 per standard deviation [SD] increase; 95% CI, 1.01-1.11) and pubertal BMI change (HR = 1.11 per SD increase; 95% CI, 1.06-1.16).

“Excessive BMI increase during puberty is associated with an increased amount of the metabolically harmful visceral fat, supporting a role of abdominal adiposity in the association between pubertal BMI change and VTE,” Lilja and colleagues wrote.

Compared with the normal weight reference group, people with a normal weight during childhood who became overweight as a young adult (HR = 1.4; 95% CI, 1.15-1.72) and people with overweight at both stages of life (HR = 1.48; 95% CI, 1.14-1.92) had significantly increased risks for VTE in adult life.

Those with overweight in childhood and as young adults additionally saw increased risks for arterial thromboembolism and TE, according to the researchers.

“We ... found that the pubertal BMI change is strongly, and BMI in childhood moderately, associated with the risk of VTE in adult men,” Lilja and colleagues concluded. “Thus, the ongoing childhood obesity epidemic may add to the burden of adult disease through the association with thromboembolism.”