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Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife.

ABSTRACT: CONTEXT:Most studies linking long-term consequences of adolescent underweight and obesity are limited to men. OBJECTIVE:To assess the sex-specific association of adolescent BMI with cardiovascular- and non-cardiovascular-related mortality in young adulthood and midlife. SETTING:A nationwide cohort. PARTICIPANTS:927,868 women, 1,366,271 men. INTERVENTIONS:Medical examination data at age 17, including BMI, were linked to the national death registry. MAIN OUTCOMES:Death attributed to cardiovascular (CVD) and non-CVD causes. RESULTS:During 17,346,230 women-years and 28,367,431 men-years of follow-up, there were 451 and 3208 CVD deaths, respectively, and 6235 and 22,223 non-CVD deaths, respectively. Compared to low-normal BMI (18.5-22.0 kg/m2), underweight women had a lower adjusted risk for CVD mortality (Cox hazard ratio (HR)?=?0.68; 95% CI 0.46-0.98) in contrast to underweight men (HR?=?0.99; 0.88-1.13). The latter were at higher risk for non-CVD mortality (HR?=?1.04; 1.00-1.09), unlike underweight women (HR?=?1.01; 0.93-1.10). Findings, which persisted when the study sample was limited to those with unimpaired health, were accentuated for the obese with???30 years follow-up. Both sexes exhibited similarly higher risk estimates already in the high-normal BMI range (22.0???BMI?

SUBMITTER: Furer A

PROVIDER: S-EPMC5989357 | biostudies-literature | 2018 Jun

REPOSITORIES: biostudies-literature

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Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife.

Furer Ariel A Afek Arnon A Orr Omri O Gershovitz Liron L Landau Rabbi Moran M Derazne Estela E Pinhas-Hamiel Orit O Fink Noam N Leiba Adi A Tirosh Amir A Kark Jeremy D JD Twig Gilad G

Cardiovascular diabetology 20180605 1

<h4>Context</h4>Most studies linking long-term consequences of adolescent underweight and obesity are limited to men.<h4>Objective</h4>To assess the sex-specific association of adolescent BMI with cardiovascular- and non-cardiovascular-related mortality in young adulthood and midlife.<h4>Setting</h4>A nationwide cohort.<h4>Participants</h4>927,868 women, 1,366,271 men.<h4>Interventions</h4>Medical examination data at age 17, including BMI, were linked to the national death registry.<h4>Main outc ...[more]

PMID: 29871640

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Project description:BackgroundCardiovascular disease is a leading cause of death worldwide. Rates of cardiovascular disease vary both across the lifespan and between sexes. While multiple factors, including adverse life experiences, impact the development and progression of cardiovascular disease, the potential interactions of biological sex and stress history on the aged heart are unknown. To this end, we examined sex- and stress-specific impacts on left ventricular hypertrophy (VH) after aging. We hypothesized that early-life chronic stress exposure impacts behavioral and physiologic responses that predict cardiac remodeling in a sex-specific manner.MethodsHistological analysis was conducted on hearts of male and female rats previously exposed to chronic variable stress during the late adolescent period (postnatal days 43-62). These animals were challenged with a forced swim test and a glucose tolerance test before aging to 15 months and again being challenged. Predictive analyses were then used to isolate factors that relate to cardiac remodeling among these groups.ResultsEarly-life chronic stress impacted cardiac remodeling in a sex-specific manner. Among rats with a history of chronic stress, females had increased concentric VH. However, there were few associations within the female groups among individual behavioral and physiologic parameters and cardiac remodeling. While males as a group did not have VH after chronic stress, they exhibited multiple individual associations with cardiac susceptibility. Passive coping in young males and active coping in aged males related to VH in a stress history-dependent manner. Moreover, baseline corticosterone positively correlated with VH in unstressed males, while chronically-stressed males had positive correlations between VH and visceral adiposity.ConclusionsThese results indicate that females as a group are uniquely susceptible to the effects of early-life stress on cardiac remodeling later in life. Conversely, males have more individual differences in vulnerability, where susceptibility to cardiac remodeling relates to endocrine, metabolic, and behavioral measures depending on stress history. These results ultimately support a framework for assessing cardiovascular risk based on biological sex and prior adverse experiences.

Dataset Information

Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife.

Publications

Sex-specific associations between adolescent categories of BMI with cardiovascular and non-cardiovascular mortality in midlife.

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