Mengyi Liu1, Zhuxian Zhang1, Chun Zhou1, Panpan He1, Yuanyuan Zhang1, Huan Li1, Qinqin Li2, Chengzhang Liu1,2, Binyan Wang2, Jianping Li3, Yan Zhang3, Xin Xu1, Xiaobin Wang4, Xiping Xu1,5, Yong Huo3, Fan Fan Hou1, Xianhui Qin1. 1. Division of Nephrology, Nanfang Hospital, Southern Medical University; National Clinical Research Center for Kidney Disease; State Key Laboratory of Organ Failure Research; Guangdong Provincial Institute of Nephrology, Guangdong Provincial Key Laboratory of Renal Failure Research, Guangzhou Regenerative Medicine and Health Guangdong Laboratory, Guangzhou, China. 2. Institute of Biomedicine, Anhui Medical University, Hefei, China. 3. Department of Cardiology, Peking University First Hospital, Beijing, China. 4. Department of Population, Family and Reproductive Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA. 5. Beijing Advanced Innovation Center for Food Nutrition and Human Health, College of Food Science and Nutritional Engineering, China Agricultural University, Beijing, China.
Abstract
CONTEXT: The effect of weight change patterns on cardiovascular diseases (CVD) remains uncertain. OBJECTIVE: We aim to examine the relation of weight change patterns and absolute weight change from young adulthood to midlife with incident CVD. DESIGN: Retrospective cohort study. SETTING: National Health and Nutrition Examination Survey (NHANES) 1999-2016. PARTICIPANTS: 20,715 US adults aged 40-79 with recalled weight at young adulthood (25 years old) and midlife (10 years before baseline). MAIN OUTCOME MEASURE: CVD status were determined by self-report of a prior diagnosis, and age at diagnosis was used to establish time of CVD onset. CVD events was defined as the first occurrence of a congestive heart failure, coronary heart disease, angina pectoris, heart attack or stroke. RESULTS: After 9.76 years of follow-up, compared with participants who remained at normal weight, those in maximum overweight, changing from the non-obese to obese, changing from the obese to non-obese, maintaining obesity between young and middle adulthood had a 39% (HR, 1.39; 95% CI:1.19-1.62), 93% (HR, 1.93; 95% CI: 1.64-2.28), 125% (HR, 2.25; 95% CI:1.29-3.94), 132% (HR, 2.32; 95% CI:1.68-3.20) higher risk of CVD, respectively. In addition, compared with weight change within 2.5 kg, weight gain ≥10.0 kg was associated with higher risk of CVD. CONCLUSIONS: Both non-obese to obese, obese to non-obese and stable obese from young to middle adulthood were associated with increased risks of CVD. The findings emphasize the importance of maintaining normal weight throughout the adulthood for preventing CVD in later life.
CONTEXT: The effect of weight change patterns on cardiovascular diseases (CVD) remains uncertain. OBJECTIVE: We aim to examine the relation of weight change patterns and absolute weight change from young adulthood to midlife with incident CVD. DESIGN: Retrospective cohort study. SETTING: National Health and Nutrition Examination Survey (NHANES) 1999-2016. PARTICIPANTS: 20,715 US adults aged 40-79 with recalled weight at young adulthood (25 years old) and midlife (10 years before baseline). MAIN OUTCOME MEASURE: CVD status were determined by self-report of a prior diagnosis, and age at diagnosis was used to establish time of CVD onset. CVD events was defined as the first occurrence of a congestive heart failure, coronary heart disease, angina pectoris, heart attack or stroke. RESULTS: After 9.76 years of follow-up, compared with participants who remained at normal weight, those in maximum overweight, changing from the non-obese to obese, changing from the obese to non-obese, maintaining obesity between young and middle adulthood had a 39% (HR, 1.39; 95% CI:1.19-1.62), 93% (HR, 1.93; 95% CI: 1.64-2.28), 125% (HR, 2.25; 95% CI:1.29-3.94), 132% (HR, 2.32; 95% CI:1.68-3.20) higher risk of CVD, respectively. In addition, compared with weight change within 2.5 kg, weight gain ≥10.0 kg was associated with higher risk of CVD. CONCLUSIONS: Both non-obese to obese, obese to non-obese and stable obese from young to middle adulthood were associated with increased risks of CVD. The findings emphasize the importance of maintaining normal weight throughout the adulthood for preventing CVD in later life.