Associations between body mass index and development of metabolic disorders in fertile women--a nationwide cohort study.
BACKGROUND
Metabolic disorders are relatively uncommon in young women, but may increase with obesity. The associations between body mass index (BMI) and risks of diabetes, hypertension, and dyslipidemia in apparently healthy, young women have been insufficiently investigated, and are the aims of this study.


RESULTS
Women giving birth during the years 2004-2009, with no history of cardiovascular disease, renal insufficiency, pregnancy-associated metabolic disorders, diabetes, hypertension, or dyslipidemia were identified in nationwide registers. Women were categorized as underweight (BMI<18.5 kg/m(2)), normal weight (BMI=18.5 to <25 kg/m(2)), overweight (BMI=25 to <30 kg/m(2)), obese-I (BMI=30 to <35 kg/m(2)), obese-II (BMI=35 to <40 kg/m(2)), and obese-III (BMI≥40 kg/m(2)). We assessed risks by Poisson regression models (adjusted for age, calendar year; reference=normal weight). The cohort comprised 252 472 women with a median age of 30.4 years (IQR=27.2;33.7) and a median follow-up of 5.5 years (IQR=3.9;6.8). In total, 2029 women developed diabetes, 3133 women developed hypertension, and 1549 women developed dyslipidemia. Rate ratios (RRs) of diabetes were: 0.84 (95% confidence interval [CI]=0.62 to 1.14) for underweight, 2.63 (CI=2.36 to 2.93) for overweight, 4.83 (CI=4.27 to 5.47) for obese grade-I, 7.17 (CI=6.10 to 8.48) for obese grade-II, and 6.93 (CI=5.47 to 8.79) for obese grade-III women. For hypertension, corresponding RRs were 0.86 (CI=0.69 to 1.09), 1.82 (CI=1.67 to 1.98), 2.81 (CI=2.52 to 3.13), 3.92 (CI=3.36 to 4.56), and 5.69 (CI=4.71 to 6.89), and for dyslipidemia, RRs were 1.18 (CI=0.85 to 1.65), 2.01 (CI=1.75 to 2.31), 3.11 (CI=2.61 to 3.70), 4.64 (CI=3.66 to 5.87), and 3.72 (CI=2.53 to 5.48).


CONCLUSIONS
In this nationwide study of fertile, apparently healthy women, pre-pregnancy BMI was strongly associated with an increased risk of diabetes, hypertension, and dyslipidemia within 5.5 years following childbirth.
Department of Cardiology, Gentofte University Hospital, Copenhagen, Denmark.
Michelle Dalgas
MD
Schmiegelow
Charlotte
C
Andersson
Lars
L
Køber
Søren Skøtt
SS
Andersen
Mette Lykke
ML
Norgaard
Thomas Bo
TB
Jensen
Gunnar
G
Gislason
Siv Mari
SM
Berger
Christian
C
Torp-Pedersen
D000328:Adult; D000367:Age Factors; D015992:Body Mass Index; D003718:Denmark / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology*; D050171:Dyslipidemias / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005298:Fertility; D006306:Health Surveys; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology*; D015994:Incidence; D053208:Kaplan-Meier Estimate; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D016017:Odds Ratio; D010298:Parity; D011247:Pregnancy; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors
body mass index; diabetes; hypercholesterolemia; hypertension; women