title: Do rapid BMI growth in childhood and early-onset obesity offer cardiometabolic protection to obese adults in mid-life? Analysis of a longitudinal cohort study of Danish men.
abstract: OBJECTIVE
  Some obese individuals have no cardiometabolic abnormalities; they are 'metabolically healthy, but obese' (MHO). Similarly, some non-obese individuals have cardiometabolic abnormalities, that is, 'metabolically at risk, normal weight' (MANW). Previous studies have suggested that early-onset obesity may be associated with MHO. We aimed to assess whether body mass index (BMI) in childhood and early-onset obesity are associated with MHO.
  
  
  METHODS
  General population longitudinal cohort study, Denmark.
  
  
  METHODS
  From 362 200 young men (mean age 20) examined for Danish national service between 1943 and 1977, all obese men (BMI ≥31 kg/m(2), N=1930) were identified along with a random 1% sample of the others (N=3601). Our analysis includes 2392 of these men attending a research clinic in mid-life (mean age 42). For 613 of these men, data on childhood BMI are available. We summarised childhood BMI growth (7-13 years) using a multilevel model. Early-onset obesity was defined as obesity at examination for national service.
  
  
  METHODS
  We defined metabolic health at the mid-life clinic as non-fasting serum cholesterol <6.6 mmol/L, non-fasting glucose <8.39 mmol/L and pulse pressure <48 mm Hg. Participants were categorised into four groups according to their obesity (BMI ≥30 kg/m(2)) and metabolic health in mid-life.
  
  
  RESULTS
  297 of 1097 (27.1%) of obese men were metabolically healthy; 826 of 1295 (63.8%) non-obese men had at least one metabolic abnormality. There was no evidence that rapid BMI growth in childhood or early-onset obesity was associated with either MHO or the MANW phenotype, for example, among obese men in mid-life, the OR for MHO comparing early-onset obesity with non-early-onset obesity was 0.97 (95% CI 0.85 to 1.10).
  
  
  CONCLUSIONS
  We found no robust evidence that early-onset obesity or rapid BMI growth in childhood is protective for cardiometabolic health.
authors.affiliation: MRC Integrative Epidemiology Unit at the University of Bristol, School of Social and Community Medicine, University of Bristol, Bristol, UK.
authors.forename: Laura D
authors.initials: LD
authors.lastname: Howe
authors.forename: Esther
authors.initials: E
authors.lastname: Zimmermann
authors.forename: Ram
authors.initials: R
authors.lastname: Weiss
authors.forename: Thorkild I A
authors.initials: TI
authors.lastname: Sørensen
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D015992:Body Mass Index; D002648:Child; D002784:Cholesterol / Q000097:blood; D003718:Denmark / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology; D063766:Pediatric Obesity / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D010641:Phenotype; D015995:Prevalence; D012307:Risk Factors
chemical_list: D001786:Blood Glucose; D002784:Cholesterol
keywords: EPIDEMIOLOGY; NUTRITION & DIETETICS; PRIMARY CARE; PUBLIC HEALTH
references.citation: PLoS One. 2011 Apr 20;6(4):e18546
references.pmid: 21541254
references.citation: BMJ. 1989 Sep 23;299(6702):767-70
references.pmid: 2508915
references.citation: Clin Chem. 1973 Dec;19(12):1380-3
references.pmid: 4757367
references.citation: Scand J Public Health. 2011 Jul;39(7 Suppl):87-90
references.pmid: 21775361
references.citation: Diabetes Care. 2008 May;31(5):1031-6
references.pmid: 18223033
references.citation: Am J Hypertens. 2005 Jul;18(7):935-42
references.pmid: 16053990
references.citation: Ann Intern Med. 2013 Dec 3;159(11):789-90
references.pmid: 24297199
references.citation: J Clin Endocrinol Metab. 2012 Jul;97(7):2482-8
references.pmid: 22508708
references.citation: Science. 2013 Aug 23;341(6148):856-8
references.pmid: 23970691
references.citation: Obesity (Silver Spring). 2013 Mar;21(3):637-43
references.pmid: 23592673
references.citation: J Epidemiol Community Health. 1989 Dec;43(4):369-74
references.pmid: 2614328
references.citation: PLoS Med. 2011 Jun;8(6):e1000440
references.pmid: 21695075
references.citation: J Clin Endocrinol Metab. 2006 Aug;91(8):2906-12
references.pmid: 16735483
references.citation: J Hypertens. 2013 Jan;31(1):145-51
references.pmid: 23079679
references.citation: Diabetes Metab. 2009 Apr;35(2):94-100
references.pmid: 19246228
references.citation: Diabetes Care. 2011 Jan;34(1):210-5
references.pmid: 20937689
references.citation: Arch Intern Med. 2008 Aug 11;168(15):1617-24
references.pmid: 18695075
references.citation: J Clin Endocrinol Metab. 2001 Mar;86(3):1020-5
references.pmid: 11238480
references.citation: Diabetes Obes Metab. 2004 Nov;6(6):456-7
references.pmid: 15479222
references.citation: J Obes. 2012;2012:460321
references.pmid: 23304462
references.citation: JAMA Intern Med. 2014 Jan;174(1):15-22
references.pmid: 24217719
references.citation: BMJ. 2010 Nov 25;341:c6224
references.pmid: 21109577
references.citation: Diabet Med. 2005 Sep;22(9):1199-205
references.pmid: 16108849
references.citation: Scand J Public Health. 2011 Jul;39(7 Suppl):196-200
references.pmid: 21775383
references.citation: J Chronic Dis. 1977 Jun;30(6):359-67
references.pmid: 874040
references.citation: Eur Heart J. 2013 Feb;34(5):389-97
references.pmid: 22947612
references.citation: Diabetes Metab. 2004 Dec;30(6):569-72
references.pmid: 15671927
references.citation: Br Med J (Clin Res Ed). 1983 Sep 17;287(6395):795-7
references.pmid: 6412831
references.citation: Diabetes Care. 2013 Aug;36(8):2388-94
references.pmid: 23491523
references.citation: J Clin Endocrinol Metab. 2004 Jun;89(6):2569-75
references.pmid: 15181025
references.citation: Obesity (Silver Spring). 2013 Jan;21(1):E166-74
references.pmid: 23505200
references.citation: Am J Clin Nutr. 2011 Dec;94(6 Suppl):1808S-1813S
references.pmid: 21633072
references.citation: Int J Obes (Lond). 2011 Sep;35(9):1193-9
references.pmid: 21326207
references.citation: Int J Obes. 1990 Apr;14(4):319-26
references.pmid: 2361809
references.citation: Int J Obes (Lond). 2011 Jul;35(7):971-81
references.pmid: 20975726
references.citation: Am J Epidemiol. 1988 Jan;127(1):104-13
references.pmid: 3337071
references.citation: Ann Intern Med. 2013 Dec 3;159(11):758-69
references.pmid: 24297192
references.citation: Int J Obes (Lond). 2009 Aug;33(8):866-77
references.pmid: 19506565
references.citation: Int J Obes (Lond). 2012 Sep;36(9):1187-94
references.pmid: 22158268
references.citation: Obesity (Silver Spring). 2013 Jan;21(1):203-9
references.pmid: 23505187
references.citation: N Engl J Med. 2007 Dec 6;357(23):2329-37
references.pmid: 18057335
references.citation: Asia Pac J Clin Nutr. 2012;21(2):227-33
references.pmid: 22507609
references.citation: Obes Facts. 2011;4(2):91-4
references.pmid: 21577014
references.citation: Stat Med. 2005 Oct 15;24(19):2911-35
references.pmid: 16152135
references.citation: Lancet. 2008 Oct 11;372(9646):1281-3
references.pmid: 18929889
references.citation: Blood Press. 2000;9(5):260-6
references.pmid: 11193129
references.citation: Biochim Biophys Acta. 2010 Mar;1801(3):400-4
references.pmid: 20045743
references.citation: Am J Epidemiol. 2012 Oct 1;176 Suppl 7:S142-9
references.pmid: 23035138
references.citation: Mol Aspects Med. 2013 Feb;34(1):59-70
references.pmid: 23068072