title: Adiposity in early, middle and later adult life and cardiometabolic risk markers in later life; findings from the British regional heart study.
abstract: OBJECTIVE
  This research investigates the associations between body mass index (BMI) at 21, 40-59, 60-79 years of age on cardiometabolic risk markers at 60-79 years.
  
  
  METHODS
  A prospective study of 3464 British men with BMI measured at 40-59 and 60-79 years, when cardiometabolic risk was assessed. BMI at 21 years was ascertained from military records, or recalled from middle-age (adjusted for reporting bias); associations between BMI at different ages and later cardiometabolic risk markers were examined using linear regression. Sensitive period, accumulation and mobility life course models were devised for high BMI (defined as BMI≥75th centile) and compared with a saturated BMI trajectory model.
  
  
  RESULTS
  At ages 21, 40-59 and 60-79 years, prevalences of overweight (BMI≥25 kg/m2) were 12%, 53%, 70%, and obesity (≥30 kg/m2) 1.6%, 6.6%, and 17.6%, respectively. BMI at 21 years was positively associated with serum insulin, blood glucose, and HbA1c at 60-79 years, with increases of 1.5% (95%CI 0.8,2.3%), 0.4% (0.1,0.6%), 0.3% (0.1,0.4%) per 1 kg/m2, respectively, but showed no associations with blood pressure or blood cholesterol. However, these associations were modest compared to those between BMI at 60-79 years and serum insulin, blood glucose and HbA1c at 60-79 years, with increases of 8.6% (8.0,9.2%), 0.7% (0.5,0.9%), and 0.5% (0.4,0.7%) per 1 kg/m2, respectively. BMI at 60-79 years was also associated with total cholesterol and blood pressure. Associations for BMI at 40-59 years were mainly consistent with those of BMI at 60-79 years. None of the life course models fitted the data as well as the saturated model for serum insulin. A sensitive period at 50 years for glucose and HbA1c and sensitive period at 70 years for blood pressure were identified.
  
  
  CONCLUSIONS
  In this cohort of men who were thin compared to more contemporary cohorts, BMI in later life was the dominant influence on cardiovascular and diabetes risk. BMI in early adult life may have a small long-term effect on diabetes risk.
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, United Kingdom.
authors.forename: Venediktos V
authors.initials: VV
authors.lastname: Kapetanakis
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, United Kingdom.
authors.forename: Alicja R
authors.initials: AR
authors.lastname: Rudnicka
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, United Kingdom.
authors.forename: Andrea K
authors.initials: AK
authors.lastname: Wathern
authors.affiliation: Primary Care and Population Health, University College London Medical School, Royal Free Campus, London, United Kingdom.
authors.forename: Lucy
authors.initials: L
authors.lastname: Lennon
authors.affiliation: Primary Care and Population Health, University College London Medical School, Royal Free Campus, London, United Kingdom.
authors.forename: Olia
authors.initials: O
authors.lastname: Papacosta
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, United Kingdom.
authors.forename: Derek G
authors.initials: DG
authors.lastname: Cook
authors.affiliation: Primary Care and Population Health, University College London Medical School, Royal Free Campus, London, United Kingdom.
authors.forename: S Goya
authors.initials: SG
authors.lastname: Wannamethee
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, United Kingdom.
authors.forename: Peter H
authors.initials: PH
authors.lastname: Whincup
authors.affiliation: Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, United Kingdom.
authors.forename: Christopher G
authors.initials: CG
authors.lastname: Owen
mesh_terms: D050154:Adiposity / Q000235:genetics* / Q000502:physiology; D000328:Adult; D000368:Aged; D001786:Blood Glucose; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D006442:Glycated Hemoglobin / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D050177:Overweight / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D012307:Risk Factors; D055105:Waist Circumference
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human