Adiposity during adolescence and carotid intima-media thickness in adulthood: Results from the 1993 Pelotas Birth Cohort.
Although several studies have examined the association between adiposity and cardiovascular risk markers, few have explored the issue prospectively in young populations. We sought to test whether higher levels of body mass index (BMI) and subscapular skinfold at different stages of adolescence were associated with carotid intima-media thickness (cIMT) in young adulthood.



In a prospective cohort, we assessed BMI and subscapular skinfold at 11, 15 and 18 years and measured cIMT at 18 years in 3264 individuals. Traditional cardiovascular risk factors and fat mass-mediating effects on cIMT were also assessed.



Both BMI and subscapular skinfolds were significantly associated with higher cIMT in a cummulative fashion: after controlling for confounders, males and females who persisted overweight/obese at all three assessments, had a mean higher cIMT (5.2 and 3.1 μm, respectively) compared to males and females with normal/healthy BMI at each evaluation (p < 0.001). Moreover, male and females that presented increased fatness in all assessments had a similar pattern of higher cIMT compared to normal/healthy fatness/skinfold at 18 years (mean cIMT 4.6 and 3.0 μm for males and females, respectively; p < 0.001). Associations between adiposity and cIMT were both direct and indirect. Indirect effects were chiefly mediated by fat mass and diastolic blood pressure.



Our results suggest adiposity exerts direct and indirect effects during adolescence that result in higher cIMT in young adulthood.
Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil. Electronic address: anamene.epi@gmail.com.
Ana Maria Baptista
AMB
Menezes
Federal University of Rio Grande do Sul (UFRGS), Brazil; Hospital de Clínicas de Porto Alegre (HCPA), Brazil.
Cristiano Tschiedel Belem
CTB
da Silva
Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Fernando César
FC
Wehrmeister
Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Paula Duarte
PD
Oliveira
Dept of Physiology and Pharmacology, Federal University of Pelotas, Pelotas, Brazil.
Isabel O
IO
Oliveira
Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Helen
H
Gonçalves
Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Maria Cecilia F
MCF
Assunção
Dept of Radiology - Lutheran University of Canoas, Brazil.
Fabiano
F
de Castro Justo
Post-graduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.
Fernando C
FC
Barros
D050154:Adiposity; D000293:Adolescent; D000367:Age Factors; D001794:Blood Pressure; D015992:Body Mass Index; D001938:Brazil / Q000453:epidemiology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D002648:Child; D003971:Diastole; D005260:Female; D006801:Humans; D008297:Male; D063766:Pediatric Obesity / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012885:Skinfold Thickness; D013997:Time Factors
Carotid intima-media thickness; Obesity; Risk factors