title: Steeper change in body mass across four decades predicts poorer cardiometabolic outcomes at midlife.
abstract: This study examined patterns of change in adiposity across four decades starting in young adulthood as well as associations between change and midlife cardiometabolic outcomes.
  
  
  
  BMI was assessed at ages 20, 40, 56, and 62 years in 977 male veterans from the Vietnam Era Twin Study of Aging. Age 62 (range 56-66) cardiometabolic outcomes included hypertension, diabetes, dyslipidemia, inflammation, and ischemic heart disease. Analyses included latent growth modeling (LGM), latent class growth modeling (LCGM), and logistic regression models.
  
  
  
  Linear BMI slope was associated with all outcomes. Accelerated (quadratic) BMI slope was significantly associated with greater risk for hypertension, diabetes, dyslipidemia, and inflammation; odds ratios ranged from 1.93 (diabetes) to 3.15 (dyslipidemia). Initial BMI did not predict later outcomes. Linear slope contributed significant unique variance for diabetes and dyslipidemia even controlling for age 62 BMI. LCGM revealed three trajectories. Men with the relatively stable, lower BMI trajectory had significantly better outcomes than those with trajectories with accelerated increases, especially those including obesity.
  
  
  
  How individuals reach late-midlife BMI is important. Steepness of BMI change across 40 years from young adulthood to late midlife, in addition to late-midlife BMI itself, was robustly associated with greater risk for poor cardiometabolic outcomes.
authors.affiliation: Department of Biostatistics, St. Louis University, St. Louis, Missouri, USA.
authors.forename: Hong
authors.initials: H
authors.lastname: Xian
authors.affiliation: Department of Anesthesiology, University of Florida, Gainesville, Florida, USA.
authors.forename: Terrie
authors.initials: T
authors.lastname: Vasilopoulos
authors.affiliation: Department of Biostatistics, St. Louis University, St. Louis, Missouri, USA.
authors.forename: Weijian
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Psychiatry & Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA.|Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA.
authors.forename: Richard L
authors.initials: RL
authors.lastname: Hauger
authors.affiliation: Department of Psychiatry & Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA.
authors.forename: Kristen C
authors.initials: KC
authors.lastname: Jacobson
authors.affiliation: Department of Psychological and Brain Sciences, Boston University, Boston, Massachusetts, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Lyons
authors.affiliation: Department of Psychiatry & Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: Panizzon
authors.affiliation: Department of Psychology, University of California Riverside, Riverside, California, USA.
authors.forename: Chandra A
authors.initials: CA
authors.lastname: Reynolds
authors.affiliation: Department of Public Health, University of Helsinki, Helsinki, Finland.
authors.forename: Eero
authors.initials: E
authors.lastname: Vuoksimaa
authors.affiliation: Department of Psychiatry & Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA.|Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Kremen
authors.affiliation: Department of Psychiatry & Center for Behavior Genetics of Aging, University of California San Diego, La Jolla, California, USA.
authors.forename: Carol E
authors.initials: CE
authors.lastname: Franz
mesh_terms: D050154:Adiposity; D000328:Adult; D000375:Aging / Q000473:pathology*; D015992:Body Mass Index; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000209:etiology*; D050171:Dyslipidemias / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D014481:United States / Q000453:epidemiology; D014728:Veterans / Q000706:statistics & numerical data; D047829:Vietnam Conflict; D055815:Young Adult