Association between duration of overall and abdominal obesity beginning in young adulthood and coronary artery...

Area of Science:

• Cardiovascular disease epidemiology
• Obesity research
• Preventive cardiology

Background:

• Younger populations face increasing lifetime exposure to excess adiposity.
• Long-term consequences of obesity remain understudied.
• Coronary artery calcification (CAC) is a subclinical predictor of coronary heart disease.

Purpose of the Study:

• To investigate the association between the duration of overall and abdominal obesity and the presence and 10-year progression of CAC.
• To assess the impact of obesity duration on subclinical coronary heart disease development.

Main Methods:

• Prospective study of 3275 adults (18-30 years) from the CARDIA study.
• Measured overall (BMI ≥30) and abdominal (waist circumference) obesity duration using repeat measurements over 25 years.
• Assessed CAC presence and 10-year progression using computed tomography scans at 15, 20, and 25-year follow-ups.

Main Results:

• 40.4% and 41.0% developed overall and abdominal obesity, respectively.
• Higher CAC rates and progression observed with longer durations (>20 years) of both overall and abdominal obesity.
• Each additional year of obesity increased CAC hazard ratios (1.02-1.03) and progression odds ratios (1.04), persisting after adjustments.

Conclusions:

• Prolonged overall and abdominal obesity are linked to subclinical coronary heart disease and its progression in midlife.
• These associations are independent of adiposity levels.
• Preventing or delaying obesity onset in young adulthood may mitigate atherosclerosis risk through middle age.