Adolescent Obesity and Charlson Comorbidity Index in Young Adults

Background: There is insufficient evidence regarding the independent risk of childhood/adolescent obesity for morbidity and mortality in adulthood. The objective of the present study was to evaluate the association of weight categories during adolescence with high-risk diseases determined by the Charlson Comorbidity Index in young adulthood. We also analyzed the association of weight categories with cumulative mortality at the age of 30. Methods: A retrospective cohort study, based on the central computerized database of a major health service organization, was conducted. The study population consisted of 80,853 adolescents. The study period was from 1 January 2007 to 31 December 2022 and was divided into the exposure period from 1 January 2007 to 31 December 2011 (ages 17-19) and the follow-up period from 1 January 2007 to 31 December 2022 (from the date of the defining BMI measurement up to the age of 30 years). Results: The five diseases with the highest cumulative incidence were chronic pulmonary disease (8.2%), mild liver disease (3.7%), cerebrovascular disease (2.8%), diabetes without end-organ damage (2.0%), and peptic disease (1.6%). When adjusted for socio-demographic variables and adult BMI, the relative risks with 95% confidence intervals for the increase in the Charlson Comorbidity Index were 1.11 (1.05-1.17), 1.17 (1.11-1.24), and 1.22 (1.09-1.35) for the "overweight", "obesity", and "class 2 obesity" categories, respectively, while the mortality for these categories were 1.60 (1.11-2.27), 1.71 (1.12-2.57), and 3.18 (1.48-6.35), respectively. Conclusions: Adolescent obesity is an independent risk factor for high-risk diseases and mortality in young adulthood. Interventions aimed at reducing the rate of adolescent overweight and obesity should be implemented as early as possible.