Cao Qiuyu, Li Mian, Qin Guijun, Yan Li, He Jiang, Xu Min, Xu Yu, Wang Tiange, Chen Yuhong, Wang Shuangyuan, Lin Hong, Zhao Zhiyun, Gao Zhengnan, Zeng Tianshu, Hu Ruying, Yu Xuefeng, Chen Gang, Su Qing, Mu Yiming, Chen Lulu, Tang Xulei, Wan Qin, Wang Guixia, Shen Feixia, Luo Zuojie, Qin Yingfen, Chen Li, Huo Yanan, Li Qiang, Ye Zhen, Zhang Yinfei, Liu Chao, Wang Youmin, Wu Shengli, Yang Tao, Deng Huacong, Zhao Jiajun, Shi Lixin, Ning Guang, Wang Weiqing, Lu Jieli, Bi Yufang
Department of Endocrine and Metabolic Diseases, Shanghai Institute of Endocrine and Metabolic Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, 197 Rui-Jin 2nd Road, Shanghai, 200025, China.
Shanghai National Clinical Research Center for metabolic Diseases, Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of the PR China, Shanghai Key Laboratory for Endocrine Tumor, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Nutr Metab (Lond). 2023 Nov 1;20(1):48. doi: 10.1186/s12986-023-00765-w.
The association between weight change during early adulthood and cardiometabolic diseases remains uncertain in Chinese population. Whether the association varies with comprehensive cardiovascular health (CVH) in midlife assessed by "Life's Essential 8" has not been characterized. We aim to examine the associations of early adulthood weight change and midlife "Life's Essential 8" CVH status with cardiometabolic outcomes in a Chinese cohort.
The study participants were from the China Cardiometabolic Disease and Cancer Cohort (4 C) Study. This analysis included 72,610 middle-aged and older participants followed for a median of 3.6 years. At baseline, the participants recalled body weight at age 20 and 40 years, and we calculated change in weight and BMI between 20 and 40 years of age. Health behaviors information in "Life's Essential 8" was collected by questionnaire, and health factors were measured in the study center. During follow-up, we ascertained incident cardiovascular events based on medical records, and diagnosed incident diabetes according to the American Diabetes Association 2010 criteria.
72,610 study participants were included with a mean age of 56.0 ± 8.8 years and 29% of them were males. Weight gain of more than 10 kg between 20 and 40 years of age was associated with 22% increased risk of incident cardiovascular events (HR: 1.22; 95%CI: 1.04-1.43) and 38% increased risk of diabetes (HR: 1.38; 95%CI: 1.25-1.53) compared to stable weight. Besides, the association of weight gain more than 10 kg in early adulthood with cardiometabolic risk was even stronger in those with low CVH score in midlife (HR: 2.44; 95%CI: 2.01-2.97 for incident cardiovascular events; HR: 2.20; 95%CI: 1.90-2.55 for incident diabetes) or with few ideal cardiovascular health metrics in midlife.
Our study indicated that weight gain in early adulthood was associated with significantly increased risk of cardiometabolic diseases. And the association could be stronger in those with poor CVH profiles in midlife. These findings confirmed the significance of weight management during early adulthood and suggested that individuals who experienced substantial weight gain in early life should be encouraged to maintain good CVH status in Chinese population.
在中国人群中，成年早期体重变化与心血管代谢疾病之间的关联仍不明确。体重变化与通过“生命八要素”评估的中年综合心血管健康（CVH）之间的关联尚未得到明确描述。我们旨在研究中国队列中成年早期体重变化和中年“生命八要素”CVH状况与心血管代谢结局之间的关联。
研究参与者来自中国心血管代谢疾病和癌症队列（4C）研究。该分析纳入了72610名中老年参与者，中位随访时间为3.6年。在基线时，参与者回忆20岁和40岁时的体重，我们计算了20岁至40岁之间的体重和BMI变化。通过问卷调查收集“生命八要素”中的健康行为信息，并在研究中心测量健康因素。在随访期间，我们根据医疗记录确定心血管事件的发生情况，并根据美国糖尿病协会2010年标准诊断新发糖尿病。
纳入72610名研究参与者，平均年龄为56.0±8.8岁，其中29%为男性。与体重稳定相比，20岁至40岁之间体重增加超过10kg与心血管事件发生风险增加22%（HR：1.22；95%CI：1.04-1.43）和糖尿病发生风险增加38%（HR：1.38；95%CI：1.25-1.53）相关。此外，成年早期体重增加超过10kg与心血管代谢风险的关联在中年CVH评分低（心血管事件发生HR：2.44；95%CI：2.01-2.97；糖尿病发生HR：2.20；95%CI：1.90-2.55）或中年理想心血管健康指标较少的人群中更强。
我们的研究表明，成年早期体重增加与心血管代谢疾病风险显著增加相关。在中年CVH状况较差的人群中，这种关联可能更强。这些发现证实了成年早期体重管理的重要性，并建议在中国人群中，应鼓励在早年体重大幅增加的个体保持良好的CVH状况。
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