Adolescent BMI trajectory and risk of XXXX .

@entity1 @entity28 @entity6 @entity301 @entity731
BACKGROUND: The association of body-mass index (BMI) from adolescence to adulthood with obesity-related diseases in young adults has not been completely delineated. METHODS: We conducted a prospective study in which we followed 37,674 apparently healthy young @entity1 for incident angiography-proven @entity301 and @entity6 through the Staff Periodic Examination Center of the Israeli Army Medical Corps. The height and weight of @entity1 were measured at regular intervals, with the first measurements taken when they were 17 years of age. RESULTS: During approximately 650,000 @entity1 -years of follow-up (mean follow-up, 17.4 years), we documented 1173 incident cases of type 2 @entity6 and 327 of @entity301 . In multivariate models adjusted for age, family history, blood pressure, lifestyle factors, and biomarkers in blood, elevated adolescent BMI (the weight in kilograms divided by the square of the height in meters; mean range for the first through last deciles, 17.3 to 27.6) was a significant predictor of both @entity6 (hazard ratio for the highest vs. the lowest decile, 2.76; 95% confidence interval [CI], 2.11 to 3.58) and angiography-proven @entity301 (hazard ratio, 5.43; 95% CI, 2.77 to 10.62). Further adjustment for BMI at adulthood completely ablated the association of adolescent BMI with @entity6 (hazard ratio, 1.01; 95% CI, 0.75 to 1.37) but not the association with @entity301 (hazard ratio, 6.85; 95% CI, 3.30 to 14.21). After adjustment of the BMI values as continuous variables in multivariate models, only elevated BMI in adulthood was significantly associated with @entity6 (b=1.115, P=0.003; P=0.89 for interaction). In contrast, elevated BMI in both adolescence (b=1.355, P=0.004) and adulthood (b=1.207, P=0.03) were independently associated with angiography-proven @entity301 (P=0.048 for interaction). CONCLUSIONS: An elevated BMI in adolescence--one that is well within the range currently considered to be normal--constitutes a substantial risk factor for @entity28 in midlife. Although the risk of @entity6 is mainly associated with increased BMI close to the time of diagnosis, the risk of @entity301 is associated with an elevated BMI both in adolescence and in adulthood, supporting the hypothesis that the processes causing incident @entity301 , particularly @entity731 , are more gradual than those resulting in incident @entity6 . (Funded by the Chaim Sheba Medical Center and the Israel Defense Forces Medical Corps.).
