Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS

Göran Bergström; Annika Rosengren; Elin Bacsovics Brolin; John Brandberg; Kerstin Cederlund; Gunnar Engström; Jan E Engvall; Maria J Eriksson; Isabel Gonçalves; Emil Hagström; Stefan K James; Tomas Jernberg; Mikael Lilja; Martin Magnusson; Anders Persson; Margaretha Persson; Anette Sandström; Caroline Schmidt; Linn Skoglund Larsson; Johan Sundström; Eva Swahn; Stefan Söderberg; Kjell Torén; Carl Johan Östgren; Erik Lampa; Lars Lind

doi:10.1016/j.atherosclerosis.2023.01.024

Body weight at age 20 and in midlife is more important than weight gain for coronary atherosclerosis: Results from SCAPIS

Atherosclerosis. 2023 May:373:46-54. doi: 10.1016/j.atherosclerosis.2023.01.024. Epub 2023 Feb 3.

Authors

Göran Bergström¹, Annika Rosengren², Elin Bacsovics Brolin³, John Brandberg⁴, Kerstin Cederlund⁵, Gunnar Engström⁶, Jan E Engvall⁷, Maria J Eriksson⁸, Isabel Gonçalves⁹, Emil Hagström¹⁰, Stefan K James¹⁰, Tomas Jernberg¹¹, Mikael Lilja¹², Martin Magnusson¹³, Anders Persson¹⁴, Margaretha Persson¹⁵, Anette Sandström¹⁶, Caroline Schmidt¹⁷, Linn Skoglund Larsson¹⁸, Johan Sundström¹⁹, Eva Swahn²⁰, Stefan Söderberg¹⁸, Kjell Torén²¹, Carl Johan Östgren²², Erik Lampa²³, Lars Lind²⁴

Affiliations

¹ Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden. Electronic address: goran.bergstrom@hjl.gu.se.
² Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Medicine Geriatrics and Emergency Medicine, Sahlgrenska University Hospital Östra Hospital, Gothenburg, Sweden.
³ Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden; Department of Radiology, Capio S:t Göran Hospital, Stockholm, Sweden.
⁴ Department of Radiology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Radiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
⁵ Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
⁶ Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden.
⁷ CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Department of Clinical Physiology and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
⁸ Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden; Department of Clinical Physiology, Karolinska University Hospital, Stockholm, Sweden.
⁹ Department of Cardiology, Skåne University Hospital, Malmö, Sweden; Cardiovascular Research Translational Studies, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden.
¹⁰ Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden; Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden.
¹¹ Department of Clinical Sciences, Danderyd University Hospital, Karolinska Institutet, Stockholm, Sweden.
¹² Department of Public Health and Clinical Medicine, Unit of Research, Education, and Development, Östersund Hospital, Umeå University, Umeå, Sweden.
¹³ Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; Department of Cardiology, Skåne University Hospital, Malmö, Sweden; Wallenberg Center for Molecular Medicine, Lund University, Lund, Sweden; Hypertension in Africa Research Team HART, North-West University, Potchefstroom, South Africa.
¹⁴ CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Department of Radiology, and Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Department of Clinical Sciences, Huddinge University Hospital, Karolinska Institutet, Stockholm, Sweden.
¹⁵ Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden.
¹⁶ Heart Centre and Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
¹⁷ Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
¹⁸ Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
¹⁹ Department of Medical Sciences, Uppsala University, Uppsala, Sweden; The George Institute for Global Health, University of New South Wales, Sydney, Australia.
²⁰ Department of Cardiology and Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden.
²¹ Section of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden.
²² CMIV, Centre of Medical Image Science and Visualization, Linköping University, Linköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
²³ Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
²⁴ Department of Medical Sciences, Clinical Epidemiology, Uppsala University, Uppsala, Sweden.

PMID: 36813601
DOI: 10.1016/j.atherosclerosis.2023.01.024

Abstract

Background and aims: Elevated body weight in adolescence is associated with early cardiovascular disease, but whether this association is traceable to weight in early adulthood, weight in midlife or to weight gain is not known. The aim of this study is to assess the risk of midlife coronary atherosclerosis being associated with body weight at age 20, body weight in midlife and body weight change.

Methods: We used data from 25,181 participants with no previous myocardial infarction or cardiac procedure in the Swedish CArdioPulmonary bioImage Study (SCAPIS, mean age 57 years, 51% women). Data on coronary atherosclerosis, self-reported body weight at age 20 and measured midlife weight were recorded together with potential confounders and mediators. Coronary atherosclerosis was assessed using coronary computed tomography angiography (CCTA) and expressed as segment involvement score (SIS).

Results: The probability of having coronary atherosclerosis was markedly higher with increasing weight at age 20 and with mid-life weight (p < 0.001 for both sexes). However, weight increase from age 20 until mid-life was only modestly associated with coronary atherosclerosis. The association between weight gain and coronary atherosclerosis was mainly seen in men. However, no significant sex difference could be detected when adjusting for the 10-year delay in disease development in women.

Conclusions: Similar in men and women, weight at age 20 and weight in midlife are strongly related to coronary atherosclerosis while weight increase from age 20 until midlife is only modestly related to coronary atherosclerosis.

Keywords: Coronary artery calcium score; Midlife; Sex; Weight; Weight gain.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Adult
Body Weight
Coronary Angiography / methods
Coronary Artery Disease* / complications
Coronary Artery Disease* / diagnostic imaging
Coronary Artery Disease* / epidemiology
Female
Humans
Male
Middle Aged
Myocardial Infarction* / complications
Risk Factors
Weight Gain
Young Adult