Presentation Abstract

Session: Obesity-Related and Other Novel Predictors of Diabetes
Abstract Number: 82-OR
Title: Trends in All-Cause Mortality In Mid-Life Over Four Decades: Effect of Adolescent Body-Mass Index
Presentation Start: 6/22/2013 8:30:00 AM
Presentation End: 6/22/2013 9:00:00 AM
Authors: GILAD TWIG, ARNON AFEK, ARI SHAMISS, ESTELA DERAZNE, DORIT TZUR, MORAN LANDAU-RABBI, AMIR TIROSH, Ramat Gan, Israel, Jerusalem, Israel, Tel Hashomer, Israel, Boston, MA.
Abstract: Background: The effect of body-mass index (BMI) at adolescence on mortality later in life is unclear.
Methods: Since 1967, measured height and weight of 2,159,327 adolescents (882,792 females and 1,276,535 males, mean age 17.4 years) were obtained from the Israel Defense Force Registry. Study's outcome was all-cause mortality before the age of 50 years (between 1967-2011).
Results: During 43,126,211 person-year of follow-up 15,469 and 3,061 deaths (5.90 deaths/104 and 1.80 deaths/104person-years) were recorded among men and women, respectively. As compared with mortality rates observed in the 25th-50th percentiles of BMI (5.59/104 and 1.67/104-person-year for males and females, respectively), all-cause mortality continuously increased across the BMI range reaching rates of 8.90/104 and 2.90/104-person-year for men and women at BMI>97th percentile, respectively. A multivariable analysis adjusted for socio-economic status, education, and ethnicity demonstrated a significant increase in mortality rates at BMI>50thpercentile (BMI>20.55 kg/m2) for men and ≥85th percentile in women (BMI>24.78 kg/m2). Increased mortality among overweight and obese adolescents was observed starting at ages 32 and 25 years, respectively. During 4o years, a significant decrease in 20-year mortality rates was documented in normal-weight males born in 1950-1960 vs. those born at 1970-1980 (4.99/104 vs. 3.60/104 person-years, p<0.001), but not in overweight (95th>BMI≥85th; p=0.281) and obese adolescents (BMI≥95th; 0.426) for the parallel groups and follow-up.
Conclusion: BMI at adolescence, well-within the currently-considered normal range, is a risk factor for all-cause mortality at midlife. As opposed to the observed trends in the entire population, mortality rates among overweight and obese adolescents did not decrease in the last 40 years. Pre-adulthood obesity is expected to attenuate the progressive increase in life-expectancy.

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