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1.
Diabetologia ; 67(5): 874-884, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38386069

RESUMO

AIMS/HYPOTHESIS: This study aimed to determine the relative contributions of low birthweight and overweight during childhood and young adulthood to the risk of type 2 diabetes in men. METHODS: We included 34,231 men born between1945 and 1961 from the population-based BMI Epidemiology Study (BEST) Gothenburg with data on birthweight and overweight status in childhood (8 years, BMI >17.9 kg/m2) and young adulthood (20 years, BMI >25 kg/m2). Participants were followed from age 30 years until 31 December 2019. Information on type 2 diabetes diagnoses was retrieved from Swedish national registers. HRs and 95% CIs for the risk of early (≤59.4 years) and late (>59.4 years) type 2 diabetes were estimated using Cox proportional hazards regression. RESULTS: During follow-up, a total of 2733 cases of type 2 diabetes were diagnosed. Birthweight below the median (<3.6 kg) and overweight at age 20 (BMI >25 kg/m2), but not overweight at age 8 (BMI >17.9 kg/m2), were associated with an increased risk of early and late type 2 diabetes. Of note, a birthweight below the median followed by overweight at age 20 years was associated with a substantially increased risk of early type 2 diabetes (HR 6.07, 95% CI 5.08, 7.27), and a low birthweight (≤2.5 kg) combined with overweight at age 20 years was associated with a massive risk of early type 2 diabetes (HR 9.94, 95% CI 6.57, 15.05). CONCLUSIONS/INTERPRETATION: Low birthweight and overweight in young adulthood are the major developmental determinants of adult type 2 diabetes risk in men. They contribute in an additive manner to the risk of type 2 diabetes. To reduce the risk of type 2 diabetes, young adult overweight should be avoided, especially in boys with a low birthweight. DATA AVAILABILITY: The SPSS analysis code, the R analysis code and a data dictionary have been made available in an online repository ( https://osf.io/bx2as/ ).


Assuntos
Diabetes Mellitus Tipo 2 , Sobrepeso , Masculino , Adulto Jovem , Humanos , Adulto , Criança , Sobrepeso/epidemiologia , Sobrepeso/complicações , Diabetes Mellitus Tipo 2/complicações , Índice de Massa Corporal , Estudos de Coortes , Peso ao Nascer , Fatores de Risco
2.
Arterioscler Thromb Vasc Biol ; 44(1): 314-321, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37970719

RESUMO

BACKGROUND: Low birth weight is a known risk factor for adult coronary heart disease (CHD), but the additional effect of weight development during childhood and early adult life has not been studied. METHODS: We included 35 659 men born 1945 to 1961 from the population-based BMI Epidemiology Study Gothenburg, with data available on birthweight, BMI in childhood (8 years), and BMI in young adulthood (20 years). Information on CHD diagnoses was retrieved from national registers. We used Cox proportional hazards regression to estimate hazard ratios and 95% CIs for the risk of early and late CHD (before and after 58.4 years of age, respectively). RESULTS: During follow-up, a total of 3380 cases of CHD (fatal and nonfatal) were registered. Birth weight was inversely associated with the risk of both early (hazard ratio, 0.88 per SD increase [95% CI, 0.84-0.92]) and late (hazard ratio, 0.94 per SD increase [95% CI, 0.90-0.98]) CHD, independently of BMI at 8 years and BMI change during puberty. In a model including birth weight (below or above the median) together with overweight at 8 and 20 years, only birth weight and young adult overweight, but not overweight in childhood, were significantly associated with the risk of CHD. A birth weight below the median, followed by overweight at 20 years of age was associated with a more than doubled risk of early CHD (hazard ratio, 2.29 [95% CI, 1.86-2.81]), compared with the reference (birth weight above the median and normal weight at 20 years of age). This excess risk was even more pronounced for a birthweight below 2.5 kg. CONCLUSIONS: We demonstrate that low birth weight and young adult overweight are important developmental markers of risk for adult CHD. These findings motivate a life course perspective for prevention and risk assessment of adult CHD.


Assuntos
Doença das Coronárias , Sobrepeso , Masculino , Humanos , Adulto Jovem , Adulto , Sobrepeso/epidemiologia , Sobrepeso/complicações , Peso ao Nascer , Índice de Massa Corporal , Fatores de Risco , Doença das Coronárias/diagnóstico , Doença das Coronárias/epidemiologia , Doença das Coronárias/complicações
3.
BMJ ; 383: e076990, 2023 11 22.
Artigo em Inglês | MEDLINE | ID: mdl-37993131

RESUMO

OBJECTIVE: To investigate the effectiveness of primary covid-19 vaccination (first two doses and first booster dose within the recommended schedule) against post-covid-19 condition (PCC). DESIGN: Population based cohort study. SETTING: Swedish Covid-19 Investigation for Future Insights-a Population Epidemiology Approach using Register Linkage (SCIFI-PEARL) project, a register based cohort study in Sweden. PARTICIPANTS: All adults (≥18 years) with covid-19 first registered between 27 December 2020 and 9 February 2022 (n=589 722) in the two largest regions of Sweden. Individuals were followed from a first infection until death, emigration, vaccination, reinfection, a PCC diagnosis (ICD-10 diagnosis code U09.9), or end of follow-up (30 November 2022), whichever came first. Individuals who had received at least one dose of a covid-19 vaccine before infection were considered vaccinated. MAIN OUTCOME MEASURE: The primary outcome was a clinical diagnosis of PCC. Vaccine effectiveness against PCC was estimated using Cox regressions adjusted for age, sex, comorbidities (diabetes and cardiovascular, respiratory, and psychiatric disease), number of healthcare contacts during 2019, socioeconomic factors, and dominant virus variant at time of infection. RESULTS: Of 299 692 vaccinated individuals with covid-19, 1201 (0.4%) had a diagnosis of PCC during follow-up, compared with 4118 (1.4%) of 290 030 unvaccinated individuals. Covid-19 vaccination with any number of doses before infection was associated with a reduced risk of PCC (adjusted hazard ratio 0.42, 95% confidence interval 0.38 to 0.46), with a vaccine effectiveness of 58%. Of the vaccinated individuals, 21 111 received one dose only, 205 650 received two doses, and 72 931 received three or more doses. Vaccine effectiveness against PCC for one dose, two doses, and three or more doses was 21%, 59%, and 73%, respectively. CONCLUSIONS: The results of this study suggest a strong association between covid-19 vaccination before infection and reduced risk of receiving a diagnosis of PCC. The findings highlight the importance of primary vaccination against covid-19 to reduce the population burden of PCC.


Assuntos
Vacinas contra COVID-19 , COVID-19 , Adulto , Humanos , COVID-19/epidemiologia , COVID-19/prevenção & controle , Suécia/epidemiologia , Estudos de Coortes , Eficácia de Vacinas
4.
JAMA Netw Open ; 6(7): e2324246, 2023 07 03.
Artigo em Inglês | MEDLINE | ID: mdl-37466944

RESUMO

This cohort study of health data from 2 regions in Sweden examines incidence rates of post­COVID-19 among children and compares incidence rates by demographic and clinical characteristics.


Assuntos
COVID-19 , Humanos , Criança , Incidência , Suécia/epidemiologia , COVID-19/epidemiologia
5.
BMJ ; 381: e074778, 2023 05 03.
Artigo em Inglês | MEDLINE | ID: mdl-37137493

RESUMO

OBJECTIVES: To evaluate the risks of any menstrual disturbance and bleeding following SARS-CoV-2 vaccination in women who are premenopausal or postmenopausal. DESIGN: A nationwide, register based cohort study. SETTING: All inpatient and specialised outpatient care in Sweden from 27 December 2020 to 28 February 2022. A subset covering primary care for 40% of the Swedish female population was also included. PARTICIPANTS: 2 946 448 Swedish women aged 12-74 years were included. Pregnant women, women living in nursing homes, and women with history of any menstruation or bleeding disorders, breast cancer, cancer of female genital organs, or who underwent a hysterectomy between 1 January 2015 and 26 December 2020 were excluded. INTERVENTIONS: SARS-CoV-2 vaccination, by vaccine product (BNT162b2, mRNA-1273, or ChAdOx1 nCoV-19 (AZD1222)) and dose (unvaccinated and first, second, and third dose) over two time windows (one to seven days, considered the control period, and 8-90 days). MAIN OUTCOME MEASURES: Healthcare contact (admission to hospital or visit) for menstrual disturbance or bleeding before or after menopause (diagnosed with the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes N91, N92, N93, N95). RESULTS: 2 580 007 (87.6%) of 2 946 448 women received at least one SARS-CoV-2 vaccination and 1 652 472 (64.0%) 2 580 007 of vaccinated women received three doses before the end of follow-up. The highest risks for bleeding in women who were postmenopausal were observed after the third dose, in the one to seven days risk window (hazard ratio 1.28 (95% confidence interval 1.01 to 1.62)) and in the 8-90 days risk window (1.25 (1.04 to 1.50)). The impact of adjustment for covariates was modest. Risk of postmenopausal bleeding suggested a 23-33% increased risk after 8-90 days with BNT162b2 and mRNA-1273 after the third dose, but the association with ChAdOx1 nCoV-19 was less clear. For menstrual disturbance or bleeding in women who were premenopausal, adjustment for covariates almost completely removed the weak associations noted in the crude analyses. CONCLUSIONS: Weak and inconsistent associations were observed between SARS-CoV-2 vaccination and healthcare contacts for bleeding in women who are postmenopausal, and even less evidence was recorded of an association for menstrual disturbance or bleeding in women who were premenopausal. These findings do not provide substantial support for a causal association between SARS-CoV-2 vaccination and healthcare contacts related to menstrual or bleeding disorders.


Assuntos
COVID-19 , ChAdOx1 nCoV-19 , Gravidez , Feminino , Humanos , Vacina BNT162 , Vacinas contra COVID-19/efeitos adversos , SARS-CoV-2 , Vacina de mRNA-1273 contra 2019-nCoV , Estudos de Coortes , COVID-19/epidemiologia , COVID-19/prevenção & controle , Menopausa , Hemorragia/epidemiologia , Distúrbios Menstruais , Casas de Saúde , Vacinação/efeitos adversos
6.
J Intern Med ; 293(5): 615-623, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36860115

RESUMO

BACKGROUND: Approximately one third of thromboembolic (TE) events are related to obesity, but to which extent elevated body mass index (BMI) during the distinct periods of childhood and puberty contributes is not known. We aimed to evaluate the impact of high BMI during childhood and puberty for the risk of adult venous and arterial thromboembolic events (VTE, ATE, respectively) in men. METHODS: We included 37,672 men from the BMI Epidemiology Study (BEST) Gothenburg with data on weight and height in childhood, young adult age, and on pubertal BMI change. Information on outcomes (VTE [n = 1683], ATE [n = 144], or any first TE event [VTE or ATE; n = 1780]) was retrieved from Swedish national registers. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regressions. RESULTS: Both BMI at 8 years of age and the pubertal BMI change were associated with VTE, independently of each other (BMI at 8: HR 1.06 per standard deviation [SD] increase, 95% CI, 1.01;1.11; pubertal BMI change: HR 1.11 per SD increase, 95% CI, 1.06;1.16). Individuals with normal weight during childhood followed by young adult overweight (HR 1.40, 95% CI, 1.15;1.72), and individuals with overweight at both childhood and young adult age (HR 1.48, 95% CI, 1.14;1.92), had a significantly increased risk of VTE in adult life, compared with the normal weight reference group. Individuals with overweight in childhood and in young adult age had increased risk of ATE and TE. CONCLUSION: Young adult overweight was a strong determinant, and childhood overweight a moderate determinant, of the risk of VTE in adult men.


Assuntos
Obesidade Infantil , Tromboembolia Venosa , Masculino , Adulto Jovem , Humanos , Adulto , Sobrepeso/complicações , Sobrepeso/epidemiologia , Índice de Massa Corporal , Tromboembolia Venosa/epidemiologia , Tromboembolia Venosa/etiologia , Obesidade Infantil/epidemiologia , Puberdade , Fatores de Risco
7.
BMC Pregnancy Childbirth ; 23(1): 206, 2023 Mar 27.
Artigo em Inglês | MEDLINE | ID: mdl-36973709

RESUMO

BACKGROUND: Birth weight is an indicator of intra-uterine conditions but also a determinant for future health. The importance of preconception health for a healthy birth weight has been emphasized, but evidence is lacking on how modifiable factors in adolescence, such as body mass index (BMI) and smoking, affect future pregnancy outcome. We evaluated associations between BMI and smoking in adolescence and at the start of pregnancy and birth weight of the first-born child. METHODS: This longitudinal study included 1256 mothers, born 1962-1992, and their first-born children, born between 1982-2016. Self-reported questionnaire information on weight, height and smoking at age 19 was cross-linked with national register data obtained at the start of pregnancy and with the birth weights of the children. Univariable and multivariable linear regressions were performed to determine the impact of maternal factors at 19 years of age and at the start of the pregnancy respectively, and the importance of BMI status at these points of time for the birth weight of the first child. RESULTS: BMI and smoking at the start of the pregnancy displayed strong associations with birth weight in a multivariable analysis, BMI with a positive association of 14.9 g per BMI unit (95% CI 6.0; 23.8 p = 0.001) and smoking with a negative association of 180.5 g (95% CI -275.7; -85.4) p = 0.0002). Smoking and BMI at 19 years of age did not show this association. Maternal birth weight showed significant associations in models at both time-points. Becoming overweight between age 19 and the start of the pregnancy was associated with a significantly higher birth weight (144.6 (95% CI 70.7;218.5) p = 0.0002) compared to mothers with normal weight at both time points. CONCLUSIONS: Our findings indicate that the time period between adolescence and first pregnancy could be a window of opportunity for targeted health promotion to prevent intergenerational transmission of obesity.


Assuntos
Índice de Massa Corporal , Sobrepeso , Gravidez na Adolescência , Fumar , Adolescente , Adulto , Criança , Feminino , Humanos , Gravidez , Adulto Jovem , Peso ao Nascer , Estudos Longitudinais , Parto , Fatores de Risco , Fumar/epidemiologia
8.
Int J Infect Dis ; 126: 104-113, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36410693

RESUMO

OBJECTIVES: The objective of this study was to provide a comprehensive characterization of patients diagnosed with post-COVID-19 condition (PCC) during the first 16 months of use of the International Classification of Diseases revision 10 (ICD-10) diagnosis code U09.9 in Sweden. METHODS: We used data from national registers and primary health care databases for all adult inhabitants of the two largest regions in Sweden, comprising 4.1 million inhabitants (approximately 40% of the Swedish population). We present the cumulative incidence and incidence rate of PCC overall and among subgroups and describe patients with COVID-19 with or without PCC regarding sociodemographic characteristics, comorbidities, subsequent diseases, COVID-19 severity, and virus variants. RESULTS: Of all registered COVID-19 cases available for PCC diagnosis (n = 506,107), 2.0% (n = 10,196) had been diagnosed with PCC using ICD-10 code U09.9 as of February 15, 2022 in the two largest regions in Sweden. The cumulative incidence was higher among women than men (2.3% vs 1.6%, P <0.001). The majority of PCC cases (n = 7162, 70.2%) had not been hospitalized for COVID-19. This group was more commonly female (69.9% vs 52.9%, P <0.001), had a tertiary education (51.0% vs 44.1%, P <0.001), and was older (median age difference 5.7 years, P <0.001) than non-hospitalized patients with COVID-19 without PCC. CONCLUSION: This characterization furthers the understanding of patients diagnosed with PCC and could support policy makers with appropriate societal and health care resource allocation.


Assuntos
COVID-19 , Classificação Internacional de Doenças , Adulto , Masculino , Humanos , Feminino , Pré-Escolar , Estudos de Coortes , Suécia/epidemiologia , COVID-19/diagnóstico , COVID-19/epidemiologia , Comorbidade
10.
Int J Obes (Lond) ; 46(2): 444-446, 2022 02.
Artigo em Inglês | MEDLINE | ID: mdl-34743176

RESUMO

Pubertal BMI change is an independent risk marker of cardiovascular mortality/morbidity. Previous studies demonstrated a secular trend of increased childhood BMI but it is unknown if there is a concomitant secular trend regarding pubertal BMI change. The aim of this study was to describe the trend in pubertal BMI change. We collected heights and weights before and after puberty from school health records and military conscript records for boys born every five years during 1946-1991 (n = 3650, total cohort) and calculated pubertal BMI change (young adult BMI at 20 years of age minus childhood BMI at 8 years of age) for all study participants. A secular trend of increasing pubertal BMI change during the study period was observed. The increase in pubertal BMI change (0.27 kg/m2 per decade [0.22; 0.32]) explained 54% of the secular trend of increasing young adult BMI (0.50 kg/m2 per decade [0.43; 0.57]). We made the novel observation that there is a secular trend of increasing pubertal BMI change. We propose that the secular trend of increasing pubertal BMI change might contribute more than the secular trend of increasing childhood BMI to the adverse cardiovascular health consequences associated with the ongoing obesity epidemic.


Assuntos
Comportamento do Adolescente/psicologia , Índice de Massa Corporal , Adolescente , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Obesidade/epidemiologia , Suécia/epidemiologia
11.
Eur J Prev Cardiol ; 29(6): 971-978, 2022 05 06.
Artigo em Inglês | MEDLINE | ID: mdl-34910135

RESUMO

AIMS: Hospitalizations for heart failure among young adults and middle-aged individuals have increased. The aims of the present study were to evaluate the association between birth weight and risk of adult heart failure and the importance of change from low birth weight to overweight/obesity at young adulthood. METHODS AND RESULTS: We used the population-based body mass index (BMI) Epidemiology Study cohort Gothenburg (n = 35 659) with birth weight and young adult BMI (20 years) available from child healthcare records, school health records, and military conscription register for men born 1945-1961. The cohort includes all children who finished school, which was mandatory, in Gothenburg, Sweden. Information on heart failure diagnosis was retrieved from the National Patient Register and the Cause of Death Register (n = 415). In cox regression analyses, there was an inverse association between birth weight and risk of heart failure [hazard ratio (HR) 0.83 per standard deviation (SD), 95% confidence interval (CI) 0.76-0.90], and a direct association for young adult BMI (HR 1.48 per SD, 95% CI 1.36-1.61). Of note, individuals with birth weight in the lowest tertile, who were overweight/obese in young adulthood had a five-fold risk of heart failure (HR 4.95, 95% CI 3.36-7.31) compared with individuals in the middle birth weight tertile who were normal weight at 20 years. CONCLUSIONS: Birth weight was inversely associated with the risk of hospitalization due to heart failure. The combination of low birth weight and overweight/obesity in young adulthood results in excess risk of heart failure beyond that of low birth weight or young adult overweight/obesity separately. These findings indicate the need of a life course perspective in heart failure prevention and risk assessment.


Assuntos
Insuficiência Cardíaca , Sobrepeso , Adulto , Peso ao Nascer , Índice de Massa Corporal , Peso Corporal , Criança , Insuficiência Cardíaca/complicações , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Obesidade/diagnóstico , Obesidade/epidemiologia , Sobrepeso/complicações , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Fatores de Risco , Adulto Jovem
12.
Cancers (Basel) ; 13(24)2021 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-34944857

RESUMO

Previous studies of pubertal timing and the risk of prostate cancer have used self-reported markers of pubertal development, recalled in mid-life, and the results have been inconclusive. Our aim was to evaluate the age at the pubertal growth spurt, an objective marker of pubertal timing, and the risk of prostate cancer and high-risk prostate cancer. This population-based cohort study included 31,971 men with sufficient height measurements to calculate age at peak height velocity (PHV). Outcomes were accessed through national registers. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regressions with follow up starting at 20 years of age. In total, 1759 cases of prostate cancer including 449 high-risk were diagnosed during follow up. Mean follow up was 42 years (standard deviation 10.0). Compared to quintiles 2-4 (Q2-4), men in the highest age at PHV quintile (Q5) had lower risk of prostate cancer (HR 0.83, 95% CI 0.73-0.94), and of high-risk prostate cancer (0.73; 0.56-0.94). In an exploratory analysis with follow up starting at age at PHV, late pubertal timing was no longer associated with reduced risk of prostate cancer. Later pubertal timing was associated with reduced risk of prostate cancer and especially high-risk prostate cancer. We propose that the risk of prostate cancer might be influenced by the number of years with exposure to adult levels of sex steroids.

13.
Acta Paediatr ; 110(12): 3349-3355, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34464992

RESUMO

AIM: The aim of this study was to present prevalence data for overweight and obesity across school age in a large, recent, population-based cohort of children in Gothenburg, Sweden. METHODS: We included 66,807 children (48.5% girls) aged 5-18.9 years who had their height and weight measured in school health care 2015-2018. The BMI values were categorised according to the age-dependent cut-offs for overweight and obesity from the International Obesity Task Force (IOTF). RESULTS: Overall, the prevalence of overweight and obesity for girls and boys was 18.1% and 18.0%, respectively. We observed increasing proportions of overweight (girls 11.5-17.1% and boys 8.4-17.4%) and obesity (girls 3.0-4.2% and boys 2.7-6.1%) with increasing age (p < 0.001 for trend in both sexes). Moreover, girls had higher prevalence of overweight during ages 5.0 to 8.9 years compared with boys (p < 0.001), while boys had higher prevalence of obesity 15.0-18.9 years compared with girls (p < 0.001). CONCLUSION: In conclusion, we demonstrate increasing prevalence of overweight and obesity across the entire school age range, as well as differences in prevalences between boys and girls, in a population-based sample of 67,000 children in Gothenburg city, Sweden. Continuous monitoring of schoolchildren, together with effective preventive measures, is crucial to curb the obesity epidemic and its consequences.


Assuntos
Obesidade , Sobrepeso , Índice de Massa Corporal , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Prevalência , Suécia/epidemiologia
14.
Vaccine ; 39(32): 4414-4418, 2021 07 22.
Artigo em Inglês | MEDLINE | ID: mdl-34187707

RESUMO

BACKGROUND: It has been hypothesised that the measles-mumps-rubella (MMR) vaccine may afford cross-protection against SARS-CoV-2 which may contribute to the wide variability in disease severity of Covid-19. METHODS: We employed a test negative case-control study, utilising a recent measles outbreak during which many healthcare workers received the MMR vaccine, to investigate the potential protective effect of MMR against SARS-CoV-2 in 5905 subjects (n = 805 males, n = 5100 females). RESULTS: The odds ratio for testing positive for SARS-CoV-2, in recently MMR-vaccinated compared to not recently MMR-vaccinated individuals was 0.91 (95% CI 0.76, 1.09). An interaction analysis showed a significant interaction for sex. After sex-stratification, the odds ratio for testing positive for males was 0.43 (95% CI 0.24, 0.79, P = 0.006), and 1.01 (95% CI 0.83, 1.22, P = 0.92) for females. CONCLUSION: Our results indicate that there may be a protective effect of the MMR vaccine against SARS-CoV-2 in males but not females.


Assuntos
COVID-19 , Sarampo , Caxumba , Rubéola (Sarampo Alemão) , Vacinas contra COVID-19 , Estudos de Casos e Controles , Feminino , Pessoal de Saúde , Humanos , Masculino , Sarampo/prevenção & controle , Vacina contra Sarampo-Caxumba-Rubéola , SARS-CoV-2 , Vacinação
15.
J Pediatr ; 237: 162-167.e4, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34186103

RESUMO

OBJECTIVE: To evaluate the association between birth weight and the risk of adult stroke in men, independent of body mass index (BMI) at young adult age. STUDY DESIGN: We included 35 659 men born between 1945 and 1961 from the BMI Epidemiology Study with data on birth weight together with BMI in childhood (8 years) and young adulthood (20 years). Information on stroke events (1184 first stroke events; 905 ischemic stroke [IS] events and 234 intracerebral hemorrhage [ICH] events) was retrieved from national registers in Sweden. RESULTS: Birth weight was inversely associated with the risk of stroke (IS, ICH and uncategorized together; hazard ratio [HR], 0.88 per SD increase, 95% CI, 0.84-0.93), IS, and ICH in a linear manner, independent of young adult BMI. This association was maintained when the analysis was restricted to individuals within the normal birth weight range only. Moreover, individuals with a birth weight in the lowest tertile followed by overweight at 20 years had an 81% greater risk of stroke (HR, 1.81; 95% CI, 1.29; 2.54), compared with a reference group of individuals with birth weight in the middle tertile who were of normal weight at age 20 years. CONCLUSIONS: We demonstrate an inverse association between birth weight and the risk of adult stroke, IS, and ICH independent of young adult BMI. These findings suggest that low birth weight should be included in assessments of stroke risk in adults.


Assuntos
Peso ao Nascer , Acidente Vascular Cerebral/epidemiologia , Índice de Massa Corporal , Criança , Estudos de Coortes , Humanos , Recém-Nascido de Baixo Peso , Recém-Nascido , Masculino , Modelos de Riscos Proporcionais , Sistema de Registros , Fatores de Risco , Fatores Sexuais , Acidente Vascular Cerebral/diagnóstico , Suécia , Adulto Jovem
16.
Arterioscler Thromb Vasc Biol ; 41(8): 2318-2327, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34134518

RESUMO

OBJECTIVE: The aim with the present study was to evaluate the association between pubertal body mass index (BMI) change and adult coronary artery calcification (CAC) score and risk of acute coronary events. APPROACH AND RESULTS: We included 37 672 men from the BMI Epidemiology Study and calculated their pubertal BMI change (BMI at 20 years−BMI at 8 years). Coronary artery computed tomography analysis of CAC score, midlife BMI, and major risk factors for coronary heart disease were available for a sub-cohort through linkage with the SCAPIS (Swedish Cardio Pulmonary Bioimage Study) cohort (n=922). Information on first acute coronary events was retrieved from Swedish national registers (n=37 672, events n=1873). Pubertal BMI change (odds ratio per SD increase, 1.32 [1.14­1.52]), but not childhood BMI, was associated with middle age CAC score ≥1. This association for pubertal BMI change was maintained after adjustment for midlife BMI at CAC analysis and in a model including major cardiovascular risk factors. Individuals who became overweight during puberty (hazard ratio, 2.11 [1.79­2.49]), but not those overweight at 8 years who normalized their weight during puberty, had substantially increased risk of acute coronary events compared with men who were never overweight. Among subjects with an acute coronary event, individuals with pubertal onset overweight were at increased risk of death due to the event. CONCLUSIONS: Pubertal BMI change is an independent predictor of CAC score and risk of acute coronary events in adult men. Excessive BMI increase during puberty may initiate the coronary atherosclerotic process, thereby increasing the risk and severity of adult acute coronary events.


Assuntos
Síndrome Coronariana Aguda/epidemiologia , Índice de Massa Corporal , Doença da Artéria Coronariana/epidemiologia , Obesidade Infantil/epidemiologia , Puberdade , Calcificação Vascular/epidemiologia , Síndrome Coronariana Aguda/diagnóstico por imagem , Adolescente , Fatores Etários , Criança , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Doença da Artéria Coronariana/diagnóstico por imagem , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade Infantil/diagnóstico , Obesidade Infantil/fisiopatologia , Prognóstico , Sistema de Registros , Medição de Risco , Fatores de Risco , Fatores Sexuais , Suécia , Fatores de Tempo , Calcificação Vascular/diagnóstico por imagem , Aumento de Peso , Adulto Jovem
17.
Am J Clin Nutr ; 113(1): 123-128, 2021 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-33184646

RESUMO

BACKGROUND: Recent findings indicate that there is a body weight-sensing homeostatic regulation of body weight in postpubertal rodents and humans. It is possible that body weight sensing also might be involved in the regulation of pubertal timing. Although an early small study suggested that there is a critical body weight for pubertal timing in girls, most studies have focused on BMI and reported an inverse association between BMI and pubertal timing. OBJECTIVES: In the present longitudinal well-powered cohort study, we revisited the critical weight hypothesis and tested if prepubertal body weight is a more robust inverse predictor of pubertal timing than prepubertal BMI in boys. METHOD: We included men born during 1945-1961 (old cohort; n = 31,971) and men born during 1981-1996 (recent cohort; n = 1465) in the large BMI Epidemiology Study (BEST) Gothenburg (combined BEST cohort n = 33,436). Men with information on prepubertal body weight and BMI at 8 y of age and age at peak height velocity (PHV; an objective measure of pubertal timing) were included. RESULTS: Body weight explained more of the variance in age at PHV than BMI in both the old cohort and the recent cohort (combined cohort, body weight 6.3%, BMI 3.6%). Both body weight (ß: -0.24 SD/SD increase in weight; 95% CI: -0.25, -0.23) and BMI (ß: -0.18 SD/SD increase in BMI, 95% CI: -0.19, -0.17) were inversely associated with age at PHV but the association for body weight was significantly more pronounced than the association for BMI (P < 0.001). CONCLUSIONS: In conclusion, prepubertal body weight is a more robust inverse predictor of pubertal timing than prepubertal BMI in boys. We propose that body weight sensing constitutes a feedback mechanism to regulate pubertal timing.

18.
J Pediatr Gastroenterol Nutr ; 70(6): 853-857, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32443046

RESUMO

There are few longitudinal data on whether childhood growth and pubertal timing may be impaired by adult-diagnosed celiac disease (CD). Through school health care records and national registers, we retrieved serial growth measurements on 37,672 Swedish boys born in 1945 to 1961, out of whom 72 (0.2%) were clinically diagnosed with CD as adults. Boys with, versus without, adult-diagnosed CD exhibited no appreciable mean differences in body mass index (BMI, kg/m) and height (cm) at ages 8 or 20 to 21 years (childhood BMI, 15.9 [CD] vs 15.7 [comparators]; childhood height, 129.1 [CD] vs 128.6 [comparators]; adult BMI, 21.3 [CD] vs 21.4 [comparators]; adult height, 180.7 [CD] vs 180.4 [comparators]). Neither did we observe any between-group differences in growth development during puberty nor in the timing of pubertal growth spurt (all P values ≥0.30). Conclusively, in this population-based longitudinal study, boys with adult-diagnosed CD had similar growth and pubertal timing as their peers.


Assuntos
Doença Celíaca , Adulto , Idoso , Estatura , Índice de Massa Corporal , Doença Celíaca/diagnóstico , Criança , Estudos de Coortes , Humanos , Estudos Longitudinais , Masculino , Suécia/epidemiologia
19.
Int J Cancer ; 147(9): 2355-2362, 2020 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-32306396

RESUMO

Hematologic malignancies are common and the incidence is increasing. Adult obesity has been associated with hematologic malignancies (HM), but the importance of body mass index (BMI) in childhood and during puberty has not been evaluated. The aim of the present study was to evaluate the relative contribution of BMI and height in childhood and during puberty for the risk of adult HM. 37 669 men born in 1946 to 1961 who had weight and height measured at 8 (childhood) and 20 (young adult age) years of age available from the BMI Epidemiology Study were included in the study. Pubertal BMI change was calculated as BMI at 20 years of age minus BMI at 8 years of age. Information on HM was retrieved from Swedish registers (459 cases of HM). Hazard ratios (HR) and 95% confidence intervals (CI) were estimated by Cox regressions. Childhood BMI (HR 1.11 per SD increase [95% CI 1.02-1.23]), but not pubertal BMI change, was associated with hematologic malignancies in a linear manner. Childhood BMI was, independent of childhood height, associated with the diagnostic entities Non-Hodgkin lymphoma (HR 1.14 [95% CI 1.00-1.30]) and its largest subgroup diffuse large B-cell lymphoma (HR 1.31 [95% CI 1.03-1.67]). Childhood height was associated with multiple myeloma (HR 1.30 [95% CI 1.04-1.64]) independent of childhood BMI. We conclude that childhood but not puberty is the critical developmental period regarding future risk of HM and we suggest that elevated childhood BMI is a determinant of Non-Hodgkin lymphoma and diffuse large B-cell lymphoma.


Assuntos
Índice de Massa Corporal , Neoplasias Hematológicas/epidemiologia , Obesidade Infantil/epidemiologia , Sistema de Registros/estatística & dados numéricos , Serviços de Saúde Escolar/estatística & dados numéricos , Adolescente , Adulto , Estatura , Peso Corporal , Criança , Seguimentos , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Obesidade Infantil/diagnóstico , Medição de Risco/métodos , Medição de Risco/estatística & dados numéricos , Fatores de Risco , Suécia/epidemiologia , Adulto Jovem
20.
ERJ Open Res ; 6(1)2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32154295

RESUMO

Men who develop overweight specifically during puberty (i.e. normal weight at age 8, overweight at age 20 years) have 70% increased risk of COPD as adults compared to men without overweight http://bit.ly/2TradZA.

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