Objective To examine influences of adiposity from early adolescence to early 20s on cardiovascular disease (CVD) risk in the multiethnic Determinants of young Adult Social well-being and Health (DASH) longitudinal study.
Methods In 2002–2003, 6643 11–13-year-olds from 51 London schools participated at baseline, and 4785 were seen again at 14–16 years. Recently, 665 (97% of invited) participated in pilot follow-up at 21–23 years, with biological and psychosocial measures and blood biomarkers (only at 21–23 years). Regression models examined interplay between ethnicity, adiposity and CVD.
Results At 21–23 years, ∼30–40% were overweight. About half of the sample had completed a degree with little ethnic variation despite more socioeconomic disadvantage in adolescence among ethnic minorities. Regardless of ethnicity, overweight increased more steeply between 14–16 years and 21–23 years than between 11–13 years and 14–16 years. More overweight among Black Caribbean and Black African females, lower systolic blood pressure (sBP) among Indian females and Pakistani/Bangladeshi males compared with White UK peers, persisted from 11–13 years. At 21–23 years, glycated haemoglobin (HbA1c) was higher among Black Caribbean females, total cholesterol higher and high-density lipoprotein (HDL) cholesterol lower among Pakistani/Bangladeshis. Overweight was associated with a ∼+2 mm Hg rise in sBP between 11–13 years and 21–23 years. Adiposity measures at 11–13 years were related to allostatic load (a cluster of several risk markers), HbA1c and HDL cholesterol at 21–23 years. Ethnic patterns in CVD biomarkers remained after adjustments.
Conclusions Adolescent adiposity posed significant risks at 21–23 years, a period in the lifespan generally ignored in cardiovascular studies, when ethnic/gender variations in CVD are already apparent.
- later CVD risk
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Contributors SH is the Principal Investigator of DASH, led on the analysis and drafted the first version of the manuscript. UR, ZEE and AC oversaw the conduct of the study, recruitment of participants and collection of data. ORM, MJS and AK conducted the quality assurance of the data and statistical analyses. KC provided expertise in the measurement of arterial stiffness and interpretation of the data. All authors contributed to study design and analyses, and contributed to the development of the manuscript and approved the final version.
Funding The study was funded by the Medical Research Council (10.13039/N4 501100000265, MC_U130015185/MC_UU_12017/1/ MC_UU_12017/13) North Central London Consortium and the Primary Care Research Network.
Competing interests None declared.
Patient consent Obtained.
Ethics approval The Multicentre Research Ethics Committee (MREC) and NHS Local Research Ethics Committees.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement The DASH data are available to researchers via a data request to the MRC Social and Public Health Science Unit. Applications and the data sharing policy for DASH can be found at http://dash.sphsu.mrc.ac.uk/DASH_dsp_v1_November-2012_draft.pdf. It reflects the MRC guidance on data sharing with the aim of making the data as widely and freely available as possible while safeguarding the privacy of participants, protecting confidential data, and maintaining the reputation of the study. All potential collaborators work with a link person, an experienced DASH researcher—to support their access to and analysis of the data. The variable-level metadata is available from the study team and also via the MRC Data Gateway.
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