Background: Central obesity predicts the risk of atherosclerosis, but whether and how life-course central obesity trajectories are associated with vascular changes in later life remains unclear. We aimed to examine the association between life-course waist circumference (WC) trajectories and vascular markers in mid-adulthood.
Methods: We used data from an Australian national cohort, with WC measured at three timepoints in childhood, young adulthood, and mid-adulthood. Age-sex-standardised WC z-scores trajectories were identified using latent class growth mixture modelling. Vascular markers included hypertension, carotid intima-media thickness (cIMT), carotid distensibility (CD), stiffness index (SI), Young’s elastic modulus (YEM), and plaque in mid-adulthood. Linear and log-binomial regression models were used to examine the associations, adjusting for baseline age, sex, lifestyle behaviours, socio-economic status, self-reported health, and follow-up duration.
Results: We included 1,156 children (mean baseline age 11.1 [2.6] years, male 49.6%, mean follow-up 32.4 [1.4] years). Compared to the persistently-low trajectory (80.4%), the persistently-high (2.8%), progressing-to-high (11.5%), and average-rise-to-peak-and-return-to-average (2.2%) trajectories had higher risk of hypertension and higher cIMT (all p<0.05). In addition, higher risk of hypertension was reported by participants on the improving-from-high trajectory (3.1%), and lower CD and higher YEM were observed for the progressing-to-high trajectory than the persistently-low trajectory. No significant difference was found for SI and presence of plaques in mid-adulthood by WC trajectories.
Conclusion: Persisting at or reaching high WC from childhood to adulthood was associated with hypertension and/or vascular impairment, while favourable change in WC did not fully reverse the increased risk associated with high WC in childhood.