• Jack T Evans, Marie-Jeanne Buscot, Brooklyn J Fraser, Markus Juonala, Yajun Guo, Camilo Fernandez, Mika Kähönen, Matthew A Sabin, Matthew K Armstrong, ViikariJorma S AJSADepartment of Medicine, University of Turku, Turku, Finland; Division of Medicine, Turku University Hospital, Turku, Finland., Lydia A Bazzano, Olli T Raitakari, and Costan G Magnussen.
• Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia.
• Prev Med. 2024 Sep 6; 189: 108128108128.

ObjectiveChild and adult body mass index (BMI) associates with adult carotid artery intima-media thickness (cIMT). However, the relative contribution of BMI at different life-periods on adult cIMT has not been quantified. This study aimed to determine the life-course model that best explains the relative contribution of BMI at different life-periods (childhood, adolescence, and young-adulthood) on cIMT in adulthood.MethodsBMI was calculated from direct measurements of height and weight at up to seven time-points from childhood to adulthood (1973-2007) among 2485 participants of the Cardiovascular Risk in Young Finns Study (YFS) and 1271 participants in the Bogalusa Heart Study (BHS). BMI measures at three ages representative of childhood (9-years), adolescence (18 years) and young-adulthood (30 years) life-periods were used. B-mode ultrasound was used to measure common cIMT in adulthood (>30 years). Associations were evaluated using the Bayesian relative life-course exposure model.ResultsIn both cohorts, cumulative exposure to higher levels of BMI across the life-course was associated with greater cIMT. Of the examined life-periods, BMI in young-adulthood provided the greatest relative contribution towards the development of adult cIMT for YFS (49.9 %, 95 % CrI = 34-68 %) and white BHS participants (48.6 %, 95 % CrI = 9-86 %), whereas BMI in childhood had the greatest relative contribution for black BHS participants (54.0 %, 95 % CrI = 8-89 %).ConclusionAlthough our data suggest sensitive periods in the life-course where prevention and intervention aimed at reducing BMI might provide most benefit in limiting the effects of BMI on cIMT, maintaining lower BMI across the life-course appears to be optimal.Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.

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