Obesity in Adolescent Men Associated With Increased Risk for Later VTE

Obesity in early adulthood is associated with increased risk for venous thromboembolism (VTE) later in life, according to study results published in the Journal of Internal Medicine.

Obesity is a well-established risk factor for cardiovascular disease in adulthood, but the effect of obesity in adolescence on health problems in adulthood is less clear. Using data from the Swedish Military Service Conscription Register, investigators aimed to evaluate the relationship between body mass index (BMI) levels in young adulthood and later development of VTE.

The study population consisted of over 1.6 million men who enlisted for military service in Sweden between the ages of 17 and 24 years. Height and weight were used to calculate BMI at enlistment. Data on cardiovascular outcomes were obtained from the National Patient Registry.

Within the study population, 1.79% of men were obese (BMI of ≥30 to <35 kg/m²) and 0.44% were severely obese (BMI of ≥35 kg/m²) at enlistment. Over the course of follow-up (median, 28 years), 17,805 cases of first VTE occurred. The event rate for VTE was over twice as high for the obese (73.7 per 100,000 years) and severely obese BMI groups (112.1 per 100,000 years) compared with the normal BMI group (BMI of ≥18.5 to <20 kg/m²; 32.8 per 100,000 years).

The cumulative incidence of VTE was higher in the obese (5.1%) and severely obese BMI groups (8.4%) than in the normal BMI group (1.8%). An incremental increase in cumulative incidence of VTE occurred with increasing BMI across all groups (P <.0001).

After adjustment for several potential confounding factors, men in the obese (hazard ratio, 2.93; 95% CI, 2.65-3.24) and severely obese BMI groups (hazard ratio, 4.95; 95% CI, 4.16-5.90) were at increased risk for VTE compared with men in the normal BMI group. This risk was most pronounced for pulmonary embolism, for which men in the obese and severely obese BMI groups were at over a 3-fold and 5-fold increased risk, respectively, compared with men in the normal BMI group.

The researchers noted that the study lacked data on subsequent weight changes after enlistment, which precluded the researchers from assessing how weight loss may have affected future cardiovascular disease risk.

“[O]verweight and obesity in young adulthood is an important risk factor for later development of VTE later in life,” the study authors concluded. “Action should be taken to reduce overweight and obesity early in life.”

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Reference

Glise Sandblad K, Jern S, Åberg M, et al. Obesity in adolescent men increases the risk of venous thromboembolism in adult life [published online April 27, 2020]. J Intern Med. doi:10.1111/joim.13044