Higher childhood body mass index (BMI) and increases in BMI during childhood are linked to an increased risk of early adult ischemic stroke, according to findings published in JAMA Neurology.1
Line K. Gjærde, MD, of the University of Copenhagen, Denmark, and colleagues sought to investigate the potential association between childhood BMI and stroke due to the high prevalence of childhood obesity and its potential as a modifiable risk factor.
The investigators gathered data from the Copenhagen School Health Records Register of 307,677 children aged 7 to 13 years, born from 1930 to 1987, and follow-up data via national health registers from 1977 to 2012. Data collected included weight and height measurements, as well as parent-reported birthweight. The researchers transformed the BMI data into a BMI z score based on an age- and sex-specific reference “chosen from a period when the prevalence of obesity was low and stable.”2 Data on stroke events was obtained from the Danish National Cause of Death Register.
During the follow-up period, 3529 women and 5370 men were diagnosed with ischemic stroke, of whom 23.0% of women and 23.4% of men were 55 years or younger. Women who had a BMI z score of 1 at age 13 had a hazard ratio (HR) of 1.26 (95% CI, 1.11-1.43) for early adult ischemic stroke. The HR increased with higher BMI z scores: women with a BMI z score of 2 had a HR of 1.76 (95% CI, 1.38-2.25). Men with a BMI z score of 1 at age 13 had a HR of 1.21 (95% CI, 1.10-1.33) for early adult ischemic stroke, and as with the women, the HR increased with higher BMI z scores; men with a BMI z score of 2 had a HR of 1.58 (95% CI, 1.27-1.98).
No significant association between higher childhood BMI and a risk of late adult ischemic stroke was found. The researchers also did not find a link between birthweight and early or late adult ischemic stroke.
“Because childhood obesity is difficult to prevent and treatment often fails, these findings suggest that the initiation of early personalized medicine may need to be undertaken to reduce the risk of early stroke among these individuals, in addition to weight reduction or maintenance,” concluded Dr Gjærde and colleagues.
The researchers noted the study was limited in that all data were taken from Danish registries, and they predict that current HRs of American children may be higher.
- Gjærde LK, Gamborg M, Ängquist L, Truelsen TC, Sørensen TIA, Baker JL. Association of childhood body mass index and change in body mass index with first adult ischemic stroke [published online August 21, 2017]. JAMA Neurol. doi:10.1001/jamaneurol.2017.1627
- Baker JL, Olsen LW, Sørensen TI. Childhood body-mass index and the risk of coronary heart disease in adulthood. N Engl J Med. 2007;357(23):2329-2337.