A longer duration of overall and abdominal obesity starting in young adulthood was associated with coronary artery calcification (CAC) and its progression during middle age independent of the degree of adiposity, according to a new study  published July 16 in the Journal of the American Medical Association.

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The study followed 3,275 white and black adults between the ages of 18 and 20 over a 25-year period. The participants, who initially did not have overall obesity (body mass index [BMI] ≥30) or abdominal obesity (men: waist circumference [WC] >102 cm; women: >88 cm), underwent computed tomography at years 15, 20 and 25 in order to measure the presence of CAC.

During the follow-up period, 40.4 percent and 41.0 percent of study participants developed overall and abdominal obesity, respectively. The study investigators note that the rates of CAC per 1000 person-years were higher for those who experienced more than 20 years vs. 0 years of overall obesity (16.0 vs. 11.0, respectively) and abdominal obesity (16.7 vs. 11.0). In addition, progression of CAC occurred in approximately 25.2 percent and 27.7 percent of those with more than 20 years of overall and abdominal obesity, respectively, compared to 20.2 percent and 19.5 percent of those who were never obese.

"These findings suggest that the longer duration of exposure to excess adiposity as a result of the obesity epidemic and an earlier age at onset will have important implications on the future burden of coronary atherosclerosis and potentially on the rates of clinical cardiovascular disease in the United States," the investigators said.

Moving forward, they suggest that "preventing or at least delaying the onset of obesity in young adulthood may substantially reduce the risk of coronary atherosclerosis and limit its progression later in life."

Keywords: Waist Circumference, Coronary Artery Disease, Follow-Up Studies, Body Mass Index, Tomography, Middle Aged, European Continental Ancestry Group, Adiposity, Obesity, African Continental Ancestry Group, United States

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