Introduction: Anthropometric measures of body fat distribution have shown that waist (WC) and hip (HC) circumferences have opposite and independent associations with atherosclerotic risk factors and disease. However, this evidence is confined to cross-sectional studies only. How the development over time of these anthropometric measures impact on pre-clinical atherosclerosis is not known.

Methods: Longitudinal data on WC and HC were derived from the Amsterdam Growth and Health Longitudinal Study (n=372, 197 women; 3 follow-up measures at the ages of 27, 32 and 36 yrs). Carotid intima-media thickness (IMT), a marker of pre-clinical atherosclerosis, was assessed by non-invasive ultrasonography when subjects were 36-yrs-old. We used generalized estimating equations to compare the patterns of development of WC and HC (adjusted for each other and for potential confounders – i.e. physical fitness, alcohol and smoking habits) over the 9-yr follow-up period between those subjects with ‘high’ (highest sex-specific quartile) vs. ‘normal’ (lower 3 quartiles) of carotid IMT at the age of 36 yrs.

Results: In men, WC increased and HC decreased significantly between the ages of 27 and 36 (p<0.001), but no differences in these longitudinal patterns of development were found between those with ‘high’ vs. normal carotid IMT at age 36. In women, however, the increase in WC was 3.47 cm (0.98 to 5.96) greater in those with ‘high’ vs. ‘normal’ IMT; in addition, the HC decreased considerably more in those with ‘high’ vs. ‘normal’ IMT [−3.60 cm (−6.54 to −0.65];.

Conclusion: The development of broader waist (possibly reflecting accumulation of abdominal fat throughout the years) and narrower hip circumferences (reflecting loss of peripheral fat and/or muscular mass) during young adulthood are independent determinants of pre-clinical atherosclerosis, particularly in women.