在中国人群中，成年早期体重变化与心脏代谢疾病之间的关系仍不确定。这种关联是否随“Life's Essential 8”评估的中年综合心血管健康（CVH）而变化，尚未得到表征。我们的目的是在中国队列中研究成年早期体重变化和中年“Life's Essential 8”CVH 状态与心脏代谢结果的关联。研究参与者来自中国心脏代谢疾病和癌症队列 (4 C) 研究。该分析包括 72,610 名中年和老年参与者，随访时间中位数为 3.6 年。在基线时，参与者回忆 20 岁和 40 岁时的体重，我们计算了 20 至 40 岁时体重和 BMI 的变化。通过问卷调查的方式收集“Life's Essential 8”中的健康行为信息，并在研究中心进行健康因素测量。在随访过程中，我们根据病历确定了心血管事件的发生情况，并根据美国糖尿病协会2010年的标准诊断了糖尿病发生情况。共纳入72,610名研究参与者，平均年龄为56.0±8.8岁，其中29%为男性。 20 至 40 岁之间体重增加超过 10 公斤，心血管事件风险增加 22%（HR：1.22；95%CI：1.04-1.43），糖尿病风险增加 38%（HR：1.38；95%CI：1.04-1.43）。 95% CI: 1.25-1.53​​) 与稳定体重相比。此外，对于中年 CVH 评分较低的人来说，成年早期体重增加超过 10 公斤与心脏代谢风险的相关性甚至更强（心血管事件的 HR：2.44；95%CI：2.01-2.97；HR：2.20；95） %CI：1.90-2.55（发病糖尿病）或中年时几乎没有理想的心血管健康指标。我们的研究表明，成年早期体重增加与心脏代谢疾病风险显着增加相关。对于中年 CVH 状况不佳的人来说，这种关联可能更强烈。这些发现证实了成年早期体重管理的重要性，并建议应鼓励早年体重大幅增加的中国人群保持良好的 CVH 状态。© 2023。作者。

The association between weight change during early adulthood and cardiometabolic diseases remains uncertain in Chinese population. Whether the association varies with comprehensive cardiovascular health (CVH) in midlife assessed by "Life's Essential 8" has not been characterized. We aim to examine the associations of early adulthood weight change and midlife "Life's Essential 8" CVH status with cardiometabolic outcomes in a Chinese cohort.The study participants were from the China Cardiometabolic Disease and Cancer Cohort (4 C) Study. This analysis included 72,610 middle-aged and older participants followed for a median of 3.6 years. At baseline, the participants recalled body weight at age 20 and 40 years, and we calculated change in weight and BMI between 20 and 40 years of age. Health behaviors information in "Life's Essential 8" was collected by questionnaire, and health factors were measured in the study center. During follow-up, we ascertained incident cardiovascular events based on medical records, and diagnosed incident diabetes according to the American Diabetes Association 2010 criteria.72,610 study participants were included with a mean age of 56.0 ± 8.8 years and 29% of them were males. Weight gain of more than 10 kg between 20 and 40 years of age was associated with 22% increased risk of incident cardiovascular events (HR: 1.22; 95%CI: 1.04-1.43) and 38% increased risk of diabetes (HR: 1.38; 95%CI: 1.25-1.53) compared to stable weight. Besides, the association of weight gain more than 10 kg in early adulthood with cardiometabolic risk was even stronger in those with low CVH score in midlife (HR: 2.44; 95%CI: 2.01-2.97 for incident cardiovascular events; HR: 2.20; 95%CI: 1.90-2.55 for incident diabetes) or with few ideal cardiovascular health metrics in midlife.Our study indicated that weight gain in early adulthood was associated with significantly increased risk of cardiometabolic diseases. And the association could be stronger in those with poor CVH profiles in midlife. These findings confirmed the significance of weight management during early adulthood and suggested that individuals who experienced substantial weight gain in early life should be encouraged to maintain good CVH status in Chinese population.© 2023. The Author(s).