Adenovirus 36 Antibodies Associated With Clinical Diagnosis of Overweight/Obesity but Not BMI Gain: A Military Cohort Study

Context: Obesity is a public health priority, which also threatens national security. Adenovirus 36 (Adv36) increases adiposity in animals and Adv36 antibody status is associated with human obesity, but it is unknown whether infection predicts the development of human adiposity. Objective: The objective of the study was to assess infection status and subsequent weight gain. Design: The study had a retrospective cohort design. Setting: The study was conducted at Air Force fitness testing and clinical encounters. Participants: Participants included Air Force male enlistees, aged 18–22 years, with a baseline body mass index (BMI) of 20–30 kg/m2 followed up from enlistment (beginning in 1995) until 2012 or separation from the Air Force. Exposure: Exposure included Adv36 infection status at the time of entry. Main Outcome Measure: Follow-up BMI, the primary outcome, and diagnosis of overweight/obesity by the International Classification of Diseases, ninth revision V85.25+ and 278.0* series (secondary outcome) were recorded. Results: The last recorded follow-up BMI was similar among infected and uninfected, 26.4 and 27.2 kg/m2, respectively (P > .05). However, infected individuals had a higher hazard of a medical provider's diagnosis of overweight/obese over time (hazard ratio 1.8, 95% confidence interval 1.0–3.1, P = .04), adjusted for baseline BMI. Additionally, infected individuals who were lean at baseline (BMI of 22.5 kg/m2) had a 3.9 times greater hazard of developing an overweight/obese clinical diagnosis (95% confidence interval 1.5–9.7, P = .004) compared with uninfected lean individuals after adjusting for interaction (P = .03) between infection and baseline BMI. Conclusions: The presence of Adv36 antibodies was not associated with higher BMI at baseline or follow-up within this military population. However, being infected was associated with developing a clinical diagnosis of overweight/obesity, especially among those lean at baseline.