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Size at birth and carotid atherosclerosis in later life
Catharine R Gale1, Hazel E Ashurst, Nigel F Hall
1MRC Environmental Epidemiology Unit (University of Southampton), Southampton General Hospital, Hants, UK. crg@mrc.soton.ac.uk
Insights
Low birth weight may not increase the risk of atherosclerosis. This study found little evidence linking impaired fetal growth to increased carotid artery thickening or stenosis in later life for elderly individuals.
Area of Science:
- Cardiovascular Epidemiology
- Developmental Origins of Health and Disease (DOHaD)
- Gerontology
Background:
- Low birth weight is linked to increased risks of stroke and coronary heart disease.
- Atherogenesis is a potential mechanism, but direct evidence is limited.
- Understanding fetal growth's impact on adult cardiovascular health is crucial.
Purpose of the Study:
- To investigate the association between birth weight and measures of atherogenesis in elderly individuals.
- To examine carotid artery stenosis and intima-media thickness in relation to birth measurements.
Main Methods:
- Duplex ultrasonography used to assess extra-cranial carotid arteries in 389 elderly Sheffield residents.
- Birth weight, head circumference, and abdominal circumference data were utilized.
- Statistical analyses adjusted for gestational age and cardiovascular risk factors.
Main Results:
- A trend for higher carotid stenosis (>30%) in individuals with low birth weight (<6.5 lbs) was not statistically significant.
- In women, birth size and head circumference showed non-significant trends towards increased intima-media thickness.
- In men, higher birth weight and larger abdominal circumference were associated with increased intima-media thickness after adjustments.
Conclusions:
- The study provides limited evidence that impaired fetal growth directly increases susceptibility to atherogenesis.
- Associations between birth size and adult cardiovascular markers appear complex and sex-specific.
- Further research is needed to fully elucidate the relationship between fetal development and long-term cardiovascular health.
Abstract:
Several studies have shown that low birthweight is associated with a higher risk of stroke and coronary heart disease in later life. Increased atherogenesis may be one underlying mechanism, but few studies have examined this directly. We used duplex ultrasonography to assess the extra-cranial carotid arteries of 389 elderly men and women born and still living in Sheffield, UK, whose recorded birth measurements were available. Men and women who had weighed 6.5 lbs or less at birth had a higher risk of having carotid stenosis >30% than those who weighed over 7.5 lbs, but this trend was not statistically significant (OR 1.8, 95% CI 1.0-3.3). Women who had been lighter or who had a smaller head circumference at birth tended to have an increased intima-media thickness, but these relations ceased to be statistically significant after adjustment for gestational age and cardiovascular risk factors. In men, by contrast, an increased intima-media thickness was associated with having been heavier at birth (P=0.049) or having had a larger abdominal circumference at birth (P=0.040), after adjustment for gestational age and cardiovascular risk factors. These results provide little evidence that impaired fetal growth increases susceptibility to atherogenesis.