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Size at birth and coronary artery disease in a population with high birth weight
Ingibjorg Gunnarsdottir1, Bryndis E Birgisdottir, Inga Thorsdottir
1Unit for Nutrition Research, Landspitali-University Hospital, Reykjavik, Iceland. ingigun@hi.is
Insights
Birth size impacts coronary artery disease (CAD) risk, with adult body size modifying this effect. This highlights the importance of both prenatal and postnatal environmental factors in CAD development.
Area of Science:
- Cardiovascular Epidemiology
- Human Growth and Development
- Public Health
Background:
- Epidemiologic studies link fetal and childhood growth to later coronary artery disease (CAD).
- The role of adult body size in the birth size-CAD relationship remains understudied.
Purpose of the Study:
- Investigate the association between birth size, adult body size, and CAD.
- Examine these associations in a unique Icelandic population with higher birth weight and lower CAD incidence.
Main Methods:
- Retrospective cohort study of 2399 men and 2376 women born in Reykjavik (1914-1935).
- Ascertained fatal or nonfatal CAD events.
- Utilized birth records and adult anthropometric data from the Reykjavik Study.
Main Results:
- In men, shorter birth length (< 50.5 cm) was inversely associated with CAD risk, especially when followed by tall adult stature.
- A U-shaped relationship between birth size and CAD was observed in women.
- Adult body size modified the effect of birth size on CAD risk.
Conclusions:
- Birth size influences CAD risk, with adult body size acting as a significant modifier.
- Environmental factors during both prenatal and postnatal periods are crucial for CAD development.
- Larger birth size in Icelanders may contribute to the lower observed CAD incidence and mortality.
Background:
Epidemiologic studies suggest a link between fetal and childhood growth and later coronary artery disease (CAD). The influence of adult body size on the relation between birth size and CAD has not been thoroughly studied.
Objective:
We investigated the association between birth and adult sizes and CAD within a population with higher birth weight and a lower incidence of and mortality rate from CAD than those seen in other Scandinavian populations.
Design:
Fatal or nonfatal CAD was ascertained in 2399 men and 2376 women born in the Greater Reykjavik area between 1914 and 1935. Birth size was obtained from the National Archives. Anthropometric measurements in adults were obtained from the randomized prospective Reykjavik Study.
Results:
CAD was inversely related to birth length (P for trend = 0.029) in men but was not significantly related to birth weight or ponderal index (kg/m(3)). In men who were born short (< or = 50.5 cm) and who became tall adults (either 175-180.5 or > 180.5 cm), the odds ratios (95% CI) for CAD were 1.9 (1.1, 3.1) and 2.2 (1.2, 4.0), respectively, when compared with men in the reference group (those born 52.5-54.0 cm long). A U-shaped relation between birth size and CAD was found for women.
Conclusions:
Size at birth has an effect on CAD, but the effect is modified by adult body size. This confirms that environmental factors operate in both the prenatal and postnatal periods with regard to the development of CAD. The large birth size seen among Icelanders may explain the lower incidence and mortality rate of CAD in Iceland than are seen in other white populations.