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Excess early postnatal weight gain leads to thicker and stiffer arteries in young children
Annemieke M V Evelein1, Frank L J Visseren, Cornelis K van der Ent
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Heidelberglaan, Utrecht, The Netherlands. a.m.v.evelein@umcutrecht.nl
Insights
Excess early weight gain in infants is linked to thicker arterial walls by age 5. For babies born smaller, this rapid weight gain also results in stiffer arteries, indicating early cardiovascular risk.
Area of Science:
- Pediatric cardiovascular health
- Developmental origins of health and disease (DOHaD)
Background:
- Early life growth patterns are linked to later cardiovascular disease (CVD).
- It remains unclear if vascular changes from excess early weight gain manifest in childhood.
Purpose of the Study:
- To investigate if excess early weight gain in infancy is associated with vascular changes in early childhood.
Main Methods:
- Utilized data from the WHISTLER birth cohort, analyzing weight and height Z-scores from birth to 3 months.
- Assessed carotid artery intima-media thickness, distensibility, and elastic modulus via ultrasound in 333 children at age 5.
- Examined the association between weight gain for length gain (WLG) and vascular characteristics using generalized linear modeling.
Main Results:
- A 1 SD increase in WLG was associated with a 5.1 μm increase in carotid intima-media thickness (P = .01).
- Significant interactions were found between birth size and WLG, indicating that thinner infants at birth had stiffer arteries with increasing WLG (P = .04 for distensibility, P = .03 for elastic modulus).
Conclusions:
- Excess early postnatal weight gain contributes to vascular changes, specifically thicker arterial walls, in early childhood.
- In infants born relatively thin, excess early weight gain also leads to arterial stiffening.
- These findings support the hypothesis that early life growth patterns influence cardiovascular disease risk.
Background:
Although early life growth pattern is associated with cardiovascular disease later in life, it is unknown whether vascular changes associated with excess early weight gain already occur in early childhood.
Methods:
In the Wheezing-Illnesses-Study-Leidsche-Rijn (WHISTLER) birth cohort, weight and height from birth to 3 months of age were used to calculate Z-scores of individual weight and length gain rates. In the first 333 children who turned 5 years old, intima-media thickness, distensibility, and elastic modulus of the carotid artery were measured ultrasonographically. The association between weight gain rate for length gain rate (WLG), as a measure of excess weight gain, and vascular characteristics was assessed by generalized linear modeling. Interaction between birth size and WLG was tested.
Results:
Per 1 SD increase in WLG, carotid intima-media thickness was 5.1 μm (95% confidence interval, 1.0-9.2; P value = .01) higher (adjusted for age, gender, current height, and observer). The thinner the children were at birth, the stiffer the arteries were with increasing WLG (interaction between birth size and WLG-distensibility: P = .04; elastic modulus: P = .03).
Conclusion:
Excess early postnatal weight gain leads to vascular changes already in early childhood, characterized by thicker arterial walls. In children who are relatively thin at birth, excess early postnatal weight gain also leads to stiffer arteries. This supports the view that cardiovascular disease risk is associated with growth pattern early in life.
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