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Associations between birth weight and adult apolipoproteins: The LifeGene cohort
Shantanu Sharma1, Louise Bennet1,2, Agne Laucyte-Cibulskiene1,3,4
1Department of Clinical Sciences in Malmö, Lund University, Lund, Sweden.
Insights
Lower birth weight is linked to higher apoB/apoA1 ratios, indicating increased cardiovascular disease (CVD) risk in adulthood. Improving maternal and child health may prevent future CVD.
Area of Science:
- Epidemiology
- Cardiovascular Disease Research
- Lipid Metabolism
Background:
- Early life factors are potential predictors of cardiovascular disease (CVD), but underlying mechanisms require further investigation.
- Emerging evidence suggests a link between early life factors and apolipoproteins, which are implicated in CVD.
- This study aimed to explore the relationship between birth characteristics and adult apolipoprotein levels (apoA1, apoB, and their ratio).
Purpose of the Study:
- To investigate the association between birth variables (birth weight, gestational age) and adult apolipoprotein levels (apoA1, apoB, apoB/apoA1 ratio).
- To examine the relationship between birth weight and other cardiovascular disease risk factors, including lipids and triglycerides.
- To provide insights into the long-term impact of early life factors on cardiovascular health.
Main Methods:
- Utilized data from the prospective, population-based LifeGene Study.
- Included 10,093 participants with birth information and adult lipoprotein levels.
- Employed univariate and multivariate general linear regression analyses to assess associations, adjusting for covariates like age, sex, BMI, and smoking history.
Main Results:
- A 1 kg increase in birth weight was associated with a significant increase in apoA1 levels (0.022 g/L) and a decrease in apoB levels (0.023 g/L).
- Inverse associations were observed between birth weight and the apoB/apoA1 ratio.
- Birth weight showed a significant inverse association with triglyceride levels, but not with total cholesterol.
Conclusions:
- Lower birth weight is associated with an adverse adult apolipoprotein profile (higher apoB/apoA1 ratio), suggesting an elevated risk for future cardiovascular disease.
- The findings underscore the importance of preconception care and pregnancy interventions to improve maternal and child outcomes.
- Interventions aimed at optimizing maternal and child health may have long-term benefits for cardiovascular disease prevention by influencing lipid profiles.
Background:
Early life factors may predict cardiovascular disease (CVD), but the pathways are still unclear. There is emerging evidence of an association of early life factors with apolipoproteins, which are linked to CVD. The study objective was to assess the associations between birth variables and adult apolipoproteins (apoA1 and apoB, and their ratio) in a population-based cohort.
Methods:
The LifeGene Study is a prospective cohort comprising index participants randomly sampled from the general population. Blood samples were collected between 2009 and 2016. In this sub-study, we used birth variables, obtained from a national registry for all participants born 1973 or later, including birth weight and gestational age, while adult CVD risk factors included age, sex, body mass index (BMI), lipids, and smoking history. We employed univariate and multivariate general linear regression to explore associations between birth variables, lipid levels and other adult CVD risk factors. The outcomes included non-fasting apoA1 and apoB and their ratio, as well as total cholesterol and triglycerides. A total of 10,093 participants with both birth information and lipoprotein levels at screening were included. Of these, nearly 42.5% were men (n = 4292) and 57.5% were women (n = 5801).
Results:
The mean (standard deviation) age of men was 30.2 (5.7) years, and for women 28.9 (5.8) years. There was an increase of 0.022 g/L in apoA1 levels per 1 kg increase in birth weight (p = 0.005) after adjusting for age, sex, BMI, gestational age, and smoking history. Similarly, there was a decrease of 0.023 g/L in apoB levels per 1 kg increase in birth weight (p<0.001) after adjusting for the same variables. There were inverse associations of birth weight with the apoB/apoA1 ratio. No independent association was found with total cholesterol, but with triglyceride levels (ẞ-coefficient (95% Confidence Interval); -0.067 (-0.114, -0.021); p-value 0.005).
Conclusions:
Lower birth weight was associated with an adverse adult apolipoprotein pattern, i.e., a higher apoB/apoA1 ratio, indicating increased risk of future CVD manifestations. The study highlights the need of preconception care and pregnancy interventions that aim at improving maternal and child outcomes with long-term impacts for prevention of cardiovascular disease by influencing lipid levels.
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