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Deterioro del crecimiento fetal y aterosclerosis de las arterias carótidas y periféricas
C N Martyn1, C R Gale, S Jespersen
1MRC Environmental Epidemiology Unit, Southampton General Hospital, UK. c.martyn@mrc.soton.ac.uk
Lancet (London, England)
|July 31, 1998
Resumen
El bajo peso al nacer está relacionado con un aumento de la aterosclerosis, particularmente en las arterias carótidas. El deterioro del crecimiento fetal puede conducir a cambios vasculares a largo plazo, aumentando el riesgo de enfermedad cardiovascular en la edad adulta.
Área de la Ciencia:
- Biología vascular Biología vascular
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
Sus antecedentes:
- Los estudios epidemiológicos indican un mayor riesgo de enfermedad coronaria y accidente cerebrovascular en adultos con bajo peso al nacer.
- Los mecanismos que vinculan el bajo peso al nacer con las enfermedades cardiovasculares en adultos siguen sin estar claros.
- La aterosclerosis es un factor clave en el desarrollo de enfermedades cardiovasculares.
Objetivo del estudio:
- Investigar si el deterioro del crecimiento fetal, indicado por el bajo peso al nacer, aumenta el riesgo de aterosclerosis.
- Para evaluar las arterias carótidas y de las extremidades inferiores en individuos alrededor de los 70 años de edad con los datos disponibles de peso al nacer.
Principales métodos:
- El estudio incluyó a 322 participantes (de 2232 nacidos entre 1922 y 1926) con registros de nacimiento disponibles.
- Aterosclerosis de la arteria carótida evaluada mediante ultrasonografía dúplex en 181 participantes.
- La aterosclerosis de la arteria de las extremidades inferiores se evaluó utilizando el índice de presión braquial del tobillo (ABPI) en 186 participantes.
Principales resultados:
- El menor peso al nacer se asoció con la mayor prevalencia y gravedad de la aterosclerosis carotídea.
- Las personas que pesaban 6.5 libras o menos al nacer tenían un riesgo significativamente mayor de estenosis carotídea (OR 5.3).
- Se observó una tendencia al aumento de la aterosclerosis de las extremidades inferiores en los individuos con menor peso al nacer, pero no fue estadísticamente significativa (OR 2.3).
Conclusiones:
- El aumento de la aterogénesis (acumulación de placa) es un mecanismo potencial que vincula el deterioro del crecimiento fetal a las enfermedades cardiovasculares.
- Las restricciones del crecimiento fetal pueden causar cambios duraderos en la estructura vascular y el metabolismo.
- El bajo peso al nacer es un factor de riesgo significativo para la aterosclerosis adulta, especialmente la enfermedad de la arteria carótida.
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