Flow-mediated dilation in 9- to 11-year-old children : The influence of intrauterine and childhood factors

• Published in: Circulation (New York, N.Y.) N.Y.), 1997-10, Vol.96 (7), p.2233-2238
• Main Authors: LEESON, C. P. M, WHINCUP, P. H, COOK, D. G, DONALD, A. E, PAPACOSTA, O, LUCAS, A, DEANFIELD, J. E
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Birth Weight; Blood Glucose - metabolism; Blood Pressure; Brachial Artery - anatomy & histology; Brachial Artery - diagnostic imaging; Brachial Artery - physiology; Cardiology. Vascular system; Cardiopathies: etiologic forms (general aspects and miscellaneous); Cardiovascular Diseases - epidemiology; Child; Cholesterol, LDL - blood; England; Female; Heart; Humans; Lipids - blood; Medical sciences; Muscle, Smooth, Vascular - anatomy & histology; Muscle, Smooth, Vascular - diagnostic imaging; Muscle, Smooth, Vascular - physiology; Parity; Pregnancy; Regional Blood Flow; Risk Factors; Socioeconomic Factors; Tobacco Smoke Pollution; Ultrasonography; Vasodilation
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/01.CIR.96.7.2233

Early life factors, particularly size at birth, may influence later risk of cardiovascular disease, but a mechanism for this influence has not been established. We have examined the relation between birth weight and endothelial function (a key event in atherosclerosis) in a population-based study of children, taking into account classic cardiovascular risk factors in childhood. We studied 333 British children aged 9 to 11 years in whom information on birth weight, maternal factors, and risk factors (including blood pressure, lipid fractions, preload and postload glucose levels, smoking exposure, and socioeconomic status) was available. A noninvasive ultrasound technique was used to assess the ability of the brachial artery to dilate in response to increased blood flow (induced by forearm cuff occlusion and release), an endothelium-dependent response. Birth weight showed a significant, graded, positive association with flow-mediated dilation (0.027 mm/kg; 95% CI, 0.003 to 0.051 mm/kg; P=.02). Childhood cardiovascular risk factors (blood pressure, total and LDL cholesterol, and salivary cotinine level) showed no relation with flow-mediated dilation, but HDL cholesterol level was inversely related (-0.067 mm/mmol; 95% CI, -0.021 to -0.113 mm/mmol; P=.005). The relation between birth weight and flow-mediated dilation was not affected by adjustment for childhood body build, parity, cardiovascular risk factors, social class, or ethnicity. Low birth weight is associated with impaired endothelial function in childhood, a key early event in atherogenesis. Growth in utero may be associated with long-term changes in vascular function that are manifest by the first decade of life and that may influence the long-term risk of cardiovascular disease.