Abstract
Early life factors may predispose an offspring to cardiovascular disease in later life; relevance of these associations may extend to ‟healthy" people in Western populations. We examined the prospective associations between early life factors and adult carotid intima-media thickness (IMT), a surrogate marker of atherosclerosis, in a healthy German population. We studied term participants (n = 265) of the DONALD Study, with bilateral sonographic measurements of IMT (4-8 measurements on both left and right carotid artery) at age 18-40 years and prospectively collected data on early life factors (maternal and paternal age at child birth, birth weight, gestational weight gain and full breastfeeding (>17weeks). Mean IMT values were averaged from mean values of both sides. Associations between early life factors and adult IMT were analyzed using multivariable linear regression models with adjustment for potential confounders. Adult mean IMT was 0.56mm, SD 0.03, (range: 0.41 mm-0.78 mm). Maternal age at child birth was of relevance for adult IMT, which was sex specific: Advanced maternal age at child birth was associated with an increased adult IMT among female offspring only (β 0.03, SE 0.009 mm/decade, P = 0.003), this was not affected by adult waist circumference, BMI or blood pressure. Other early life factors were not relevant for IMT levels in males and females. This study suggests that advanced maternal age at child birth is of prospective relevance for adult IMT levels in a healthy German population and this association may be of adverse relevance for females only.
Highlights
Interest in research on early life exposures as possible determinants of disease in later life greatly increased since the discovery of the Barker hypothesis that cardiovascular disease (CVD) has its origins in early life [1]
Maternal age at child birth was of relevance for adult intima media thickness (IMT), which was sex specific: Advanced maternal age at child birth was associated with an increased adult IMT among female offspring only (β 0.03, SE 0.009 mm/decade, P = 0.003), this was not affected by adult waist circumference, BMI or blood pressure
This study suggests that advanced maternal age at child birth is of prospective relevance for adult IMT levels in a healthy German population and this association may be of adverse relevance for females only
Summary
Interest in research on early life exposures as possible determinants of disease in later life greatly increased since the discovery of the Barker hypothesis that cardiovascular disease (CVD) has its origins in early life [1]. The atherosclerotic process begins early in life, i.e. many years before cardiovascular complications develop later in life [2]. Increases in carotid intima media thickness (IMT) and endothelial dysfunction have been suggested as preliminary indications of atherosclerotic plaque development [4, 5] alterations in the IMT have been indicated as a marker of subclinical atherosclerosis [6,7,8] with a high IMT shown to correlate with CV risk factors [6, 9, 10], and to predict CVD [10, 11]. Life factors may predispose an offspring to cardiovascular disease in later life; relevance of these associations may extend to ‟healthy” people in Western populations.
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