From the Boden Institute of Obesity, Nutrition, Exercise, and Eating Disorders (M.R.S), and Sydney Medical School (D.S.C.), University of Sydney, Sydney, Australia; Research Centre of Applied and Preventive Cardiovascular Medicine (N.S., M.J., O.T.R.), Department of Clinical Physiology and Nuclear Medicine (O.T.R.), and Department of Medicine (J.S.A.V., M.J.), University of Turku and Turku University Hospital, Turku, Finland; Department of Clinical Physiology and Nuclear Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland (T. Laitinen); Department of Clinical Chemistry, Fimlab Laboratories (I.S., T. Lehtimäki), and Department of Clinical Physiology (M.K.), University of Tampere and Tampere University Hospital, Tampere, Finland; Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland (P.W.); and Department of Pediatrics, University of Oulu, Oulu, and Department of Pediatrics, Vaasa Central Hospital, Vaasa, Finland (L.T.).
There is some evidence that people born with high birth weight may be at increased risk of cardiovascular disease in adulthood. Details of the underlying mechanisms remain unknown. We sought to determine whether people born large for gestational age have poor arterial health, increased adiposity, and a poor cardiovascular risk factor profile.
Carotid intima-media thickness, brachial flow-mediated dilatation, and cardiovascular risk factors were compared between young adults (24-45 years) born at term who were large for gestational age (birth weight >90th percentile; n=171), and a control group with normal birth weight (50-75th percentile; n=525), in the Cardiovascular Risk in Young Finns Study. Those born large for gestational age had higher body mass index throughout childhood, adolescence, and as young adults (26.4 kg/m(2) [SD 4.9], versus normal birth weight 25.1 kg/m(2) [SD 4.6]; P=0.002), and 2-fold greater risk of obesity. Other cardiovascular risk factors and arterial function did not differ; however, carotid intima-media thickness was increased in people born large for gestational age (0.60 mm [SD 0.09], versus normal birth weight 0.57 mm [SD 0.09]; P=0.003), independent of cardiovascular risk factors (P=0.001 after adjustment). Both obesity and high birth weight were independently associated with carotid intima-media thickness in a graded and additive fashion.
Young adults born large for gestational age are more likely to be obese, yet have an otherwise healthy cardiovascular risk profile. Nonetheless, they have increased carotid intima-media thickness, a marker of subclinical atherosclerosis, consistent with an increased risk of cardiovascular disease.