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Early postnatal weight gain could increase risk for CVD
The risk for cardiovascular disease is linked to postnatal weight gain early in life, study results published in the Journal of Clinical Endocrinology and Metabolism suggest.
“Postnatal growth has previously been shown to be a determinant of later life CVD risk factors and CVD events. The present study shows that among healthy young children, excess early postnatal weight gain leads to thicker arterial walls,” researchers from the Netherlands wrote.
These findings were part of the Wheezing Illnesses Study Leidsche Rijn (WHISTLER) birth cohort. Researchers calculated z scores of individual weight and length gain rates in patients aged birth to 3 months. Of the first 333 of 461 children included who reached age 5 years, the researchers measured intima-media thickness, distensibility and elastic modulus of the carotid artery via ultrasonography. Their weight gain relative to length gain (WLG) was also measured.
According to data, higher WLG was linked to higher weight, height BMI and waist circumference at age 5 years. Additionally, carotid intima-media thickness was 5.1 mcm (95% CI, 1.0-9.2) greater per 1 standard deviation increase in postnatal WLG.
Further data indicate children thinner at birth displayed stiffer arteries with increasing WLG.
“These results support the view that an increased CVD risk in adulthood is associated with different growth patterns early in life,” the researchers concluded.
Disclosure: The researchers report no relevant financial disclosures.
Perspective
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It is well known that cardiovascular disease occurs early in childhood. The Bogalusa Heart Study, a long-term study of predictors of CVD in a parish near New Orleans found that children who died from accidents or non-disease-related causes already had fatty streaks in their coronary arteries and aortas at age 3. These lesions are reversible and were related to BMI, LDL and blood pressure, and inversely related to HDL. Autopsy studies further revealed raised fibrous plaques, the early findings of atherosclerosis, in aortas and coronary arteries, which were again related to BMI, LDL and BP in children as young as 8 years. However, the WHISTLER study was the first to evaluate CV status in a population based cohort of 461 children measuring both length and weight gain over the first 3 months of life on later development of arterial thickness using ultrasound measurements of carotid intima media thickness (IMT) and of arterial stiffness high resolution echo-tracking technology to measure arterial distensibility. Weight gain was adjusted for length gain. This weight length gain (WLG) score was associated with carotid IMT at 5 years, though postnatal weight gain alone was not associated with carotid IMT after adjusting for height at 5 years, indicating that excess weight gain in the first 3 months of life was associated with thicker vessels at the age of school entrance. Those children who were thin at birth but had excess weight gain in the first 3 months of life had stiffer arteries at 5 years.
Previous studies have shown an association between rapid weight gain in early life and insulin resistance. These studies further expand our knowledge of the association of early excess weight gain and vascular abnormalities, and stress the importance of measuring not only the rapidity of weight gain but also the rate of length increase.