Arterial Structural and Functional Characteristics at End of Early Childhood and Beginning of Adulthood: Impact of Body Size Gain during Early, Intermediate, Late and Global Growth

Abstract

An association between nutritional characteristics in theearlylife stages and the state of the cardiovascular (CV) system in early childhood itself and/or at the beginning of adulthood has been postulated. It is still controversial whether changes in weight, height and/or body mass index (BMI) during childhood or adolescence are independently associated with hemodynamics and/or arterial properties in early childhood and adulthood.

Aims: First, to evaluate and compare the strength of association between CVproperties (at 6 and 18 years (y)) and (a) anthropometric data at specific growth stages (e.g., birth, 6 y, 18 y) and (b) anthropometric changes during early (0-2 y), intermediate (0-6 y), late (6-18 y) and global (0-18 y) growth. Second, to determine whether the associations between CVproperties and growth-related body changes depend on size at birth and/or at the time of CVstudy. Third, to analyze the capacity of growth-related body size changes to explain hemodynamic and arterial properties in early childhood and adulthood before and after adjusting for exposure to CV risk factors. Anthropometric, hemodynamic (central, peripheral) and arterial parameters (structural, functional; elastic, transitional and muscular arteries) were assessed in two cohorts (children, n = 682; adolescents, n = 340). Data wereobtained and analyzed following identical protocols.

Results: Body-size changes in infancy (0-2 y) and childhood (0-6 y) showed similar strength of association with CV properties at 6 y. Conversely, 0-6, 6-18 or 0-18 ychanges were not associated with CV parameters at 18 y. The association between CV properties at 6 yand body-size changes during growth showed: equal or greater strength than the observed for body-size at birth, and lower strength compared to that obtained for current z-BMI. Conversely, only z-BMI at 18 y showed associations with CV z-scores at 18 y. Body size at birth showed almost no association with CVproperties at 6 or 18 y.

Conclusion: current z-BMI showed the greatest capacity to explain variations in CV properties at 6 and 18 y. Variations in some CV parameters were mainly explained by growth-related anthropometric changes and/or by their interaction with current z-BMI. Body size at birth showed almost no association with arterial properties at 6 or 18 y.

Keywords: adolescents; arterial stiffness; birth weight; blood pressure; body-size trajectories; cardio-metabolic health; children; growth; intima-media thickness.

Figure 1

1-A: Radial pulse wave obtained by applanation tonometry (SphygmoCor device); pSBP, pDBP, pPP: peripheral systolic, diastolic and pulse pressure. GTF: general transfer function. 1-B: Aortic wave derived using a GTF; augmented pressure (AP) and augmentation index (AIx) quantified from time-domain pulse wave analysis (PWA). cSBP, cDBP, cPP: central systolic, diastolic and pulsepressure. P1, P2: first and second pressure wave peaks. 1-C: Forward (Pf) and backward (Pb) components’ amplitude obtained from wave separation analysis (WSA). 2-A, 2-B: Methodological approach used to assess common carotid (CCA) and femoral (CFA) artery diameter and intima-media thickness (IMT). Z: acoustic impedance. 2-C: Software for IMT and diameter measurement (Hemodyn-4M). 3-A, 3-B: Methodological approach used to assess carotid-femoral pulse wave velocity (cfPWV). Δx: CCA-to-CFA distance. Δt1, Δt2: time delay between R (ECG) and CCA and CFA foot wave. Δt3: time delay between arterial waves. 3-C: Software for cfPWV measurement (SphygmoCor device).