Early life factors and their relevance to intima-media thickness of the common carotid artery in early adulthood

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Fig 1. Participant flowchart diagram for IMT and early life factors.

Fig 2. Association between maternal age at child birth and intima media thickness.

Maternal age at child birth by tertiles of average IMT adjusted for age by the residual method in young adulthood among female participants. Data are means and 95% CI adjusted for adult age at IMT measurement, the physician taking the IMT measurement and birth year (residuals of birth year were calculated on age at IMT measurement), (n = 142).

Fig 3. Association between maternal age at child birth and intima media thickness.

Maternal age at child birth by tertiles of average IMT adjusted for age by the residual method in young adulthood among male participants. Data are means and 95% CI adjusted for adult age at IMT measurement, the physician taking the IMT measurement and birth year (residuals of birth year were calculated on age at IMT measurement), (n = 120).