Increased Aortic Intima-Media Thickness Is Related to Lipid Profile in Newborns with Intrauterine Growth Restriction

Abstract

Background and Aim: Low birth-weight is known to be associated with an increase in cardiovascular risk similar to that seen with major environmental risk factors, such as cigarette smoking or hypertension. Much epidemiological evidence has linked low birth-weight with hypertriglyceridaemia. Method: We measured aortic wall thickness by ultrasonography and lipid profile in 40 newborn babies with intrauterine growth restriction and 40 controls. Results: Maximum and mean aortic intima-media thickness were significantly higher in the babies with intrauterine growth retardation (0.58 ± 0.06, 0.52 ± 0.03 mm, respectively) than in controls (0.44 ± 0.05, 0.40 ± 0.03 mm, p < 0.0001, p < 0.0001, respectively), more so after adjustment for birth-weight (maximum intima-media thickness: 0.23 ± 0.03 mm/kg vs. 0.12 ± 0.02 mm/kg, p < 0.0001; mean intima-media thickness: 0.21 ± 0.02 mm/kg vs. 0.11 ± 0.01 mm/kg, p < 0·0001). Serum triglyceride levels were significantly higher in the intrauterine growth retardation group (48.9 ± 14.8 mg/dl) compared with the control group (32.5 ± 9.8 mg/dl, p < 0.0001). The mean body mass index, prepregnancy weight, weight gain during pregnancy, maternal LDL cholesterol level and, height of the mothers were significantly lower in the intrauterine growth retardation group compared with the control group. For maximum aIMT, significant associations included the ponderal index (p = <0.01), length (p = 0.01) and serum triglyceride levels of infants (p = 0.02). Conclusion: Newborn babies with growth restriction have significant maximum aortic thickening with hypertriglyceridaemia, suggesting that prenatal events might predispose to later cardiovascular risk.

Neonatal Arterial Morphology Is Related to Body Size in Abnormal Human Fetal Growth

“…21 Moreover, our reported arterial layer thicknesses are much thinner than those previously reported, indicating an important difference in methodology attributable improved axial resolution, as recently discussed. 26 However, our results may not be directly comparable to the studies by Skilton et al, 13 Koklu et al, 14 Gunes et al, 15 Koklu et al, 16 Cosmi et al, 17 and Zanardo, 18 as these examined the aorta and not the carotid, brachial, or femoral Femoral artery lumen diameter, intima-media thickness, and intima-media-adventitia thickness in relation to gestational age and body surface area in large for gestational age (blue), small for gestational age (red), and appropriate for gestational age (white) neonates. Layers were below resolution in the smallest neonates as indicated by the lack of data at the level of <0.05 mm.…”

“…[13][14][15][16][17][18][19][20] Our findings are inconsistent with studies reporting an increase in arterial wall layer thickness in LGA neonates 26,27 but in concordance with previous autopsy studies on SGA neonates. 21 Moreover, our reported arterial layer thicknesses are much thinner than those previously reported, indicating an important difference in methodology attributable improved axial resolution, as recently discussed.…”

“…Assessing the vascular phenotype during the early stages of life is necessary for distinguishing longitudinal changes taking place before and after birth. Increased sonographic IMTs [13][14][15][16][17][18][19][20] and normal histological IMTs 21 have been reported in SGA neonates. Smaller arterial lumen diameters (LDs) and reduced microvasculature have also been reported in this population.…”

Ethnic differences in maternal total cholesterol and triglyceride levels during pregnancy: the contribution of demographics, behavioural factors and clinical characteristics

“…In addition, increased cholesterol deposition in foetal aortas could give rise to exaggerated lipid-rich lesions in both aortic arch and abdominal aorta in children (Napoli et al, 1997(Napoli et al, , 1999. These observations correspond to the 'foetal origins hypothesis', which states that an unfavourable intrauterine metabolic environment predisposes for premature cardiovascular disease (Koklu et al, 2006;Skilton, 2008).…”

Aortic Intima-Media Thickness, Serum IGF-I, IGFBP-3, and Leptin Levels in Intrauterine Growth-Restricted Newborns of Healthy Mothers

“…Although the clinical complications of atherosclerosis occur in adult life, the process of atherogenesis begins in childhood (4). In our previous study (5), we found that newborn babies with growth restriction had significant aortic thickening with hypertriglyceridemia.…”