Impaired endothelial function and increased carotid stiffness in 9-year-old children with low birthweight.
BACKGROUND
Low birthweight (LBW) has been associated with an increased incidence of adult cardiovascular disease. Endothelial dysfunction and loss of arterial elasticity are early markers of hypertension and atherosclerosis. We studied the prevalence of these markers in 44 healthy, prepubertal (age 9+/-1.3 years) children, 22 with LBW for age.


RESULTS
Endothelial function in skin was tested with the local application of acetylcholine (inducing endothelium-dependent vasodilation) and nitroglycerin (endothelium-independent vasodilation), and local perfusion changes were measured with the laser Doppler method. The elastic properties of the abdominal aorta and common carotid artery were measured with an ultrasonic vessel-wall tracking system. Endothelium-dependent vasodilation was lower in children with LBW (88+/-33 perfusion units [PU]) than in normal-birthweight controls (133+/-34 PU, P<0.001). There was no difference in aortic or carotid elasticity between the 2 groups, but a negative correlation was found between birthweight and stiffness of the carotid artery wall (r=-0.45, P<0.01). Endothelium-independent vasodilation and blood pressure were similar in the 2 groups.


CONCLUSIONS
Schoolchildren with a history of LBW show impaired endothelial function and a trend toward increased carotid stiffness. These findings may be early expressions of vascular compromise, contributing to susceptibility to disease in adult life.
Martin
H
H
Department of Women and Child Health, Division of Neonatology, Karolinska Hospital, Department of Clinical Science, Unit of Obstetrics and Gynecology, Huddinge Hospital, Karolinska Institutet, Stockholm, Sweden. helena.martin@kbh.ki.se
Hu
J
J
Gennser
G
G
Norman
M
M
D000109:Acetylcholine / Q000494:pharmacology; D000328:Adult; D000367:Age Factors; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002339:Carotid Arteries / Q000473:pathology* / Q000503:physiopathology; D002648:Child; D004548:Elasticity; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D005996:Nitroglycerin / Q000494:pharmacology; D012737:Sex Factors; D014664:Vasodilation / Q000187:drug effects
D005996:Nitroglycerin; D000109:Acetylcholine