The relation between birth weight and intima-media thickness in middle-aged adults.
BACKGROUND
Birth weight has been found to be inversely associated with the risk of coronary heart disease and stroke, although the mechanisms for this association remain unclear. Here, we investigate the relation between reported birth weight and atherosclerosis in middle age.


METHODS
We included the 9817 participants (age 44-65) in the Atherosclerosis Risk in Communities (ARIC) study who were neither a twin nor born prematurely. Carotid atherosclerosis was assessed as intima-media thickness measured by B-mode ultrasound. We studied the association with recalled exact birth weight, and for those unable to recall exact birth weight, with recalled birth weight category.


RESULTS
Mean intima-media thickness (+/- standard deviation) was 0.73 +/- 0.17 mm. Mean birth weight for the 4635 participants recalling exact birth weight was 3.49 +/- 0.71 kg. A further 4946 participants recalled birth weight category, with 4730 (96%) reporting "medium" birth weight. In univariate analysis, birth weight and intima-media thickness were positively related. However, adjustment for confounding factors reduced the association to only a 0.004 mm higher intima-media thickness (95% CI = - 0.003 to 0.011) mm per 1 kg of birth weight. The same pattern of univariate positive relationship and attenuation with adjustment was seen for birth weight category and intima-media thickness. There was no evidence of interaction between adult body mass index (BMI) and birth weight, or of interaction between category of adult BMI and birth weight category. An inverse relation between birth weight category and intima-media thickness was seen only for those in the lowest category of adult BMI (BMI <25 kg/m).


CONCLUSIONS
We found no evidence of a clinically significant relation between birth weight and carotid atherosclerosis.
Department of Social Medicine, University of Bristol, Canynge Hall, Whiteladies Road, Bristol, UK. kate.tilling@bristol.ac.uk
Kate
K
Tilling
George Davey
GD
Smith
Lloyd
L
Chambless
Kathryn
K
Rose
June
J
Stevens
Debbie
D
Lawlor
Moyses
M
Szklo
D000328:Adult; D000368:Aged; D001724:Birth Weight; D001794:Blood Pressure; D015992:Body Mass Index; D002340:Carotid Artery Diseases / Q000453:epidemiology* / Q000209:etiology; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking; D012959:Socioeconomic Factors; D017539:Tunica Intima / Q000473:pathology*; D014481:United States / Q000453:epidemiology