title: Predictors of carotid intima-media thickness and carotid plaque in young Indian adults: the New Delhi birth cohort.
abstract: BACKGROUND
  Carotid intima-media thickness (CIMT) and carotid plaques represent preclinical markers of atherosclerosis. We sought to describe predictors of CIMT and carotid plaques, including early life growth, in a young urban Indian cohort free of clinical cardiovascular disease (CVD).
  
  
  METHODS
  In 2006-2009, we performed B-mode carotid ultrasound on 600 participants (mean [SD] age 36 [1.1] years; 45% women) from the New Delhi Birth Cohort to evaluate CIMT and carotid plaques (>1mm). Height and weight were recorded at birth, 2 and 11 years of age. Data on CVD risk factors, anthropometry, medical history, socio-economic position, and lifestyle habits were collected in 1998-2002.
  
  
  RESULTS
  Mean (SD) CIMT for men and women was 0.91 (0.12) and 0.86 (0.13) mm, respectively. Carotid plaque was present in 33% of men and 26% of women. Waist circumference in 1998-2002 was positively associated with CIMT (β coefficient 0.26 mm [0.17, 0.36] per SD) and carotid plaque (OR 1.27 [1.06,1.52] per SD) in 2006-2009. Higher triglycerides, PAI-1, insulin resistance, and diastolic blood pressure, metabolic syndrome, and lower HDL-cholesterol and physical activity predicted higher CIMT and/or plaque (p<0.05). Longer length at 2 years was associated with higher CIMT (p<0.05). These associations were attenuated after adjusting for adult waist circumference.
  
  
  CONCLUSIONS
  These are the first prospective data from India showing that early life growth, adult socio-demographics, and CVD risk factors predict future CIMT and/or carotid plaque. These relationships appear primarily mediated through central adiposity, highlighting the importance of maintaining a healthy weight in early adulthood to prevent CVD.
authors.affiliation: The Heart Centre, New Delhi, India.
authors.forename: Anita
authors.initials: A
authors.lastname: Khalil
authors.forename: Mark D
authors.initials: MD
authors.lastname: Huffman
authors.forename: Dorairaj
authors.initials: D
authors.lastname: Prabhakaran
authors.forename: Clive
authors.initials: C
authors.lastname: Osmond
authors.forename: Caroline H D
authors.initials: CH
authors.lastname: Fall
authors.forename: Nikhil
authors.initials: N
authors.lastname: Tandon
authors.forename: Ramakrishnan
authors.initials: R
authors.lastname: Lakshmy
authors.forename: Poornima
authors.initials: P
authors.lastname: Prabhakaran
authors.forename: S K Dey
authors.initials: SK
authors.lastname: Biswas
authors.forename: Siddarth
authors.initials: S
authors.lastname: Ramji
authors.forename: Harshpal S
authors.initials: HS
authors.lastname: Sachdev
authors.forename: Santosh K
authors.initials: SK
authors.lastname: Bhargava
mesh_terms: D000328:Adult; D002340:Carotid Artery Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness / Q000639:trends*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007231:Infant, Newborn; D008297:Male; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000453:epidemiology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors