Endothelial dysfunction in children with low birth weight, born at term

Aydın Akyüz; Şeref Alpsoy; Dursun Çayan Akkoyun; Burçin Nalbantoğlu; Birol Topçu; Feti Tülübaş; Burcu Özdilek; Mustafa Metin Donma

doi:10.5455/GMJ-30-2013-164

Authors

Aydın Akyüz Namık Kemal University, Faculty of Medicine, Department of Cardiology, Tekirdağ
Şeref Alpsoy Namık Kemal University, Faculty of Medicine, Department of Cardiology, Tekirdağ
Dursun Çayan Akkoyun Namık Kemal University, Faculty of Medicine, Department of Cardiology, Tekirdağ
Burçin Nalbantoğlu Namık Kemal University, Faculty of Medicine, Department of Pediatrics, Tekirdağ
Birol Topçu Namık Kemal University, Faculty of Medicine, Department of Biostatistics, Tekirdağ
Feti Tülübaş Namık Kemal University, Faculty of Medicine, Department of Biochemistry, Tekirdağ
Burcu Özdilek Namık Kemal University, Faculty of Medicine, Department of Pediatrics, Tekirdağ
Mustafa Metin Donma Namık Kemal University, Faculty of Medicine, Department of Pediatrics, Tekirdağ

DOI:

https://doi.org/10.5455/GMJ-30-2013-164

Keywords:

Atherosclerosis, birth weight, childhood, flow mediated dilatation

Abstract

The aim of our study was to assess whether endothelial function of the brachial artery is normal or impaired in children born at term with low birth weight (LBW) compared with their normal birth weight (NBW) peers, because there are still few data on this subject in children born at term with LBW. We compared brachial artery flow mediated dilatation (FMD) in children with LBW (n= 55, 30 male) and NBW (n= 45, 24 male) who were born at term. Age, gender, weight, height, waist and hip circumference, body mass index, body mass Z score, fasting glucose, total cholesterol, triglycerides, low density lipoprotein-cholesterol, high density lipoprotein- cholesterol, calcium, C-reactive protein, hemoglobin, serum insulin concentration, homeostatic model assessment index, creatinine values, brachial artery baseline diameter and brachial artery post dilatation diameter were similar in both groups (all p values >0.05). Compared with the NBW group, the LBW group had lower FMD (%) (6.68 ± 2.1 vs. 7.8 ± 1.9, p = 0.004). Brachial artery FMD was negatively correlated with waist circumferences (r = - 0.521, p < 0.001). A general linear analysis model, FMD as the dependent variable revealed significant effect of waist circumference (β ± SE:- 0.07±0.02, p<0.001) and LBW controlling for age (β ± SE: -0.028±0.01, p = 0.004). LBW closely affects to FMD. Therefore, the children with LBW born at term may be potentially at risk for early atherosclerosis compared with their peers.

Metrics

Metrics Loading ...

References

- Ferraz EM, Gray RH, Cunha TM. Determinants of preterm delivery and intrauterine growth retardation in north-east Brazil. Int J Epidemiol 1990;19(1):101-8.

Martyn CN, Barker DJ, Jespersen S, Greenwald S, Osmond C, Berry C. Growth in utero, adult blood pressure, and arterial compliance. Br Heart J 1995;73(2):116-21.

Chong E, Yosypiv IV. Developmental programming of hypertension and kidney disease. Int J Nephrol 2012;2012:760580.

Fewtrell MS, Doherty C, Cole TJ, Stafford M, Hales CN, Lucas A. Effects of size at birth, gestational age and early growth in preterm infants on glucose and insulin concentrations at 9- 12 years. Diabetologia 2000;43(6):714-7.

Singhal A, Cole TJ, Fewtrell M, Deanfield J, Lucas A. Is slower early growth beneficial for long-term cardiovascular health? Circulation 2004;109(9):1108-13.

Hovi P, Turanlahti M, Strang-Karlsson S, Wehkalampi K, Järvenpää AL, Eriksson JG, et al. Intima-media thickness and flow-mediated dilatation in the Helsinki study of very low birth weight adults. Pediatrics 2011;127(2):e304-11.

Leeson CP, Whincup PH, Cook DG, Donald AE, Papacosta O, Lucas A, et al. Flow-mediated dilation in 9- to 11-year-old children: the influence of intrauterine and childhood factors. Circulation 1997;96(7):2233-8.

Leeson CP, Kattenhorn M, Morley R, Lucas A, Deanfield JE. Impact of low birth weight and cardiovascular risk factors on endothelial function in early adult life. Circulation 2001;103(9):1264-8.

Martin H, Hu J, Gennser G, Norman M. Impaired endothelial function and increased carotid stiffness in 9-year-old children with low birthweight. Circulation 2000;102(22):2739-44.

Goodfellow J, Bellamy MF, Gorman ST, Brownlee M, Ramsey MW, Lewis MJ, et al. Endothelial function is impaired in fit young adults of low birth weight. Cardiovasc Res 1998;40(3):600-6.

Skilton MR, Viikari JS, Juonala M, Laitinen T, Lehtimäki T, Taittonen L, et al. Fetal growth and preterm birth influence cardiovascular risk factors and arterial health in young adults: the Cardiovascular Risk in Young Finns Study. Arterioscler Thromb Vasc Biol 2011;31(12):2975-81.

Norman M, Martin H. Preterm birth attenuates association between low birth weight and endothelial dysfunction. Circulation 2003;108(8):996-1001.

Franco MC, Christofalo DM, Sawaya AL, Ajzen SA, Sesso R. Effects of low birth weight in 8- to 13-year-old children: implications in endothelial function and uric acid levels. Hypertension 2006;48(1):45-50.

do Carmo Pinho Franco M, Nigro D, Fortes ZB, Tostes RC, Carvalho MH, Lucas SR, et al. Intrauterine undernutrition-- renal and vascular origin of hypertension. Cardiovasc Res 2003;60(2):228-34.

Franco Mdo C, Arruda RM, Dantas AP, Kawamoto EM, Fortes ZB, Scavone C, et al. Intrauterine undernutrition: expression and activity of the endothelial nitric oxide synthase in male and female adult offspring. Cardiovasc Res 2002;56(1):145-53.

Urbina EM, Williams RV, Alpert BS, Collins RT, Daniels SR, Hayman L, et al. American Heart Association Atherosclerosis, Hypertension, and Obesity in Youth Committee of the Council on Cardiovascular Disease in the Young. Noninvasive assessment of subclinical atherosclerosis in children and adolescents: recommendations for standard assessment for clinical research: a scientific statement from the American Heart Association. Hypertension 2009;54(5):919-50.

Uehata A, Lieberman EH, Gerhard MD, Anderson TJ, Ganz P, Polak JF, et al. Noninvasive assessment of endotheliumdependent flow-mediated dilation of the brachial artery. Vasc Med 1997;2(2):87-92.

Cole TJ, Green PJ. Smoothing reference centile curves: the LMS method and penalized likelihood. Stat Med 1992;11(10):1305-19.

Friedewald WT, Levy RI, Fredrickson DS. Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. Clin Chem 1972;18(6):499-502.

Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985;28(7):412-9.

Lekakis J, Abraham P, Balbarini A, Blann A, Boulanger CM, Cockcroft J, et al. Methods for evaluating endothelial function: a position statement from the European Society of Cardiology Working Group on Peripheral Circulation. Eur J Cardiovasc Prev Rehabil 2011;18(6):775-89.

Benjamin EJ, Larson MG, Keyes MJ, Mitchell GF, Vasan RS, Keaney JF Jr, et al. Clinical correlates and heritability of flowmediated dilation in the community: the Framingham Heart Study. Circulation 2004;109(5):613-9.

Title LM, Cummings PM, Giddens K, Nassar BA. Oral glucose loading acutely attenuates endothelium-dependent vasodilation in healthy adults without diabetes: an effect prevented by vitamins C and E. J Am Coll Cardiol 2000;36(7):2185-91.

Shechter M, Sharir M, Labrador MJ, Forrester J, Merz CN. Improvement in endothelium-dependent brachial artery flow-mediated vasodilation with low-density lipoprotein cholesterol levels <100 mg/dl. Am J Cardiol 2000;86(11):1256-9.

Lupattelli G, Lombardini R, Schillaci G, Ciuffetti G, Marchesi S, Siepi D, et al. Flow-mediated vasoactivity and circulating adhesion molecules in hypertriglyceridemia: association with small, dense LDL cholesterol particles. Am Heart J 2000;140(3):521-6.

Celermajer DS, Sorensen KE, Gooch VM, Spiegelhalter DJ, Miller OI, Sullivan ID, et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of atherosclerosis. Lancet 1992;340(8828):1111-5.

Juonala M, Viikari JS, Laitinen T, Marniemi J, Helenius H, Rönnemaa T, et al. Interrelations between brachial endothelial function and carotid intima-media thickness in young adults: the cardiovascular risk in young Finns study. Circulation 2004;110(18):2918-23.

Arı H, Arı S, Erdoğan E, Tiryakioğlu O, Huysal K, Koca V, et al. The effects of endothelial dysfunction and inflammation on slow coronary flow. Turk Kardiyol Dern Ars 2010;38(5):327-33.

Schächinger V, Britten MB, Zeiher AM. Prognostic impact of coronary vasodilator dysfunction on adverse long-term outcome of coronary heart disease. Circulation 2000;101(16):1899-906.

Verma S, Anderson TJ. Fundamentals of endothelial function for the clinical cardiologist. Circulation 2002;105(5):546-9.

Liew G, Wang JJ, Duncan BB, Klein R, Sharrett AR, Brancati F, et al. Atherosclerosis Risk in Communities Study. Low birthweight is associated with narrower arterioles in adults. Hypertension 2008;51(4):933-8.