| Title: | Lower birth weight is linked to poorer cardiovascular health in middle-aged population-based adults |
| Journal: | Heart |
| Published: | 16 Nov 2022 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/36384749/ |
| DOI: | https://doi.org/10.1136/heartjnl-2022-321733 |
| Citations: | 10 (10 in last 2 years) as of 8 Aug 2024 |
Publication 10696
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Abstract
OBJECTIVE: To examine associations of birth weight with clinical and imaging indicators of cardiovascular health and evaluate mechanistic pathways in the UK Biobank.</p>
METHODS: Competing risk regression was used to estimate associations of birth weight with incident myocardial infarction (MI) and mortality (all-cause, cardiovascular disease, ischaemic heart disease, MI), over 7-12 years of longitudinal follow-up, adjusting for age, sex, deprivation, maternal smoking/hypertension and maternal/paternal diabetes. Mediation analysis was used to evaluate the role of childhood growth, adulthood obesity, cardiometabolic diseases and blood biomarkers in mediating the birth weight-MI relationship. Linear regression was used to estimate associations of birth weight with left ventricular (LV) mass-to-volume ratio, LV stroke volume, global longitudinal strain, LV global function index and left atrial ejection fraction.</p>
RESULTS: 258 787 participants from white ethnicities (61% women, median age 56 (49, 62) years) were studied. Birth weight had a non-linear relationship with incident MI, with a significant inverse association below an optimal threshold of 3.2 kg (subdistribution HR: 1.15 (1.08 to 1.22), p=6.0×10-5) and attenuation to the null above this threshold. The birth weight-MI effect was mediated through hypertension (8.4%), glycated haemoglobin (7.0%), C reactive protein (6.4%), high-density lipoprotein (5.2%) and high cholesterol (4.1%). Birth weight-mortality associations were statistically non-significant after Bonferroni correction. In participants with cardiovascular magnetic resonance (n=19 314), lower birth weight was associated with adverse LV remodelling (greater concentricity, poorer function).</p>
CONCLUSIONS: Lower birth weight was associated with greater risk of incident MI and unhealthy LV phenotypes; effects were partially mediated through cardiometabolic disease and systemic inflammation. These findings support consideration of birth weight in risk prediction and highlight actionable areas for disease prevention.</p>
9 Keywords
- Birth Weight
- Female
- Heart
- Humans
- Hypertension
- Male
- Myocardial Infarction
- Risk Factors
- Ventricular Function, Left
9 Authors
- Zahra Raisi-Estabragh
- Jackie Cooper
- Mae S Bethell
- Celeste McCracken
- Adam J Lewandowski
- Paul Leeson
- Stefan Neubauer
- Nicholas C Harvey
- Steffen E Petersen
1 Application
| Application ID | Title |
|---|---|
| 2964 | Description of cardiovascular phenotype in the UK Biobank population based on cardiovascular magnetic resonance and carotid ultrasound |
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