Impaired Endothelial Function and Increased Carotid Stiffness in 9-Year-Old Children With Low Birthweight

Abstract

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 9Ϯ1.3 years) children, 22 with LBW for age. Methods and 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 (88Ϯ33 perfusion units [PU]) than in normal-birthweight controls (133Ϯ34 PU, PϽ0.001).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 (rϭϪ0.45, PϽ0.01). 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.

Intensive insulin therapy improves endothelial function and microvascular reactivity in young people with type 1 diabetes

“…This combination of iontophoresis and laser Doppler imaging has been used successfully by us and others in Values are medians (interquartile range) a Postcodes were used to obtain the Carstairs deprivation score, which was based on results from the 2001 census. A higher score represents a higher level of deprivation No significant differences in categorical variables using χ 2 or continuous variables using ANOVA were identified SDS, standard deviation score many studies [20,21], and the good reproducibility of the technique has been confirmed [22,23]. A recent study showed that skin microvascular responses to iontophoretically applied ACh strongly correlated with flow-mediated dilatation responses in the brachial artery [24].…”

Adult Sequelae of Intrauterine Growth Restriction

“…Several studies have shown that endothelial-dependant and -independent vasodilation is impaired and flow-mediated dilation is decreased in low-birthweight individuals at 3 months of age, in later childhood and in early adult life. [63][64][65] In rats that were undernourished during the first 18 days of gestation, increased blood pressure at 60 days after birth was noted, and the maximal vasoconstriction response to phenylephrine and norepinephrine was reduced in isolated femoral arteries, 66 although other maternal nutrient restricted diets 67,68 showed no effect on vasoconstrictor responses.…”

Renal and extrarenal mechanisms of perinatal programming after intrauterine growth restriction

“…39 Interestingly, the application of sodium nitroprusside causing endothelium-independent vasodilation does not yield differences between children with low and normal birth weight. 40 These findings suggest a crucial role for the endothelium, in particular of the nitric oxide (NO) system. As mechanisms underlying impaired NO-mediated vasodilation increased generation of superoxide and decreased expression of soluble guanylate cyclase have been proposed (Nuyt 1 ; Figure 2).…”