BACKGROUNDMultiple neonatal characteristics and adult cardiovascular risk factors are associated with the development of atherosclerosis, however little conclusive evidence exists characterizing the relative strength of these factors. In a large retrospective study, we investigated the association between both objective neonatal measurements and comprehensive adult cardiovascular risk factors with the development of atherosclerosis, quantified by carotid intima-media thickness (CIMT). Further, we assessed the impact of gender on the relative impact of these risk factors.

METHODSCIMT, a measure of atherosclerosis, was determined by carotid ultrasound on 1568 participants (age 50-85) whose birth records were obtained from Peking Union Medical College Hospital. In addition, each participant was given a physical examination, and completed a medical questionnaire to identify a panel of cardiovascular risk factors. Multiple regression analysis was performed on the population and on the male and female cohorts individually, to identify the relative contribution of these risk factors to increased CIMT.

RESULTSFor the total population the Framingham score, renal function, adult abdominal circumference and mother's gestational age were associated with CIMT, accounting for 14.7%, 1.4%, 0.9%, and 0.2% of total variance, respectively. In the male population the Framingham score, renal function, abdominal circumference and hemoglobin were the most significant risk factors for CIMT. Risk in the female population was associated with Framingham score, renal function, insulin resistance and gestational age. No relationship between birth weight or head circumference and CIMT were observed.

CONCLUSIONSAdult cardiovascular risk factors were the most significantly associated with the development of atherosclerosis; however mother's age at birth was associated with CIMT, particularly in the female cohort. The relative contribution of the risk factors analyzed varied between the male and female populations.