Abstract 18112: Impact of Exogenous Cholesterol in Newborns on Arterial Stiffness Decades Later: A 25 Year Prospective Follow-Up Study
Background: In postmortem studies, exposure to high maternal cholesterol levels during prenatal life is related to increased fatty streak formation in the fetal aorta. However, it is unknown whether increased exogenous cholesterol exposure during this time has any long-term effects on cardiovascular risk. We therefore studied the long-term impact of intravenous lipid exposure during postnatal life on aortic function in young adulthood.
Methods: We performed a prospective follow-up study of 33 subjects born premature now in young adulthood (age range = 23 to 26 years). 11 individuals received postnatal intravenous lipids and 22 subjects were controls matched for age, sex and gestational age at birth. Aortic pulse wave velocity (PWV), a measure of aortic stiffness, was determined by cardiovascular magnetic resonance imaging for all subjects. Metabolic parameters were measured at various time points throughout life, in addition to other cardiovascular risk factors including birth weight, gestational age, body size, blood pressure, and smoking.
Results: Individuals that received intravenous lipids had significantly higher maximum cholesterol levels during the first nine weeks of life than those that did not receive infusions (mean±SD = 4.41±1.63 vs 3.13±0.83 mmol/L, P=0.031). There was a graded relation between the maximum cholesterol level achieved during this period and aortic PWV in young adult life (Beta=0.694, P<0.001). In multivariate regression including cardiovascular risk factors in early adulthood, maximum cholesterol level achieved in the first few weeks of life was an independent predictor of aortic PWV in young adulthood and accounted for 27.3% of the variance in aortic PWV in hierarchical multiple regression (Beta=0.597, P=0.002).
Conclusions: This novel human experimental model demonstrates that high exogenous cholesterol exposure during the first nine weeks of life is associated with long term changes in aortic function independent of native cholesterol production.
- © 2010 by American Heart Association, Inc.