Early Life Adipose Tissue Development Tied to Cardiovascular Risks in Adolescents: JAMA

The findings indicate that evaluating adipose tissue development in childhood can help identify lifelong risk patterns and inform personalized cardiovascular prevention and management strategies.

Carotid intima-media thickness is a widely recognized marker for atherosclerosis and cardiovascular disease risk. Increased cIMT and carotid stiffness during adolescence can foreshadow cardiovascular issues in later life, making early detection essential.

Atherogenesis begins in childhood, highlighting this period as a crucial opportunity to prevent atherosclerotic cardiovascular disease in later life. Considering this, Isabelle A. van der Linden, University Medical Center Utrecht, Utrecht, the Netherlands, and colleagues aimed to identify early-life risk factors for preclinical atherosclerosis in adolescence.

For this purpose, the researchers conducted a cohort study as part of the ongoing Wheezing Illness Study in Leidsche Rijn (WHISTLER) prospective birth cohort, which includes 3,005 healthy newborns born between December 2001 and December 2012 in the Leidsche Rijn area of Utrecht, the Netherlands. The study focused on participants from this cohort who attended adolescent follow-up visits between March 2019 and October 2020, with analyses carried out in January 2024.

To assess early-life growth, the researchers evaluated participants at multiple stages: from birth to 6 months, at five years, and again at ages 12 to 16. They utilized abdominal ultrasonography to measure both abdominal subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) depth, alongside calculating blood pressure percentiles and body mass index (BMI) z scores.

Carotid ultrasonography was performed when participants reached ages 12 to 16 years to evaluate carotid intima-media thickness (cIMT) and the distensibility coefficient (DC), which are well-established measures of preclinical atherosclerosis. Multivariable linear regression models were employed to identify early-life risk factors for cIMT and DC during adolescence.

The following were the key findings of the study:

• In total, 232 adolescents (median age, 14.9 years; 52.2% females) were included.
• More postnatal weight gain (B = 12.34), higher systolic BP at five years (B = 0.52), more VAT at five years (B = 3.48), and a larger change in VAT between 5 and 12 to 16 years (B = 3.13) were associated with a higher cIMT in adolescence.
• A higher BMI (B = −2.70) and VAT at five years (B = −0.56), as well as a larger change in BMI between 5 and 12 to 16 years (B = −3.63), were associated with a higher carotid stiffness in adolescence.
• A larger change in SAT between 5 and 12 to 16 years (B = 0.37) was associated with a higher carotid DC in adolescence.

"In the study involving 232 participants, we found that early-life growth parameters—especially the development of abdominal VAT—were linked to increased carotid intima-media thickness and carotid stiffness during adolescence," the researchers wrote.

"These results indicate that evaluating adipose tissue growth in childhood can help identify lifetime risk patterns and inform personalized cardiovascular prevention and management strategies," they concluded.

Reference:

van der Linden IA, Roodenburg R, Nijhof SL, et al. Early-Life Risk Factors for Carotid Intima-Media Thickness and Carotid Stiffness in Adolescence. JAMA Netw Open. 2024;7(9):e2434699. doi:10.1001/jamanetworkopen.2024.34699