CAN CARDIOVASCULAR RISK BE PREDICTED BY NEWBORN, CHILDHOOD, AND ADOLESCENT BODY-SIZE - AN EXAMINATION OF LONGITUDINAL DATA IN URBAN AFRICAN-AMERICANS

Objective: Recent retrospective studies of older adults have demonstra ted a correlation between lower birth weight and hypertension and insu lin resistance. We tested this finding in our sample of urban African Americans with prospective data on growth and blood pressure and also tested other variables (in addition to birth weight) for their relatio nship to adult cardiovascular risk. Study design: ii prospective study or birth weight, growth, and blood pressure (Philadelphia Perinatal C ollaborative Project) followed a sample of 137 African Americans, with nine examinations from birth through 28.0 +/- 2.7 years. Metabolic me asurements (oral glucose tolerance testing, euglycemic hyperinsulinemi c clamp, and plasma lipid concentration) were performed on the subject s as adults. Bivariate correlations among parameters were computed usi ng the Pearson r. The chi-squared statistic was used to determine asso ciations of outcomes with birth weight, Stepwise multiple linear regre ssions were computed using newborn, early childhood, adolescent, and y oung adult parameters to predict adult outcomes. Results: Birth weight and blood pressure at age 28 rears are not correlated (Pearson r = 0. 06). Birth weight is also unrelated to adult obesity. However, weight at 0.3 years and after and body mass index al 7 years and after are co rrelated with adult weight. Furthermore, weight at age 14 years is sig nificantly negatively correlated with measures of insulin-stimulated g lucose use, indicating that obese adolescents may be at greater risk t han nonobese adolescents for development of non-insulin dependent diab etes in adulthood. Conclusions: We found no relationship between birth weight and adult outcomes pertaining to cardiovascular risk in this s ample of adult African Americans, However, we did iind evidence thar s omatic growth (body weight and body mass index) is significantly relat ed to obesity and attenuated insulin-stimulated glucose utilization in adulthood. These findings indicate that the origins of adult cardiova scular disease are related to somatic growth, but not intrauterine gro wth, and are evident during childhood.