Relationship of endothelial function to birth weight in humans

OBJECTIVE - Low birth weight has been associated with hyperlipidemia, hyper tension, diabetes, and coronary heart disease in adult life, but the precis e mechanism is debated. The endothelium is thought to play a pivotal role i n each of the above conditions with abnormalities being detectable before t he development of overt disease. To investigate the possibility that endoth elium has a role in mediating the excessive risk of adult vascular disease associated with low birth weight, endothelial function was assessed in youn g healthy adults who were either of low or normal birth weight at term. RESEARCH DESIGN AND METHODS - Twelve low birth weight (2.2 +/- 0.05 kg mean +/- SEM) subjects (six men/six women; age 28 +/- 0.2 years) and twelve age - and sex matched normal birth weight (3.3 +/- 0.07 kg) control subjects we re studied. The L-arginine-nitric oxide pathway was assessed in the forearm vascular bed by using venous occlusion plethysmography during intra-arteri al brachial infusion of acetylcholine, sodium nitroprusside, norepinephrine , and N-G-monomethyl-L-arginine (L-NMMA). Von Willebrand factor, a noninvas ive marker of endothelial dysfunction, was also measured. Comparisons were made using Student's t rests. RESULTS - Von Willebrand factor was significantly elevated in low birth wei ght compared with normal birth weight subjects (136.9 +/- 12.7 vs. 95.6 +/- 9.5%; P = 0.016). The groups did not differ in the responses to acetylchol ine (P = 0.76), sodium nitroprusside (P = 0.84), nor epinephrine (P = 0.21) , or L-NMMA (P = 0.35). CONCLUSIONS - The finding of elevated von Willebrand factor in low birth Me ight subjects is suggestive of endothelial cell injury but does not appear to be associated with dysfunction of the L-arginine-nitric oxide pathway.