Childhood growth pattern predicts adult coronary risk

To examine the association between growth in early childhood and later coronary events, investigators used data from 8,760 people born in Helsinki, Finland, from 1934 through 1944. They examined birth records, information from child-welfare clinics and schools, and hospital records of admissions and deaths from coronary artery disease.

On average, people who had a coronary event as an adult had a low birth weight and were thin at 2 years of age. Boys who had an event were born thin, whereas these girls became thin during the first 6 months of life. The mean body mass index (BMI) of these boys and girls was still low at 2 years of age but rose rapidly after that. By the time the boys and girls were 11 years old, their BMI reached, or exceeded (in girls), the average BMI for the study group as a whole (16.8, for boys; 17.1, for girls). The rapidity of weight gain after 2 years of age was a stronger predictor of a later coronary event than was the BMI at any age.

Small size at birth, low BMI at 2 years of age, and high BMI at 11 years of age also were associated with two measures of insulin resistance-elevated fasting plasma insulin and proinsulin concentrations. Low birth weight and low BMI at 2 years of age (but not an increase in BMI between 2 and 11 years of age) also were related to increased serum triglyceride concentrations (Barker DJP et al: N Engl J Med 2005;353:1802).