Low birth weight and markers of inflammation and endothelial activation in adulthood: The ARIC study

Lucia C. Pellanda, Bruce B. Duncan, Alvaro Vigo, Kathryn Rose, Aaron R. Folsom, Thomas P. Erlinger

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34 Scopus citations


Background: To investigate the hypothesis that intrauterine growth restriction might produce a longstanding pro-inflammatory tendency, we investigated the association of low birth weight with blood levels of markers of inflammation and endothelial activation in middle-aged adults. Methods: The ARIC Study enrolled subjects aged 45-64 years sampled from four U.S. communities. An inflammation/endothelial activation score from 0 to 6 was created, one point being given for each above-median value of white blood cell count, fibrinogen, von Willebrand factor and Factor VIII, and for each below-median value of albumin and activated partial thromboplastin time. Results: Of the 9809 individuals reporting birth weight and having all inflammation/endothelial markers and covariates, 349 (3.6%) reported low birth weight (LBW). The mean (standard deviation) score was 3.5 (1.5) for those with and 3.1 (1.6) for those without LBW (p < 0.001). In robust poisson regression models adjusting for gender, ethnicity, age, study center, educational level, and current drinking and smoking status and amount, those with LBW were more likely to have a high score (≥ 4 points) (RR = 1.16, 95% CI: 1.05-1.29). Conclusion: In the ARIC Study, LBW predicted greater inflammation and endothelial activation, as indicated by the higher score of blood markers, consistent with the hypothesis that early life events may result in a hyper-responsive innate immune system. Such a pro-inflammatory tendency could help explain the association of low birth weight with elements of the metabolic syndrome and ischemic heart disease.

Original languageEnglish (US)
Pages (from-to)371-377
Number of pages7
JournalInternational Journal of Cardiology
Issue number3
StatePublished - May 29 2009

Bibliographical note

Funding Information:
The Atherosclerosis Risk in Communities Study is carried out as a collaborative study supported by National Heart, Lung, and Blood Institute contracts N01-HC-55015, N01-HC-55016, N01-HC-55018, N01-HC-55019, N01-HC-55020, N01-HC-55021, and N01-HC-55022. The authors thank the staff and participants of the ARIC study for their important contributions. Dr. Duncan received a support from the Centers of Excellence Grant of CNPq (Brazilian National Research Council).


  • Endothelial activation
  • Fibrinogen
  • Inflammation
  • Leukocytes
  • Low birth weight


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