Abdominal Aortic Intima-Media Thickness in Infants at 6 Weeks of Age as an Early Life Marker of Atherosclerosis: A Longitudinal Twin Birth Cohort Study

Purpose: Aortic intima-media thickness (aIMT) is an indicator to assess preclinical atherosclerosis in early life and may be influenced by prenatal and perinatal factors. We aimed to examine the predictive role of aIMT at 6 weeks of age and investigate the potential influencing factors by using a longitudinal twin birth cohort. Methods: The abdominal aIMT and abdominal aortic diameter (AoD) were evaluated in 173 twin infants at 6 weeks of age by transabdominal ultrasound. Infant anthropometrics were measured at the same time. Data on maternal information were collected from self-made questionnaires and medical records. Data on neonatal outcomes were collected from medical records. Generalized estimation equation models were constructed to determine the associations between the mean aIMT value and cardiometabolic risk and perinatal factors. Results: The mean aIMT value at 6 weeks of age was associated with total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL) and apolipoprotein B (apoB) levels at the age of four years (β = 19.24, 95% CI 0.04,38.44; P < 0.05; β=-43.88, 95% CI -54.45, -33.30; P < 0.001; β = 25.05, 95% CI 2.64,47.46; P < 0.05; β = 91.39, 95% CI 12.98,169.79; P < 0.05). An increased birthweight and AoD were associated with the mean aIMT value (β = 37.89 µm, 95% CI 12.54, 63.24; P < 0.01; β = 0.03 µm, 95% CI 0.02, 0.04; P < 0.001). Conclusions: The abdominal aIMT value at the age of 6 weeks was correlated with the risk of atherosclerosis at 4 years of age in twins, particularly in monozygotic (MZ) twins, suggesting that aIMT may be a marker of preclinical atherosclerosis in infants.