Association between anthropometry, cardiometabolic risk factors, & early life factors & adult measures of endothelial function: Results from the New Delhi Birth Cohort
Mark D Huffman1, Anita Khalil2, Clive Osmond3, Caroline H D Fall3, Nikhil Tandon4, Ramakrishnan Lakshmy4, Siddharth Ramji5, Tarun Gera6, Poornima Prabhakaran7, SK Dey Biswas8, K Srinath Reddy9, Santosh K Bhargava5, Harshpal S Sachdev10, Dorairaj Prabhakaran11, on behalf of the New Delhi Birth Cohort12
1 Centre for Chronic Disease Control, New Delhi, India; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; USA, USA
2 The Heart Centre, New Delhi, India
3 Medical Research Council Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
4 All India Institute of Medical Sciences, New Delhi, India
5 Department of Pediatrics, Maulana Azad Medical College, New Delhi, India
6 Department of Pediatrics, Sunder Lal Jain Hospital, New Delhi, India
7 Initiative for Cardiovascular Health Research in Developing Countries, New Delhi, India
8 Indian Council of Medical Research, New Delhi, India
9 Initiative for Cardiovascular Health Research in Developing Countries; Indian Council of Medical Research, New Delhi, India
10 Department of Pediatrics, Sitaram Bhartiya Institute for Science & Research, New Delhi, India
11 Centre for Chronic Disease Control; Public Health Foundation of India, New Delhi, India
Mark D Huffman
Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL 60660
Source of Support: None, Conflict of Interest: None
Background & objectives: Abnormal endothelial function represents a preclinical marker of atherosclerosis. This study was conducted to evaluate associations between anthropometry, cardiometabolic risk factors, and early life factors and adult measures of endothelial function in a young urban Indian cohort free of clinical cardiovascular disease.
Methods: Absolute changes in brachial artery diameter following cuff inflation and sublingual nitroglycerin (400 µg) were recorded to evaluate endothelium-dependent and -independent measures of endothelial function in 600 participants (362 men; 238 women) from the New Delhi Birth Cohort (2006-2009). Data on anthropometry, cardiometabolic risk factors, medical history, socio-economic position, and lifestyle habits were collected. Height and weight were recorded at birth, two and 11 yr of age. Age- and sex-adjusted linear regression models were developed to evaluate these associations.
Results: The mean age of participants was 36±1 yr. Twenty two per cent men and 29 per cent women were obese (BMI th > 30 kg/m  ). Mean systolic blood pressure (SBP) was 131±14 and 119±13 mmHg, and diabetes prevalence was 12 and 8 per cent for men and women, respectively. Brachial artery diameter was higher for men compared with women both before (3.48±0.37 and 2.95±0.35 cm) and after hyperaemia (3.87±0.37 vs. 3.37±0.35 cm). A similar difference was seen before and after nitroglycerin. Markers of increased adiposity, smoking, SBP, and metabolic syndrome, but not early life anthropometry, were inversely associated with endothelial function after adjustment for age and sex.
Interpretation & conclusions: The analysis of the current prospective data from a young urban Indian cohort showed that cardiometabolic risk factors, but not early life anthropometry, were associated with worse endothelial function.