Objective: The mechanisms that increase cardiovascular risk in individuals born small for gestational age (SGA) are not well understood. Telomere shortening has been suggested to be a predictor of disease onset. Our aim was to determine whether impaired intrauterine growth is associated with early signs of vascular aging and whether telomere length could be a biomarker of this pathway.
Methods: One hundred and fourteen healthy young men born SGA or after normal pregnancy [appropriate for gestational age (AGA)] were enrolled. Patient data were gathered from questionnaires and clinical exams, including blood pressure (BP) measurement routine laboratory analyses, and carotid intima–media thickness (cIMT). Leukocyte telomere length (LTL) was assessed by quantitative PCR. Birth data were obtained from medical records.
Results: The SGA group had significantly higher pulse pressure and cIMT, and a trend to increased SBP and heart rate in comparison to the AGA group. Interestingly, SGA men exhibited a 42% longer LTL than the AGA group. LTL was inversely associated with age, BMI, BP and birth parameters. In multiple regression analysis, BMI was the key determinant of SBP and cIMT.
Conclusion: Young men born SGA show early signs of vascular aging. Unexpectedly, in our cohort, the SGA group had longer telomeres than the normal controls. Although longer telomeres are predictive of better health in the future, our findings could indicate a faster telomere attrition rate and probable early onset of cardiovascular risk in SGA participants. Follow-up of this cohort will clarify hypothesis and validate telomere dynamics as indicators of future health risks.
aDepartment for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Croatia
bDanish Aging Research Center, University of Southern Denmark, Aarhus and Copenhagen, Denmark
cDepartment for Molecular Biology, Ruđer Bošković Institute
dDepartment of Cardiovascular Diseases, University Hospital Center
eDepartment for Molecular Medicine, Ruđer Bošković Institute, Zagreb, Croatia
fDepartment of Clinical Sciences, Lund University, Skåne University Hospital, Malmö, Sweden
Correspondence to Mario Laganović, MD, PhD, Department for Nephrology, Arterial Hypertension, Dialysis and Transplantation, University Hospital Center Zagreb, Kišpaićeva 12, 10000 Zagreb, Croatia. Tel: +385 23 88 271; fax: +385 1 23 67 468; e-mail: firstname.lastname@example.org
Abbreviations: ABPM, ambulatory blood pressure monitoring; AGA, appropriate for gestational age; BP, blood pressure; BSA, body surface area; cIMT, carotid intima–media thickness; IUGR, intrauterine growth restriction; Log-T/S ratio, log-transformed telomere length presented as T/S ratio; LTL, leukocyte telomere length; SGA, small for gestational age
Received 23 October, 2013
Revised 20 March, 2014
Accepted 20 March, 2014