Weight gain in infancy is associated with carotid extra-medial thickness in later childhood

•Excessive weight gain over the first 18 months of life has important consequences for later cardiovascular risk.•We find that weight gain from birth to 18 months is associated with carotid extra-medial thickness in later childhood.•Excessive weight gain during infancy may influence both arterial intima-media and adventitial thickening.

ObjectiveEarly life is an important period for determining future risk of cardiovascular disease. Carotid extra-medial thickness is a novel noninvasive measure that estimates arterial adventitial thickness, information concerning vascular health not captured by assessment of arterial intima-media thickness alone. We sought to determine whether fetal growth and early postnatal growth are associated with carotid extra-medial thickness in 8 year old children.MethodsCarotid extra-medial thickness was assessed by high-resolution ultrasound in 379 non-diabetic children aged 8-years, with complete data for birth weight, gestational age, early postnatal weight gain and carotid extra-medial thickness.ResultsWeight gain during infancy, from birth to 18 months of age, was significantly and positively associated with carotid EMT (11 μm per kg length-adjusted weight gain [95% CI 3, 18], P = 0.007). This association was significantly stronger in boys than girls (Pheterogeneity = 0.005). By contrast, there was no significant association between birth weight and carotid EMT (6 μm/kg birth weight [95% CI −12, 24], P = 0.51).ConclusionExcessive weight gain during infancy is associated with increased carotid extra-medial thickness, indicating that the alterations to the vasculature associated with excessive early postnatal growth likely include arterial adventitial thickening.