Predictors of carotid intima-media thickness and carotid plaque in young Indian adults: The New Delhi Birth Cohort

Anita Khalil, Mark D. Huffman, Dorairaj Prabhakaran, Clive Osmond, Caroline H.D. Fall, Nikhil Tandon, Ramakrishnan Lakshmy, Poornima Prabhakaran, S. K.Dey Biswas, Siddarth Ramji, Harshpal S. Sachdev, Santosh K. Bhargava

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31 Scopus citations


Background: Carotid intima-media thickness (CIMT) and carotid plaques represent preclinical markers of atherosclerosis. We sought to describe predictors of CIMT and carotid plaques, including early life growth, in a young urban Indian cohort free of clinical cardiovascular disease (CVD). Methods: In 2006-2009, we performed B-mode carotid ultrasound on 600 participants (mean [SD] age 36 [1.1] years; 45% women) from the New Delhi Birth Cohort to evaluate CIMT and carotid plaques (> 1 mm). Height and weight were recorded at birth, 2 and 11 years of age. Data on CVD risk factors, anthropometry, medical history, socio-economic position, and lifestyle habits were collected in 1998-2002. Results: Mean (SD) CIMT for men and women was 0.91 (0.12) and 0.86 (0.13) mm, respectively. Carotid plaque was present in 33% of men and 26% of women. Waist circumference in 1998-2002 was positively associated with CIMT (β coefficient 0.26 mm [0.17, 0.36] per SD) and carotid plaque (OR 1.27 [1.06,1.52] per SD) in 2006-2009. Higher triglycerides, PAI-1, insulin resistance, and diastolic blood pressure, metabolic syndrome, and lower HDL-cholesterol and physical activity predicted higher CIMT and/or plaque (p < 0.05). Longer length at 2 years was associated with higher CIMT (p < 0.05). These associations were attenuated after adjusting for adult waist circumference. Conclusions: These are the first prospective data from India showing that early life growth, adult socio-demographics, and CVD risk factors predict future CIMT and/or carotid plaque. These relationships appear primarily mediated through central adiposity, highlighting the importance of maintaining a healthy weight in early adulthood to prevent CVD.

Original languageEnglish
Pages (from-to)1322-1328
Number of pages7
JournalInternational Journal of Cardiology
Issue number4
StatePublished - Aug 20 2013


  • Birth weight
  • Carotid intima media thickness
  • Carotid plaque
  • Cohort
  • India
  • Infant and childhood growth


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