Marker of heart disease in low-birthweight babies identified

Some low birth weight infants have large particles rich in apolipoprotein C-1, a blood protein that could put them at risk for heart disease later in life, according to a national study led by Johns Hopkins Children's Center researchers.

For the study, Peter O. Kwiterovich, Jr., M.D., professor of pediatrics and director of the Lipid Clinic at Johns Hopkins, and colleagues analyzed the umbilical cord blood of 163 infants born at 28 or more weeks of gestational age at Johns Hopkins Hospital between January 3 and September 27, 2000. Nineteen percent of the babies were found to have enriched levels of apolipoprotein C-1 bound up in the high density lipoproteins (HDL) circulating in their blood. These infants were born on average 1.3 pounds less and three weeks earlier than those who had normal HDL levels of the suspect particles.

Results are published in the April 20 issue of the Journal of the American Medical Association.

In adults, HDL enriched with apolipoprotein C-1 may be dysfunctional and cause the death of smooth muscle cells that normally are an important part of the protective cap on top of cholesterol plaque in the blood vessels in the heart, Kwiterovich said. If the cap is weakened, the plaque can rupture, causing a heart attack.

"Our hypothesis is that infants with elevated apo C-1 levels at birth will have higher apo C-1 levels in childhood and adulthood" Kwiterovich said. "Many people associate HDL as being the 'good' cholesterol, and indeed, higher levels of HDL in general are, in adults, good. It is the higher apo C-1 levels in these infants that we find worth watching as an early predictor of heart disease. A low-fat diet is particularly important for these children to reduce their risk of heart disease."

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