Puberty timing and markers of cardiovascular structure and function at 25 years: a prospective cohort study

dc.contributor.authorMaher, Gillian M.
dc.contributor.authorRyan, Lisa
dc.contributor.authorMcCarthy, Fergus P.
dc.contributor.authorHughes, Alun
dc.contributor.authorPark, Chloe
dc.contributor.authorFraser, Abigail
dc.contributor.authorHowe, Laura D.
dc.contributor.authorKearney, Patricia M.
dc.contributor.authorO'Keeffe, Linda M.
dc.contributor.funderMedical Research Councilen
dc.contributor.funderUniversity of Bristolen
dc.contributor.funderBritish Heart Foundationen
dc.contributor.funderHealth Research Boarden
dc.description.abstractBackground: Whether earlier onset of puberty is associated with higher cardiovascular risk in early adulthood is not well understood. Our objective was to examine the association between puberty timing and markers of cardiovascular structure and function at age 25 years. Methods: We conducted a prospective birth cohort study using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants were born between April 1, 1991, and December 31, 1992. Exposure of interest was age at peak height velocity (aPHV), an objective and validated growth-based measure of puberty onset. Outcome measures included cardiovascular structure and function at age 25 years: carotid intima-media thickness (CIMT), left ventricular mass index (LVMI) and relative wall thickness (RWT), pulse wave velocity (PWV) and systolic blood pressure (SBP). Multiple imputation was used to impute missing data on covariates and outcomes. Linear regression was used to examine the association between aPHV and each measure of cardiac structure and function, adjusting for maternal age, gestational age, household social class, maternal education, mother's partner's education, breastfeeding, parity, birthweight, maternal body mass index, maternal marital status, maternal prenatal smoking status and height and fat mass at age 9. All analyses were stratified by sex. Results: A total of 2752-4571 participants were included in the imputed analyses. A 1-year older aPHV was not strongly associated with markers of cardiac structure and function in males and females at 25 years and most results spanned the null value. In adjusted analyses, a 1-year older aPHV was associated with 0.003 mm (95% confidence interval (CI) 0.00001, 0.006) and 0.0008 mm (95% CI - 0.002, 0.003) higher CIMT; 0.02 m/s (95% CI - 0.05, 0.09) and 0.02 m/s (95% CI - 0.04, 0.09) higher PWV; and 0.003 mmHg (95% CI - 0.60, 0.60) and 0.13 mmHg (95% CI - 0.44, 0.70) higher SBP, among males and females, respectively. A 1-year older aPHV was associated with - 0.55 g/m(2.7) (95% CI - 0.03, - 1.08) and - 0.89 g/m(2.7) (95% CI - 0.45, - 1.34) lower LVMI and - 0.001 (95% CI - 0.006, 0.002) and - 0.002 (95% CI - 0.006, 0.002) lower RWT among males and females. Conclusions: Earlier puberty is unlikely to have a major impact on pre-clinical cardiovascular risk in early adulthood.en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.identifier.citationMaher, G. M., Ryan, L., McCarthy, F. P., Hughes, A., Park, C., Fraser, A., Howe, L. D., Kearney, P. M. and O'Keeffe, L. M. (2021) 'Puberty timing and markers of cardiovascular structure and function at 25 years: a prospective cohort study', BMC medicine, 19, 78, (8pp). doi: 10.1186/s12916-021-01949-yen
dc.identifier.journaltitleBMC medicineen
dc.publisherBioMed Centralen
dc.relation.projectinfo:eu-repo/grantAgreement/WT/Population and Public Health/217065//The Avon Longitudinal Study of Parents and Children (ALSPAC): A multi-generation, longitudinal resource focusing on life course health and well-being./en
dc.relation.projectinfo:eu-repo/grantAgreement/WT/Population and Public Health/076467//ALSPAC: consolidation of a two generation cell line backed resource, for the study of the environment and genetic determinants of health and development from before birth to late puberty./en
dc.relation.projectinfo:eu-repo/grantAgreement/WT/Population and Public Health/086676//Early Life determinants of Blood pressure patterns in young Adults (ELBA Study)./en
dc.rights© The Author(s). 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.en
dc.subjectCardiovascular structureen
dc.titlePuberty timing and markers of cardiovascular structure and function at 25 years: a prospective cohort studyen
dc.typeArticle (peer-reviewed)en
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