Periconceptional ambient temperature and adult atherogenic lipid profile: A life-course study of acute coronary syndrome patients and matched controls.

AIM: Emerging evidence suggests that early-life environmental conditions may induce long-term metabolic programming. We evaluated the association of the season of conception and periconceptional or perinatal climatic conditions with the adult Atherogenic Index of Plasma (AIP) in patients with Acute Coronary Syndrome (ACS) and matched controls.

METHODS

In this life-course study, we analysed 833 patients with ACS and 833 age- and sex-matched controls. Individual data were linked with historical climatological records to determine mean temperature and diurnal temperature range (DTR) during the estimated month of conception, and sunshine hours during the month of birth. Adjusted multiple linear regression models identified predictors of adult AIP.

RESULTS

ACS patients presented higher AIP than controls (0.15 ± 0.28 vs. 0.06 ± 0.29; p < 0.001). Summer conception predicted higher adult AIP in ACS patients (B = 0.042; 95% CI: 0.003-0.081; p = 0.035) and controls (B = 0.051; 95% CI: 0.006-0.097; p = 0.028). Higher mean temperature (B = 0.007; 95% CI: 0.001-0.014; p = 0.030) and wider DTR (B = 0.085; 95% CI: 0.002-0.169; p = 0.045) at conception also predicted higher adult AIP, with consistent findings across cohorts. No association was found with perinatal sunshine hours.

CONCLUSIONS

Conception in summer and with higher ambient temperatures or wider DTR is associated with a pro-atherogenic lipid phenotype decades later. These findings suggest that environmental conditions at the very beginning of life may induce long-term metabolic programming of cardiovascular risk; an association increasingly important to understand given current global warming trends.