Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis

Abstract Background Previous studies have shown the effects of teratogen exposure in utero on the vascular system, but its direct and indirect effects are still questionable. Therefore, this study explored the effects of potential mediators of teratogen exposure on carotid intima–media thickness (cI...

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Main Authors: Tammy Hartel, Aamer Sandoo, André Oelofse, Juléy De Smidt
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Cardiovascular Disorders
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Online Access:https://doi.org/10.1186/s12872-025-05010-1
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author Tammy Hartel
Aamer Sandoo
André Oelofse
Juléy De Smidt
author_facet Tammy Hartel
Aamer Sandoo
André Oelofse
Juléy De Smidt
author_sort Tammy Hartel
collection DOAJ
description Abstract Background Previous studies have shown the effects of teratogen exposure in utero on the vascular system, but its direct and indirect effects are still questionable. Therefore, this study explored the effects of potential mediators of teratogen exposure on carotid intima–media thickness (cIMT) and flow-mediated dilation (FMD). Methods This study was conducted between January 2022 and August 2024 in Cape Town, South Africa, and included 307 adolescents (aged 10–14) and their mothers. Anthropometry data, lipid profiles, systolic (SBP) and diastolic blood pressure (DBP), physical activity and maternal health behaviours were obtained. Vascular measurements (left and right cIMT and brachial artery FMD) were obtained via ultrasound, which included analysing the peak artery diameter separately. Statistical analyses were performed via SPSS® version 29, and mediation analyses were conducted via PROCESS Macros. Results The cohort included a control group (n = 105), tobacco-exposed individuals (n = 115), dual-exposed individuals (tobacco and alcohol) (n = 73), and alcohol-exposed individuals (n = 14). A significant positive correlation was observed between alcohol exposure duration and LcIMT (rho = 0.531, p < 0.05), and a strong negative correlation was observed with peak diameter (rho=-0.788, p < 0.001), with a very strong correlation in males (r=-0.894, p < 0.05). The duration of alcohol exposure significantly affected LcIMT (p = 0.0468) after adjusting for body mass index (BMI), SBP and DBP. However, brachial artery (BA) peak diameter was not significantly associated with the duration of alcohol consumption during pregnancy after the adjustment for age, SBP or BA baseline diameter. Conclusion Increased BMI and SBP may contribute to a reduced peak diameter in adolescents exposed to alcohol, potentially indicating lower FMD in adulthood. Further studies should elucidate the biological mechanisms involved through long-term prospective studies.
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spelling doaj-art-9a89072d6729420eb8bcfb01f78d2c982025-08-20T03:04:10ZengBMCBMC Cardiovascular Disorders1471-22612025-08-0125111110.1186/s12872-025-05010-1Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysisTammy Hartel0Aamer Sandoo1André Oelofse2Juléy De Smidt3Department of Medical Biosciences, Faculty of Natural Sciences, University of the Western CapeSchool of Psychology and Sport Science, George Building, Bangor UniversityDepartment of Medical Biosciences, Faculty of Natural Sciences, University of the Western CapeDepartment of Medical Biosciences, Faculty of Natural Sciences, University of the Western CapeAbstract Background Previous studies have shown the effects of teratogen exposure in utero on the vascular system, but its direct and indirect effects are still questionable. Therefore, this study explored the effects of potential mediators of teratogen exposure on carotid intima–media thickness (cIMT) and flow-mediated dilation (FMD). Methods This study was conducted between January 2022 and August 2024 in Cape Town, South Africa, and included 307 adolescents (aged 10–14) and their mothers. Anthropometry data, lipid profiles, systolic (SBP) and diastolic blood pressure (DBP), physical activity and maternal health behaviours were obtained. Vascular measurements (left and right cIMT and brachial artery FMD) were obtained via ultrasound, which included analysing the peak artery diameter separately. Statistical analyses were performed via SPSS® version 29, and mediation analyses were conducted via PROCESS Macros. Results The cohort included a control group (n = 105), tobacco-exposed individuals (n = 115), dual-exposed individuals (tobacco and alcohol) (n = 73), and alcohol-exposed individuals (n = 14). A significant positive correlation was observed between alcohol exposure duration and LcIMT (rho = 0.531, p < 0.05), and a strong negative correlation was observed with peak diameter (rho=-0.788, p < 0.001), with a very strong correlation in males (r=-0.894, p < 0.05). The duration of alcohol exposure significantly affected LcIMT (p = 0.0468) after adjusting for body mass index (BMI), SBP and DBP. However, brachial artery (BA) peak diameter was not significantly associated with the duration of alcohol consumption during pregnancy after the adjustment for age, SBP or BA baseline diameter. Conclusion Increased BMI and SBP may contribute to a reduced peak diameter in adolescents exposed to alcohol, potentially indicating lower FMD in adulthood. Further studies should elucidate the biological mechanisms involved through long-term prospective studies.https://doi.org/10.1186/s12872-025-05010-1Blood pressureBody mass index mediatorsTeratogensVascular dysfunction
spellingShingle Tammy Hartel
Aamer Sandoo
André Oelofse
Juléy De Smidt
Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis
BMC Cardiovascular Disorders
Blood pressure
Body mass index mediators
Teratogens
Vascular dysfunction
title Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis
title_full Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis
title_fullStr Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis
title_full_unstemmed Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis
title_short Carotid intima–media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero: a mediation analysis
title_sort carotid intima media thickness and endothelial function in adolescents exposed to alcohol consumption and cigarette smoking in utero a mediation analysis
topic Blood pressure
Body mass index mediators
Teratogens
Vascular dysfunction
url https://doi.org/10.1186/s12872-025-05010-1
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