Niu Z, Wen X, Buka S, et al. - An elevated risk of predicted midlife atherosclerotic lesions and hypercholesterolemia may exist in individuals with short birth telomere length (TL).

• From a US birth cohort, 144 adult offspring born in 1959–1966 were recruited.

• Banked cord blood was used to measure birth TL.

• Pathobiological Determinants of Atherosclerosis in Youth (PDAY) score was assessed to predict atherosclerotic lesions.

• Midlife follow-up revealed hypercholesterolemia and hypertension diagnosis was received by 31.2% and 18.7% of participants, respectively, and 8.3% fulfilled the criteria for metabolic syndrome.

• Higher PDAY score, elevated odds of hypercholesterolemia and the presence of any cardiometabolic abnormalities were evident in relation to short birth TL, vs longer birth TL, after adjusting for prenatal confounders.