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Dinerstein A, Aspres N, Nieto R, Saure C, Cimbaro Canella R, Casale MR, Moiron MDC, Kasten L, Benitez A, Galindo A, Conti R. Presence of metabolic syndrome markers in very low birth weight ex-premature infants during early adolescence. J Pediatr Endocrinol Metab 2024; 37:613-621. [PMID: 38912751 DOI: 10.1515/jpem-2023-0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 05/15/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVES To investigate the association of growth patterns with overweight/obesity and markers of metabolic syndrome in ex-premature adolescents; to assess the relationship between the increase (1 SD) in Z-score weight at term and at 2 years with outcomes in adolescents with or without intrauterine growth restriction; and to evaluate the association between the Cook criteria and overweight/obesity according to body mass index. METHODS Cohort, retrospective, analytical study. Population: adolescents born weighting<1,500 g. RESULTS One hundred twenty-seven adolescents (11.3 years) were included. There is an association between the 1 SD increase in the percentile (Pc) of weight at 40 weeks and at 2 years in the population with adequate birth weight (PCA) with insulin levels, resistance, and sensitivity at 11 years. Catch-up at 2 years was associated with significantly higher proportion of HDL value<41 (18.75 vs. 5.36 %) OR 4.08 95% CI (1.04-16.05) p=0.031. Overweight/obesity was associated with waist circumference index>0.5, HDL<41, and with blood pressure greater than Pc 90 for sex and height. CONCLUSIONS In preterm infants, a 1 SD increase in weight Z score at 40 weeks and 2 years was predictive of metabolic and cardiovascular disorders in adolescence.
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Affiliation(s)
- Alejandro Dinerstein
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Norma Aspres
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Ricardo Nieto
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Carola Saure
- Nutrition and Diabetes Division, Hospital JP Garrahan, Ciudad Autónoma de Buenos Aires, Argentina
| | - Raul Cimbaro Canella
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Maria Rosa Casale
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Maria Del Carmen Moiron
- Biochemistry Clinical Section, 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Laura Kasten
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Alicia Benitez
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Ana Galindo
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
| | - Roxana Conti
- Division of Neonatology 154743 Hospital Materno Infantil Ramón Sardá , Ciudad Autónoma de Buenos Aires, Argentina
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Tekeba B, Techane MA, Workneh BS, Zegeye AF, Gonete AT, Ahmed MA, Wassie YA, Wassie M, Kassie AT, Ali MS, Mekonen EG, Tamir TT, Tsega SS. Determinants of preterm birth among reproductive age women in sub-Saharan Africa: Evidence from the most recent Demographic and Health Survey data-2019-2022. PLoS One 2024; 19:e0305810. [PMID: 38917208 PMCID: PMC11198911 DOI: 10.1371/journal.pone.0305810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Accepted: 06/05/2024] [Indexed: 06/27/2024] Open
Abstract
INTRODUCTION Preterm birth is the leading cause of both infant and neonatal mortality. It also had long-term consequences for the physical and neurological development of a growing child. The majority of these and related problems occur in low- and middle-income countries, particularly in sub-Saharan Africa, due to resource scarcity to sustain the lives of premature babies. Despite this, there is a paucity of recent information on the pooled prevalence and factors associated with preterm birth in sub-Saharan Africa. Therefore, this study aimed to update the pooled prevalence and determinants of preterm birth in sub-Saharan Africa based on the most recent Demographic and Health Survey data. METHODS A cross-sectional study design using the most recent demographic and health survey data from eight sub-Saharan African countries was used. We included a total weighted sample of 74,871 reproductive-aged women who gave birth in the five years preceding the survey. We used a multilevel logistic regression model to identify associated factors of preterm birth in sub-Saharan Africa. The adjusted odds ratio at 95% Cl was computed to assess the strength and significance of the association between explanatory and outcome variables. Factors with a p-value of <0.05 are declared statistically significant. RESULTS In this study, the pooled prevalence of preterm birth among reproductive-aged women in eight sub-Saharan African countries was 3.11% (95% CI: 2.98-3.25). Working mothers (AOR = 0.61; 95% CI: 0.38-0.97), being married (AOR = 0.63; 95% CI: 0.40-0.99), and having media exposure (AOR = 0.59; 95% CI: 0.36-0.96) decrease the odds of preterm birth. On the other hand, being low birth weight (AOR = 17.7; 95% CI: 10.7-29.3), having multiple pregnancies (AOR = 3.43; 95% CI: 1.82-6.45), having a history of terminated pregnancies (AOR = 1.56; 95% CI: 1.01-2.41), being un-educated (AOR = 3.16; 95% CI: 1.12-8.93), being of a maternal age above 35 (AOR = 1.63; 95% CI: 1.08-2.45), maternal alcohol use (AOR = 19.18; 95% CI: 13.6-38.8), and being in the low socio-economic status (AOR = 1.85; 95% CI: 1.11-3.07) of the community increase the odds of preterm birth. CONCLUSION The burden of preterm birth among reproductive-age women in sub-Saharan Africa showed improvements as compared to previous findings. To further lessen the burden, policymakers and other pertinent organizations must prioritize maternal health, expand media access, educate and empower women, and promote a healthy lifestyle for reproductive-age women.
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Affiliation(s)
- Berhan Tekeba
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Masersha Asmare Techane
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Belayneh Shetie Workneh
- Department of Emergency and Critical Care Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alebachew Ferede Zegeye
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Almaz Tefera Gonete
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Medina Abdela Ahmed
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yilkal Abebaw Wassie
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mulugeta Wassie
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Tadesse Kassie
- Department of Clinical Midwifery, School of Midwifery, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Mohammed Seid Ali
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Enyew Getaneh Mekonen
- Department of Surgical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Tarik Tamir
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sintayehu Simie Tsega
- Department of Medical Nursing, School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Diao S, Chen C, Benani A, Magnan C, Van Steenwinckel J, Gressens P, Cruciani-Guglielmacci C, Jacquens A, Bokobza C. Preterm birth: A neuroinflammatory origin for metabolic diseases? Brain Behav Immun Health 2024; 37:100745. [PMID: 38511150 PMCID: PMC10950814 DOI: 10.1016/j.bbih.2024.100745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/16/2024] [Accepted: 02/21/2024] [Indexed: 03/22/2024] Open
Abstract
Preterm birth and its related complications have become more and more common as neonatal medicine advances. The concept of "developmental origins of health and disease" has raised awareness of adverse perinatal events in the development of diseases later in life. To explore this concept, we propose that encephalopathy of prematurity (EoP) as a potential pro-inflammatory early life event becomes a novel risk factor for metabolic diseases in children/adolescents and adulthood. Here, we review epidemiological evidence that links preterm birth to metabolic diseases and discuss possible synergic roles of preterm birth and neuroinflammation from EoP in the development of metabolic diseases. In addition, we explore theoretical underlying mechanisms regarding developmental programming of the energy control system and HPA axis.
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Affiliation(s)
- Sihao Diao
- Université Paris Cité, Inserm, NeuroDiderot, 75019, Paris, France
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
- Key Laboratory of Neonatal Diseases, National Health Commission, China
| | - Chao Chen
- Department of Neonatology, Children's Hospital of Fudan University, Shanghai, 201102, China
- Key Laboratory of Neonatal Diseases, National Health Commission, China
| | - Alexandre Benani
- CSGA, Centre des Sciences du Goût et de l'Alimentation, UMR 6265 CNRS, INRAE, Institut Agro Dijon, Université Bourgogne Franche-Comté, Dijon, France
| | | | | | - Pierre Gressens
- Université Paris Cité, Inserm, NeuroDiderot, 75019, Paris, France
| | | | - Alice Jacquens
- Université Paris Cité, Inserm, NeuroDiderot, 75019, Paris, France
- Department of Anesthesia and Critical Care, APHP-Sorbonne University, Hôpital La Pitié- Salpêtrière, Paris, France
| | - Cindy Bokobza
- Université Paris Cité, Inserm, NeuroDiderot, 75019, Paris, France
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Karabulut D, Karabulut U, Kalyoncuoğlu M, Katkat F, Berber İ. Predictive value of triglyceride/glucose index for cardiac outcomes in non-diabetic renal transplant recipients. Acta Cardiol 2024; 79:319-326. [PMID: 37767903 DOI: 10.1080/00015385.2023.2257983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 08/22/2023] [Indexed: 09/29/2023]
Abstract
OBJECTIVES Insulin resistance (IR) is associated with an increased risk of adverse cardiovascular outcomes. The triglyceride-glucose index (TyG index) is a reliable marker of IR. No study has examined the impact of the TyG index on major adverse cardiac and cerebrovascular events (MACCEs) in RTRs. Therefore, this study aimed to investigate the predictive value of the TyG index for MACCEs in RTRs. MATERIALS AND METHODS Non-diabetic patients undergoing renal transplantation were retrospectively enrolled. The patients were divided into two groups according to MACCE development. The cut-off value of the TyG index for MACCE was conducted. RESULTS The mean age of 522 patients was 41 (31-51) years, and 349 (66.9%) were male. During the 5.4-year follow-up, 84 (16%) MACCE were recorded. TyG index was significantly higher in the group that developed MACCE (p < 0,001). Cox regression analysis revealed that TyG index [HR: 3.297 (1.228-8.855), p = 0.018], left ventricle ejection fraction [HR: 0.934 (0.900-0.968), p < 0.001], cadaveric transplantation [HR: 8.886 (4.764-16.576), p < 0.001], graft survey [HR: 0.608 (0.542-0.682), p < 0.001)], and smoking [HR: 1.965 (1.117-3.456), p = 0.019] were independent predictors of MACCEs in nondiabetic RTRs. CONCLUSION TyG index is an independent predictor of MACCEs in non-diabetic RTRs. The widespread use of the TyG index may positively affect long-term treatment costs and survival.
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Affiliation(s)
- Dilay Karabulut
- Cardiology Department, Bakırkoy Dr. Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Umut Karabulut
- Cardiology Department, Acıbadem International Hospital, Istanbul, Turkey
| | - Muhsin Kalyoncuoğlu
- Cardiology Department, Haseki Sultangazi Educational and Research Hospital, Istanbul, Turkey
| | - Fahrettin Katkat
- Cardiology Department, Bağcılar Training and Research Hospital, İstanbul, Turkey
| | - İbrahim Berber
- Cardiology Department, Acıbadem International Hospital, Istanbul, Turkey
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Juvinao-Quintero DL, Sanchez SE, Workalemahu T, Pinto N, Liang L, Williams MA, Gelaye B. Genetic association study of Preterm birth and Gestational age in a population-based case-control study in Peru. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.22.23298891. [PMID: 38045296 PMCID: PMC10690348 DOI: 10.1101/2023.11.22.23298891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
Preterm birth (PTB) is an adverse pregnancy outcome affecting ∼15 million pregnancies worldwide. Genetic studies have identified several candidate loci for PTB, but results remain inconclusive and limited to European populations. Thus, we conducted a genome-wide association study (GWAS) of PTB and gestational age at delivery (GA) among 2,212 Peruvian women. PTB cases delivered ≥ 20 weeks' but < 37 weeks' gestation, while controls delivered at term (≥ 37 weeks but < 42 weeks). After imputation (TOPMED) and quality control, we assessed the association of ∼6 million SNPs with PTB and GA using multivariable regression models adjusted for maternal age and the first two genetic principal components. In silico functional analysis (FUMA-GWAS) was conducted among top signals detected with an arbitrary P < 1.0×10 -5 in each GWAS. We sought to replicate genetic associations with PTB and GA identified in Europeans, and we developed a genetic risk score for GA based on European markers. Mean GA was 30 ± 4 weeks in PTB cases (N=933) and 39 ± 1 in the controls (N=1,279). PTB cases were slightly older and had higher C-sections and vaginal bleeding than controls. No association was identified at genome-wide level. Top suggestive ( P < 1.0×10 -5 ) signals were seen at rs13151645 ( LINC01182 ) for PTB, and at rs72824565 ( CTNNA2 ) for GA. Top PTB variants were enriched for biological pathways associated with polyketide, progesterone, steroid hormones, and glycosyl metabolism. Top GA variants were enriched in intronic regions and cancer pathways, and these genes were upregulated in the brain and subcutaneous adipose tissue. In combination with non-genetic risk factors, top SNPs explained 14% and 15% of the phenotypic variance of PTB and GA in our sample, but these results need to be interpreted with caution. Variants in WNT4 associated with GA in Europeans were replicated in our study. The genetic risk score based in European markers, was associated with a 2-day longer GA (R 2 =0.003, P =0.002) per standard deviation increase in the score in our sample. This genetic association study identified various signals suggestively associated with PTB and GA in a non- European population; they were linked to relevant biological pathways related to the metabolism of progesterone, prostanoid, and steroid hormones, and genes associated with GA were significantly upregulated in relevant tissues for the pathophysiology of PTB based on the in- silico functional analysis. None of these top variants overlapped with signals previously identified for PTB or GA in Europeans.
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Abdo CVBP, Belém CGMS, Colosimo EA, Viana MCFB, Silva IN. Association of preterm birth with poor metabolic outcomes in schoolchildren. J Pediatr (Rio J) 2023; 99:464-470. [PMID: 37059119 PMCID: PMC10492147 DOI: 10.1016/j.jped.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 04/16/2023] Open
Abstract
OBJECTIVE To investigate, at school age, the metabolic profile of children born preterm. METHODS A cross-sectional study of children 5 to 8 years old, born with gestational age (GA) < 34 weeks and/or weight ≤ 1,500 grams. Clinical and anthropometric data were assessed by a single trained pediatrician. Biochemical measurements were done at the organization's Central Laboratory using standard methods. Data on health conditions, eating, and daily life habits were retrieved from medical charts and through validated questionnaires. Binary logistic and linear regression models were built to identify the association between variables, weight excess, and GA. RESULTS Out of 60 children (53.3% female), 6.8 ± 0.7 years old, 16.6% presented excess weight, 13.3% showed increased insulin resistance markers and 36.7% had abnormal blood pressure values. Those presenting excess weight had higher waist circumferences and higher HOMA-IR than normal-weight children (OR = 1.64; CI = 1.035-2.949). Eating and daily life habits were not different among overweight and normal-weight children. The small-for-gestational-age (SGA) and appropriate-for-gestational-age (AGA, 83.3%) birth weight children did not differ regarding clinical (body weight, blood pressure) or biochemical variables (serum lipids, blood glucose, HOMA-IR). CONCLUSION Schoolchildren born preterm, regardless of being AGA or SGA, were overweight, and presented increased abdominal adiposity, reduced insulin sensitivity, and altered lipid profile, justifying longitudinal follow-up regarding adverse metabolic outcomes in the future.
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Affiliation(s)
- Cristiane Valéria Batista Pereira Abdo
- Endocrinologia Pediátrica, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil; Medicina (Saúde da Criança e do Adolescente), Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Enrico Antonio Colosimo
- Departamento de Estatística, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Ivani Novato Silva
- Departamento de Pediatria, Hospital das Clínicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.
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Méio MDBB, Moreira MEL, Villela LD, de Rodrigues MCC, de Almeida Di Maio Ferreira FCP, de Paula Barros LB, Nehab SRG, Ribas SA, Teixeira MT, Amorim MHM, Gomes-Junior SCS. Physical and social activities constraint and its effects on Body Mass Index of former Neonatal Intensive Care children. Early Hum Dev 2023; 183:105817. [PMID: 37413948 DOI: 10.1016/j.earlhumdev.2023.105817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/23/2023] [Accepted: 06/27/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE It is reported weight gain in children due to the confinement measures during the Covid-19 pandemic. We aimed to describe the effect of these measures on the nutritional status of former Neonatal Intensive Care Unit children. METHODS Cross-sectional study, including former Neonatal Intensive Care Unit children. The outcome was the Body mass index (BMI). RESULTS We enrolled 126 children (74.6 % preterm; 31 % small-for-gestational-age). Weight excess was greater in the youngest group (≤5 years: 33.8 %; >5 years: 15.2 %). Prematurity was associated with weight excess in both groups (≤5 years: p value 0.006; >5 years: p value 0.046; Pearson test). Mealtime changes, lack of physical activity, socioeconomic factors and the perinatal morbidities significantly influenced the mean BMI. Birth length Z score less than -1.28 was negatively associated with BMI, while gestational age at birth presented a positive association with BMI (linear regression model). CONCLUSIONS The BMI increase due to the confinement measures associated with the gestational age at birth and in those born with intrauterine growth restriction is a matter of concern, as it might indicate a risk for future obesity.
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Affiliation(s)
- Maria Dalva Barbosa Baker Méio
- Post-graduation of Applied Clinical Research, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
| | - Maria Elisabeth Lopes Moreira
- Post-graduation of Applied Clinical Research, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Letícia Duarte Villela
- Department of Neonatology, Coordinator of the Follow-Up Clinic, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Maura Calixto Cecherelli de Rodrigues
- Department of Pediatrics and at the High-risk Newborn Follow-up Clinic, Hospital Universitário Pedro Ernesto, Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | | | | | - Sylvia Reis Gonçalves Nehab
- Department of Neonatology, Follow-Up Clinic, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
| | - Simone Augusta Ribas
- External Collaborator - Professor of the Extension Project Outpatient Follow-up of High-Risk Newborns, Hospital Universitário Pedro Ernesto, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | - Michelle Teixeira Teixeira
- Hospital Universitário Gaffrée Guinle, Universidade Federal do Estado do Rio de Janeiro - UNIRIO, Rio de Janeiro, RJ, Brazil.
| | - Maria Helena Miranda Amorim
- Universidade UNIGRANRIO, Bolsista PIBIC at Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil.
| | - Saint Clair S Gomes-Junior
- Post-graduation of Applied Clinical Research, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, RJ, Brazil
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Cauzzo C, Chiavaroli V, Di Valerio S, Chiarelli F. Birth size, growth trajectory and later cardio-metabolic risk. Front Endocrinol (Lausanne) 2023; 14:1187261. [PMID: 37342257 PMCID: PMC10277632 DOI: 10.3389/fendo.2023.1187261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/19/2023] [Indexed: 06/22/2023] Open
Abstract
There is increasing evidence of a strong association between intrauterine growth and subsequent development of chronic disease in adult life. Birth size and growth trajectory have been demonstrated to have an impact on cardio-metabolic health, both in childhood and adult life. Hence, careful observation of the children's growth pattern, starting from the intrauterine period and the first years of life, should be emphasized to detect the possible onset of cardio-metabolic sequelae. This allows to intervene on them as soon as they are detected, first of all through lifestyle interventions, whose efficacy seems to be higher when they are started early. Recent papers suggest that prematurity may constitute an independent risk factor for the development of cardiovascular disease and metabolic syndrome, regardless of birth weight. The purpose of the present review is to examine and summarize the available knowledge about the dynamic association between intrauterine and postnatal growth and cardio-metabolic risk, from childhood to adulthood.
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Affiliation(s)
- Chiara Cauzzo
- Department of Pediatrics, University of Chieti, Chieti, Italy
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9
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Ni Y, Lancaster R, Suonpera E, Bernardi M, Fahy A, Larsen J, Trickett J, Hurst JR, Wolke D, Johnson S, Marlow N. Growth in extremely preterm children born in England in 1995 and 2006: the EPICure studies. Arch Dis Child Fetal Neonatal Ed 2022; 107:193-200. [PMID: 34257100 PMCID: PMC8867260 DOI: 10.1136/archdischild-2020-321107] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 06/28/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVES To determine growth outcomes at 11 years of age in children born <27 weeks of gestation in England in 2006 (EPICure2) and to compare growth from birth to 11 years of age for births<26 weeks with those in England in 1995 (EPICure). METHODS 200 EPICure2 children assessed at 11 years alongside 143 term-born controls. Growth measures from birth to 11 years were compared for births<26 weeks between EPICure2 (n=112) and EPICure (n=176). Growth parameter z-scores were derived from 1990 UK standards. RESULTS Among EPICure2 children, mean z-scores for height and weight were close to the population standards (0.08 and 0.18 SD, respectively) but significantly below those of controls: difference in mean (Δ) z-scores for weight -0.42 SD (95% CI -0.68 to -0.17), for height -0.45 SD (-0.70 to -0.20) and for head circumference (HC) -1.05 SD (-1.35 to -0.75); mean body mass index (BMI) z-score in EPICure2 children was 0.18 SD, not significantly different from controls (0.43 SD, p=0.065). Compared with EPICure, EPICure2 children born <26 weeks at 11 years had higher z-scores for weight (Δ 0.72 (0.47, 0.96)), height (Δ 0.55 (0.29, 0.81)) and BMI (Δ 0.56 (0.24, 0.87)), which were not fully explained by perinatal/demographic differences between eras. Weight catch-up was greater from term-age to 2.5/3 years in EPICure2 than in EPICure (1.25 SD vs 0.53 SD; p<0.001). Poor HC growth was observed in EPICure2, unchanged from EPICure. CONCLUSIONS Since 1995, childhood growth in weight, height and BMI have improved for births <26 weeks of gestation, but there was no improvement in head growth.
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Affiliation(s)
- Yanyan Ni
- EGA Institute for Women's Health, University College London, London, UK .,Department of Psychology, University of Warwick, Coventry, UK
| | - Rebecca Lancaster
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Emmi Suonpera
- EGA Institute for Women's Health, University College London, London, UK
| | | | - Amanda Fahy
- EGA Institute for Women's Health, University College London, London, UK
| | - Jennifer Larsen
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Jayne Trickett
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Dieter Wolke
- Department of Psychology, University of Warwick, Coventry, UK,Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Samantha Johnson
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Neil Marlow
- EGA Institute for Women's Health, University College London, London, UK
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Tagi VM, Samvelyan S, Chiarelli F. An update of the consensus statement on insulin resistance in children 2010. Front Endocrinol (Lausanne) 2022; 13:1061524. [PMID: 36465645 PMCID: PMC9709113 DOI: 10.3389/fendo.2022.1061524] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 10/14/2022] [Indexed: 11/17/2022] Open
Abstract
In our modern society, where highly palatable and calorie-rich foods are readily available, and sedentary lifestyle is common among children and adolescents, we face the pandemic of obesity, nonalcoholic fatty liver disease, hypertension, atherosclerosis, and T2D. Insulin resistance (IR) is known to be the main underlying mechanism of all these associated health consequences; therefore, the early detection of IR is fundamental for preventing them.A Consensus Statement, internationally supported by all the major scientific societies in pediatric endocrinology, was published in 2010, providing all the most recent reliable evidence to identify the definition of IR in children, its measurement, its risk factors, and the effective strategies to prevent and treat it. However, the 2010 Consensus concluded that further research was necessary to assess some of the discussed points, in particular the best way to measure insulin sensitivity, standardization of insulin measurements, identification of strong surrogate biomarkers of IR, and the effective role of lifestyle intervention and medications in the prevention and treatment of IR.The aim of this review is to update each point of the consensus with the most recent available studies, with the goal of giving a picture of the current state of the scientific literature regarding IR in children, with a particular regard for issues that are not yet fully clarified.
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Affiliation(s)
- Veronica Maria Tagi
- Department of Pediatrics, University of Chieti, Chieti, Italy
- *Correspondence: Veronica Maria Tagi,
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11
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Alamneh TS, Teshale AB, Worku MG, Tessema ZT, Yeshaw Y, Tesema GA, Liyew AM, Alem AZ. Preterm birth and its associated factors among reproductive aged women in sub-Saharan Africa: evidence from the recent demographic and health surveys of sub-Sharan African countries. BMC Pregnancy Childbirth 2021; 21:770. [PMID: 34781891 PMCID: PMC8591945 DOI: 10.1186/s12884-021-04233-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 10/25/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Globally, preterm birth is the leading cause of neonatal and under-five children mortality. Sub-Saharan African (SSA) accounts for the majority of preterm birth and death following its complications. Despite this, there is limited evidence about the pooled prevalence and associated factors of preterm birth at SSA level using nation-wide representative large dataset. Therefore, this study aimed to determine the pooled prevalence and associated factors of preterm birth among reproductive aged women. METHODS The recent Demographic and Health Surveys (DHSs) data of 36 SSA countries were used. We included a total weighted sample of 172,774 reproductive-aged women who were giving birth within five years preceding the most recent survey of SSA countries were included in the analysis. We used a multilevel logistic regression model to identify the associated factors of preterm birth in SSA. We considered a statistical significance at a p-value less than 0.05. RESULTS In this study, 5.33% (95% CI: 5.23, 5.44%) of respondents in SSA had delivered preterm baby. Being form eastern Africa, southern Africa, rural area, being educated, substance use, having multiple pregnancy, currently working history, having history of terminated pregnancy, and previous cesarean section delivery, primi-parity, and short birth interval were associated with higher odds of preterm birth among reproductive aged women. However, having better wealth index, being married, wanted pregnancy, and having four or more antenatal care visit were associated with lower odds for a preterm birth among reproductive aged women. CONCLUSION The prevalence of preterm birth among reproductive-aged women remains a major public health problem in SSA. Preterm birth was affected by various socio-economic and obstetrical factors. Therefore, it is better to consider the high-risk groups during intervention to prevent the short-term and long-term consequences of preterm birth.
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Affiliation(s)
- Tesfa Sewunet Alamneh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Achamyeleh Birhanu Teshale
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Misganaw Gebrie Worku
- Department of Human Anatomy, University of Gondar, College of Medicine and Health Science, School of Medicine, Gondar, Ethiopia
| | - Zemenu Tadesse Tessema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yigizie Yeshaw
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Physiology, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Getayeneh Antehunegn Tesema
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemneh Mekuriaw Liyew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Adugnaw Zeleke Alem
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Chiavaroli V, Derraik JGB, Jayasinghe TN, Rodrigues RO, Biggs JB, Battin M, Hofman PL, O'Sullivan JM, Cutfield WS. Lower insulin sensitivity remains a feature of children born very preterm. Pediatr Diabetes 2021; 22:161-167. [PMID: 33084185 DOI: 10.1111/pedi.13140] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 09/24/2020] [Accepted: 10/15/2020] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND The first report of children born very preterm (<32 weeks of gestation) having insulin resistance was made 16 years ago. However, neonatal care has improved since. Thus, we aimed to assess whether children born very preterm still have lower insulin sensitivity than term controls. METHODS Participants were prepubertal children aged 5 to 11 years born very preterm (<32 weeks of gestation; n = 51; 61% boys) or at term (37-41 weeks; n = 50; 62% boys). Frequently sampled intravenous glucose tolerance tests were performed, and insulin sensitivity was calculated using Bergman's minimal model. Additional clinical assessments included anthropometry, body composition using whole-body dual-energy X-ray absorptiometry scans, clinic blood pressure, and 24-hour ambulatory blood pressure monitoring. RESULTS Children born very preterm were 0.69 standard deviation score (SDS) lighter (P < .001), 0.53 SDS shorter (P = .003), and had body mass index 0.57 SDS lower (P = .003) than children born at term. Notably, children born very preterm had insulin sensitivity that was 25% lower than term controls (9.4 vs 12.6 × 10-4 minutes-1 ·[mU/L]; P = .001). Other parameters of glucose metabolism, including fasting insulin levels, were similar in the two groups. The awake systolic blood pressure (from 24-hour monitoring) tended to be 3.1 mm Hg higher on average in children born very preterm (P = .054), while the clinic systolic blood pressure was 5.4 mm Hg higher (P = .002). CONCLUSIONS Lower insulin sensitivity remains a feature of children born very preterm, despite improvements in neonatal intensive care. As reported in our original study, our findings suggest the defect in insulin action in prepubertal children born very pretermis primarily peripheral and not hepatic.
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Affiliation(s)
- Valentina Chiavaroli
- Liggins Institute, University of Auckland, Auckland, New Zealand.,Neonatal Intensive Care Unit, Pescara Public Hospital, Pescara, Italy
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Endocrinology Department, Children's Hospital of Zhejiang University School of Medicine, Hangzhou, China
| | | | | | - Janene B Biggs
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Malcolm Battin
- Newborn Services, Auckland City Hospital, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.,A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
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13
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Ni Y, Beckmann J, Hurst JR, Morris JK, Marlow N. Size at birth, growth trajectory in early life, and cardiovascular and metabolic risks in early adulthood: EPICure study. Arch Dis Child Fetal Neonatal Ed 2021; 106:149-155. [PMID: 32796060 PMCID: PMC7116791 DOI: 10.1136/archdischild-2020-319328] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/13/2020] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate whether size at birth and growth trajectories in infancy and childhood are associated with determinants of cardiovascular and metabolic risks in young adults born extremely preterm (EP, <26 weeks of gestation). METHODS We used longitudinal data from the EPICure study of 129 EP survivors up to 19 years in the UK and Ireland in 1995. Determinants of cardiovascular and metabolic risks at 19 years included the presence of metabolic syndrome, body mass index (BMI) and systolic blood pressure (SBP). Predictors were birth weight for gestation and gain in weight z-scores in the following periods: birth-postmenstrual age of 40 weeks (term), infancy (term-2.5 years), early childhood (2.5-6.0 years) and late childhood (6-11 years). RESULTS Metabolic syndrome was present in 8.7% of EP participants at 19 years. Compared with subjects without metabolic syndrome, those with metabolic syndrome tended to have a smaller size at birth (difference in means: -0.55 SD, 95% CI -1.10 to 0.01, p=0.053) and a greater increase in weight z-scores from term to 2.5 years (difference in means: 1.00 SD, 95% CI -0.17 to 2.17, p=0.094). BMI at 19 years was positively related to growth from 2.5 to 6.0 years ( β : 1.03, 95% CI 0.31 to 1.75, p=0.006); an inverse association with birthweight z-scores was found in the lower socioeconomic status group ( β : -1.79, 95% CI -3.41 to -0.17, p=0.031). Central SBP was positively related to growth from 2.5 to 6.0 years ( β : 1.75, 95% CI 0.48 to 3.02, p=0.007). CONCLUSION Size at EP birth and increased catch-up in weight from 2.5 to 6.0 years were associated with BMI and central SBP in early adulthood.
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Affiliation(s)
- Yanyan Ni
- UCL EGA Institute for Women's Health, University College London, London, UK
| | - Joanne Beckmann
- Institute for Women’s Health, University College London, London, UK
| | - John R Hurst
- UCL Respiratory, University College London, London, UK
| | - Joan K Morris
- Population Health Research Institute, St George’s, University of London, UK
| | - Neil Marlow
- Institute for Women’s Health, University College London, London, UK
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van der Pal SM, van der Meulen SA, Welters SM, Bakker LA, de Groot CJM, van Kaam AH, Verrips E(G. Reproductive risks in 35-year-old adults born very preterm and/or with very low birth weight: an observational study. Eur J Pediatr 2021; 180:1219-1228. [PMID: 33161502 PMCID: PMC7940302 DOI: 10.1007/s00431-020-03864-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 10/26/2020] [Accepted: 10/29/2020] [Indexed: 11/29/2022]
Abstract
Evidence suggests that increased survival over the last decades of very preterm (VPT; gestational age < 32 weeks)- and very low birth weight (VLBW; birth weight < 1500 g)-born infants is not matched by improved outcomes. The objective of our study was to evaluate the reproductive rate, fertility, and pregnancy complications in 35-year-old VPT/VLBW subjects. All Dutch VPT/VLBW infants born alive in 1983 and surviving until age 35 (n = 955) were eligible for a POPS-35 study. A total of 370 (39%) subjects completed a survey on reproductive rate, fertility problems, pregnancy complications, and perinatal outcomes of their offspring. We tested differences in these parameters between the VPT/VLBW subjects and their peers from Dutch national registries. POPS-35 participants had less children than their peers in the CBS registry. They reported more problems in conception and pregnancy complications, including a three times increased risk of hypertension during pregnancy.Conclusion: Reproduction is more problematic in 35-year olds born VPT/VLBW than in the general population, possibly mediated by an increased risk for hypertension, but their offspring have no elevated risk for preterm birth. What is known: At age 28, the Dutch national POPS cohort, born very preterm or with a very low birth in 1983, had lower reproductive rates than the general Dutch population (female 23% versus 32% and male 7% versus 22%). What is new: At age 35, the Dutch POPS cohort still had fewer children than the general Dutch population (female 56% versus 74% and male 40% versus 56%). Females in the POPS cohort had a higher risk of fertility problems and pregnancy complications than their peers in the Dutch national registries, but their offspring had no elevated risk for preterm birth.
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Affiliation(s)
| | | | - Sophie M. Welters
- Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | | | - Christianne J. M. de Groot
- Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Reproduction & Development Research Institute, Amsterdam, The Netherlands
| | - Anton H. van Kaam
- Department of Neonatology, Emma Children’s Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Whey Versus Casein as a Protein Source during the Weaning Period: Impact on Growth and Later Adiposity and Glucose Homeostasis in a Rat Model of Intrauterine Growth Restriction. Nutrients 2020; 12:nu12113399. [PMID: 33167459 PMCID: PMC7694472 DOI: 10.3390/nu12113399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/26/2020] [Accepted: 11/03/2020] [Indexed: 11/17/2022] Open
Abstract
The impact of early life protein source (whey vs. casein) on short- and long-term glucose homeostasis and adiposity is unknown and was investigated in this study. At the end of the suckling period, non-IUGR (intrauterine growth restriction) and IUGR pups were separated from dams and were randomized into four groups. From age 21-49 days, non-IUGR and IUGR pups were fed ad-libitum chow or a semi-synthetic diet (20% from protein; casein or whey) and from age 50-199 days, all groups were fed ad-libitum chow. Food intake, body composition, glucose, and insulin homeostasis were assessed. Among the chow groups, IUGR had slower growth and higher fasting glucose at age 42 days, as well as higher fasting and AUC glucose at age 192 days relative to non-IUGR. The whey IUGR group had a slower growth rate and higher fasting glycemia in early life (age 21-49 days) and higher HOMA-IR later in life (age 120-122 and 190-192 days) relative to casein IUGR. This study shows the potential advantage of casein relative to whey during weaning on short term energy intake, growth, and glucose homeostasis in an IUGR model and reveals, for the first time, its long term impact on insulin sensitivity, which may have implications for later metabolic health, particularly in small-for-gestational-age populations at risk of type 2 diabetes.
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16
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Kistner A. Does low birthweight matter? Acta Paediatr 2020; 109:228-230. [PMID: 31746022 PMCID: PMC7004169 DOI: 10.1111/apa.15064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Anna Kistner
- Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden
- Medical Radiation Physics and Nuclear Medicine, Imaging and Physiology Karolinska University Hospital Stockholm Sweden
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17
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Tagi VM, Giannini C, Chiarelli F. Insulin Resistance in Children. Front Endocrinol (Lausanne) 2019; 10:342. [PMID: 31214120 PMCID: PMC6558106 DOI: 10.3389/fendo.2019.00342] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/13/2019] [Indexed: 12/28/2022] Open
Abstract
Insulin resistance (IR) is a pathological condition strongly associated with obesity. However, corticosteroids or growth hormone therapy and genetic diseases may affect insulin sensitivity lifelong. In obese children and adolescents of any age there is an evident association between IR and an increased prevalence of type 2 diabetes (T2D) and other elements contributing to the metabolic syndrome, leading to a higher cardiovascular risk. Therefore, early diagnosis and interventions in the attempt to prevent T2D when glycemia values are still normal is fundamental. The gold standard technique used to evaluate IR is the hyperinsulinemic euglycemic clamp, however it is costly and difficult to perform in clinical and research sets. Therefore, several surrogate markers have been proposed. Although the treatment of insulin resistance in children is firstly targeted to lifestyle interventions, in selected cases the integration of a pharmacological intervention might be taken into consideration. The aim of this review is to present the current knowledge on IR in children, starting with an outline of the recent evidences about the congenital forms of deficiency in insulin functioning and therefore focusing on the physiopathology of IR, its appropriate measurement, consequences, treatment options and prevention strategies.
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18
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van der Pal SM, Maurice-Stam H, Grootenhuis MA, van Wassenaer-Leemhuis AG, Verrips GHW. Psychosocial developmental trajectory of a cohort of young adults born very preterm and/or with a very low birth weight in the Netherlands. J Patient Rep Outcomes 2019; 3:17. [PMID: 30847606 PMCID: PMC6405782 DOI: 10.1186/s41687-019-0106-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 02/25/2019] [Indexed: 11/10/2022] Open
Abstract
Background The achievement of age-specific developmental milestones in youth is of great importance to the adjustment in adult life. Young adults who were born preterm, might go through a different developmental trajectory and transition into adulthood than their peers. This study aimed to compare the psychosocial developmental trajectory of young adults who were born preterm with peers from the general population. Young adults from the POPS (Project On Preterm and Small for gestational age infants) cohort study, born in 1983 in the Netherlands, completed online the Course of Life Questionnaire (CoLQ - achievement of psychosocial developmental milestones) at 28 years of age. Analysis of variance by group, age and gender was performed to test differences on the CoLQ scale scores between the POPS-group and 211 peers (25–30 years) from the general population (Ref-group). Differences on item level, representing the achievement of individual milestones, were analyzed with logistic regression analyses by group, age and gender. Results The POPS-group (n = 300, 32,3% biased response) scored significantly lower than the Ref-group on the scales Psychosexual Development (effect size − 0.26, p < 0.01), Antisocial Behavior (ES − 0.44, p < 0.001) and Substance Use & Gambling (ES − 0.35, p < .001). A further exploration on item-level revealed, among others, that the POPS-group had their first boyfriend/girlfriend at later age, were more often single, misbehaved less at school and smoked, drank and gambled less than the Ref-group. On the scales Autonomy Development and Social Development no differences were found between the POPS-group and the Ref-group. Conclusions A relatively less vulnerable respondent group of young adults born preterm showed some psychosocial developmental trajectory delays and might benefit from support at teenage age. Because of the non-response bias, we hypothesize that the total group of young adults born preterm will show more severe psychosocial developmental problems.
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Affiliation(s)
| | - Heleen Maurice-Stam
- Psychosocial Department, Emma Children's Hospital, University Medical Center, Amsterdam, Netherlands
| | - Martha A Grootenhuis
- Psychosocial Department, Emma Children's Hospital, University Medical Center, Amsterdam, Netherlands.,Princess Máxima Center for paediatric oncology, Utrecht, Netherlands
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20
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Abrantes MA, Valencia AM, Bany-Mohammed F, Aranda JV, Beharry KD. Dose response effects of postnatal hydrocortisone on growth and growth factors in the neonatal rat. Steroids 2018; 140:1-10. [PMID: 30142369 DOI: 10.1016/j.steroids.2018.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/08/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND PURPOSE Hydrocortisone (HC), at different dosages, is used in critically ill newborns for lung stability, blood pressure support, and prevention of chronic lung disease (CLD). Its long-term effects on postnatal growth are not well studied. We hypothesized that early exposure to high doses of HC adversely affects growth, growth factors, metabolic hormones, and neurological outcomes, persisting in adulthood. EXPERIMENTAL DESIGN Rat pups received a single daily intramuscular dose of HC (1 mg/kg/day, 5 mg/kg/day, or 10 mg/kg/day on days 3, 4 & 5 postnatal age (P3, P4, P5). Age-matched controls received equivalent volume saline. Body weight, linear growth, and neurological outcomes were monitored. Animals were sacrificed at P21, P45, and P70 for blood glucose, insulin, IGF-I, GH, leptin, and corticosterone levels. Liver mRNA expression of IGFs and IGFBPs were determined at P21 and P70. Memory and learning abilities were tested using the Morris water maze test at P70. RESULTS HC suppressed body weight and length at P12, P21 and P45, but by P70 there was catchup overgrowth in the 5 and 10 mg/kg/day groups. At P70 blood insulin, IGF-I, GH, and leptin levels were low, whereas blood glucose, and liver IGFs and IGFBPs were high in the high dose groups. High HC also caused delayed memory and learning abilities at P70. CONCLUSIONS These data demonstrate that while higher doses of HC may be required for hemodynamic stability and prevention of CLD, these doses may result in growth deficits, as well as neurological and metabolic sequelae in adulthood.
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Affiliation(s)
- Maria A Abrantes
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Long Beach Memorial Medical Center, Long Beach, CA 90806, USA; Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of California, Irvine Medical Center, Orange, CA 92868, USA; Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Kaiser Permanente, Anaheim, CA 92806, USA
| | - Arwin M Valencia
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Long Beach Memorial Medical Center, Long Beach, CA 90806, USA; Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of California, Irvine Medical Center, Orange, CA 92868, USA; Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Saddleback Memorial Medical Center, Laguna Hills, CA 92653, USA
| | - Fayez Bany-Mohammed
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of California, Irvine Medical Center, Orange, CA 92868, USA.
| | - Jacob V Aranda
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA; Department of Ophthalmology, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
| | - Kay D Beharry
- Department of Pediatrics, Division of Neonatal-Perinatal Medicine, Long Beach Memorial Medical Center, Long Beach, CA 90806, USA; Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of California, Irvine Medical Center, Orange, CA 92868, USA; Department of Pediatrics, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA; Department of Ophthalmology, Division of Neonatal-Perinatal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203, USA.
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Crispi F, Miranda J, Gratacós E. Long-term cardiovascular consequences of fetal growth restriction: biology, clinical implications, and opportunities for prevention of adult disease. Am J Obstet Gynecol 2018; 218:S869-S879. [PMID: 29422215 DOI: 10.1016/j.ajog.2017.12.012] [Citation(s) in RCA: 195] [Impact Index Per Article: 32.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2017] [Revised: 12/04/2017] [Accepted: 12/06/2017] [Indexed: 02/07/2023]
Abstract
In the modern world, cardiovascular disease is a leading cause of death for both men and women. Epidemiologic studies consistently have suggested an association between low birthweight and/or fetal growth restriction and increased rate of cardiovascular mortality in adulthood. Furthermore, experimental and clinical studies have demonstrated that sustained nutrient and oxygen restriction that are associated with fetal growth restriction activate adaptive cardiovascular changes that might explain this association. Fetal growth restriction results in metabolic programming that may increase the risk of metabolic syndrome and, consequently, of cardiovascular morbidity in the adult. In addition, fetal growth restriction is strongly associated with fetal cardiac and arterial remodeling and a subclinical state of cardiovascular dysfunction. The cardiovascular effects ocurring in fetal life, includes cardiac morphology changes, subclinical myocardial dysfunction, arterial remodeling, and impaired endothelial function, persist into childhood and adolescence. Importantly, these changes have been described in all clinical presentations of fetal growth restriction, from severe early- to milder late-onset forms. In this review we summarize the current evidence on the cardiovascular effects of fetal growth restriction, from subcellular to organ structure and function as well as from fetal to early postnatal life. Future research needs to elucidate whether and how early life cardiovascular remodeling persists into adulthood and determines the increased cardiovascular mortality rate described in epidemiologic studies.
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Chehade H, Simeoni U, Guignard JP, Boubred F. Preterm Birth: Long Term Cardiovascular and Renal Consequences. Curr Pediatr Rev 2018; 14:219-226. [PMID: 30101715 PMCID: PMC6416185 DOI: 10.2174/1573396314666180813121652] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 07/26/2018] [Accepted: 07/27/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Cardiovascular and chronic kidney diseases are a part of noncommunicable chronic diseases, the leading causes of premature death worldwide. They are recognized as having early origins through altered developmental programming, due to adverse environmental conditions during development. Preterm birth is such an adverse factor. Rates of preterm birth increased in the last decades, however, with the improvement in perinatal and neonatal care, a growing number of preterm born subjects has now entered adulthood. Clinical and experimental evidence suggests that preterm birth is associated with impaired or arrested structural or functional development of key organs/systems making preterm infants vulnerable to cardiovascular and chronic renal diseases at adulthood. This review analyzes the evidence of such cardiovascular and renal changes, the role of perinatal and neonatal factors such as antenatal steroids and potential pathogenic mechanisms, including developmental programming and epigenetic alterations. CONCLUSION Preterm born subjects are exposed to a significantly increased risk for altered cardiovascular and renal functions at young adulthood. Adequate, specific follow-up measures remain to be determined. While antenatal steroids have considerably improved preterm birth outcomes, repeated therapy should be considered with caution, as antenatal steroids induce long-term cardiovascular and metabolic alterations in animals' models and their involvement in the accelerated cellular senescence observed in human studies cannot be excluded.
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Affiliation(s)
- Hassib Chehade
- Division of Pediatrics and DOHaD Lab, CHUV-UNIL, Lausanne, CH, Switzerland
| | - Umberto Simeoni
- Division of Pediatrics and DOHaD Lab, CHUV-UNIL, Lausanne, CH, Switzerland
| | | | - Farid Boubred
- Medecine Neonatale, Hopital La Conception, APHM, Aix-Marseille Universite, Marseille, France
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Schehr LK, Johnson TS. Concept Analysis of Growth Failure in Preterm Infants in the NICU. J Obstet Gynecol Neonatal Nurs 2017; 46:870-877. [PMID: 29031041 DOI: 10.1016/j.jogn.2017.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2017] [Indexed: 01/04/2023] Open
Abstract
Growth failure has not been consistently defined for preterm infants, which contributes to unclear clinical guidelines for optimal growth and development. Therefore, the purpose of this concept analysis was to identify all uses and attributes of the concept, present model and contrary cases, identify antecedents and consequences, define empirical referents, and provide an operational definition of growth failure among preterm infants in the NICU.
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The impact of intrauterine and extrauterine weight gain in premature infants on later body composition. Pediatr Res 2017; 82:658-664. [PMID: 28678222 DOI: 10.1038/pr.2017.123] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Accepted: 03/30/2017] [Indexed: 11/09/2022]
Abstract
BackgroundThe impact of intrauterine and extrauterine growth on later insulin resistance and fat mass (FM) in very low birth weight (VLBW) infants is not well established. The aim of our study was to evaluate the effects of intrauterine and early/late extrauterine growth on later insulin resistance and body composition in VLBW infants from 6 months' corrected age (CA) to 36 months.MethodsProspective measurements of body composition by dual-energy X-ray absorptiometry and insulin resistance by homeostasis model assessment insulin resistance (HOMA-IR) along with other fasting plasma biochemistries were made in 95 VLBW infants at 6, 12, 18, and 24 months' CA and 36 months' postnatal age. Mixed-effect models were used to evaluate the effects of age, sex, maturation status, and Δweight SD score on percentage FM (PFM), FM index (FMI), fat-free mass index (FFMI), and HOMA-IR.ResultsPFM and FMI were negatively associated with a decrease in weight-SD scores from birth to 36 weeks' postmenstrual age (PMA; P=0.001) and from 36 weeks' PMA to 6 months' CA (P=0.003). PFM and FMI were higher in AGA than in small for gestational age (SGA) infants. HOMA-IR was not associated with the Δweight-SD scores in either period.ConclusionsCatch-down growth in terms of weight is associated with persistently lower adiposity but not insulin resistance up to 36 months of age.
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Genoni G, Binotti M, Monzani A, Bernascone E, Stasi I, Bona G, Ferrero F. Nonrandomised interventional study showed that early aggressive nutrition was effective in reducing postnatal growth restriction in preterm infants. Acta Paediatr 2017. [PMID: 28632972 DOI: 10.1111/apa.13958] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM This study evaluated whether an early aggressive nutrition (EAN) strategy could limit extrauterine growth restriction (EUGR) in a cohort of preterm infants. METHODS This prospective nonrandomised interventional study was carried out in the neonatal intensive care unit of an Italian hospital from January 2013 to December 2015. The prevalence of EUGR was assessed in 100 infants with a gestational age of ≤34 weeks, 50 after the introduction of an EAN regimen in October 2014 and 50 before. RESULTS The prevalence of EUGR at discharge was significantly lower after the introduction of EAN than before for weight (34% vs. 66%), head circumference (22% vs. 42%) and length at discharge (20% vs. 48%). The Z-scores for all measurements were significantly higher after the introduction of EAN. In the EAN group, weight velocity was significantly higher and maximum weight loss and negative changes in the Z-scores from birth to discharge for weight were lower than in the pre-intervention controls. In extremely low birthweight subjects, the weight Z-score and weight velocity were significantly higher in the EAN group than the control group. CONCLUSION The use of EAN at a very early age reduced EUGR and improved auxological outcomes in preterm infants.
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Affiliation(s)
- Giulia Genoni
- Division of Pediatrics; Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Marco Binotti
- Neonatal and Pediatric Intensive Care Unit; Maggiore della Carità Hospital; Novara Italy
| | - Alice Monzani
- Division of Pediatrics; Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Elena Bernascone
- Division of Pediatrics; Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Ilaria Stasi
- Neonatal and Pediatric Intensive Care Unit; Maggiore della Carità Hospital; Novara Italy
| | - Gianni Bona
- Division of Pediatrics; Department of Health Sciences; University of Piemonte Orientale; Novara Italy
| | - Federica Ferrero
- Neonatal and Pediatric Intensive Care Unit; Maggiore della Carità Hospital; Novara Italy
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McGill-Vargas L, Gastaldelli A, Liang H, Anzueto Guerra D, Johnson-Pais T, Seidner S, McCurnin D, Muscogiuri G, DeFronzo R, Musi N, Blanco C. Hepatic Insulin Resistance and Altered Gluconeogenic Pathway in Premature Baboons. Endocrinology 2017; 158:1140-1151. [PMID: 28324053 PMCID: PMC5460827 DOI: 10.1210/en.2016-1806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 01/12/2017] [Indexed: 12/24/2022]
Abstract
Premature infants have altered glucose regulation early in life and increased risk for diabetes in adulthood. Although prematurity leads to an increased risk of diabetes and metabolic syndrome in adult life, the role of hepatic glucose regulation and adaptation to an early extrauterine environment in preterm infants remain unknown. The purpose of this study was to investigate developmental differences in glucose metabolism, hepatic protein content, and gene expression of key insulin-signaling/gluconeogenic molecules. Fetal baboons were delivered at 67%, 75%, and term gestational age and euthanized at birth. Neonatal baboons were delivered prematurely (67% gestation), survived for two weeks, and compared with similar postnatal term animals and underwent serial hyperinsulinemic-euglycemic clamp studies. Premature baboons had decreased endogenous glucose production (EGP) compared with term animals. Consistent with these results, the gluconeogenic molecule, phosphoenolpyruvate carboxykinase messenger RNA, was decreased in preterm baboons compared with terms. Hepatic insulin signaling was altered by preterm birth as evidenced by decreased insulin receptor-β, p85 subunit of phosphoinositide 3-kinase, phosphorylated insulin receptor substrate 1, and Akt-1 under insulin-stimulated conditions. Furthermore, preterm baboons failed to have the normal increase in glycogen synthase kinase-α from fetal to postnatal life. The blunted responses in hepatic insulin signaling may contribute to the hyperglycemia of prematurity, while impaired EGP leads to hypoglycemia of prematurity.
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Affiliation(s)
- Lisa McGill-Vargas
- Department of Pediatrics, Neonatology Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
| | - Amalia Gastaldelli
- Department of Medicine, Diabetes Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
- Cardiometabolic Risk Unit, Institute of Clinical Physiology, 56100 Pisa, Italy
| | - Hanyu Liang
- Department of Medicine, Diabetes Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
| | - Diana Anzueto Guerra
- Department of Pediatrics, Neonatology Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
| | - Teresa Johnson-Pais
- Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas 78229
| | - Steven Seidner
- Department of Pediatrics, Neonatology Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
| | - Donald McCurnin
- Department of Pediatrics, Neonatology Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
| | - Giovanna Muscogiuri
- Department of Medicine, Diabetes Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
| | - Ralph DeFronzo
- Department of Medicine, Diabetes Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
- Texas Diabetes Institute, San Antonio, Texas 78207
| | - Nicolas Musi
- Department of Medicine, Diabetes Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
- Texas Diabetes Institute, San Antonio, Texas 78207
- San Antonio Geriatric, Research, Education and Clinical Center, San Antonio, Texas 78229
- Barshop Institute for Longevity and Aging Studies, San Antonio, Texas 78245
| | - Cynthia Blanco
- Department of Pediatrics, Neonatology Division, Texas Health Science Center at San Antonio, San Antonio, Texas 78229
- University Health System, San Antonio, Texas 78229
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Henderson YO, Nalloor R, Vazdarjanova A, Murphy AZ, Parent MB. Sex-dependent effects of early life inflammatory pain on sucrose intake and sucrose-associated hippocampal Arc expression in adult rats. Physiol Behav 2017; 173:1-8. [PMID: 28108332 DOI: 10.1016/j.physbeh.2017.01.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 01/09/2017] [Accepted: 01/13/2017] [Indexed: 12/14/2022]
Abstract
We hypothesize that dorsal hippocampal (dHC) neurons, which are critical for episodic memory, form a memory of a meal and inhibit the initiation of the next meal and the amount ingested during that meal. In support, we showed previously that (1) consuming a sucrose meal induces expression of the synaptic plasticity marker activity-regulated cytoskeleton-associated protein (Arc) in dHC neurons and (2) reversible inactivation of these neurons immediately following a sucrose meal accelerates the onset of the next meal and increases the size of that meal. These data suggest that hippocampal-dependent memory inhibits intake; therefore, the following experiments were conducted to determine whether hippocampal-dependent memory impairments are associated with increased intake. We reported recently that one episode of early life inflammatory pain impairs dHC-dependent memory in adult rats. The present study determined whether neonatal inflammatory pain also increases sucrose intake and attenuates sucrose-associated Arc expression. Male and female Sprague-Dawley rats were given an intraplantar injection of the inflammatory agent carrageenan (1%) on the day of birth and sucrose intake and sucrose-associated dHC Arc expression were measured in adulthood. Neonatal inflammatory pain increased sucrose intake in adult female and male rats, decreased sucrose-associated dHC Arc expression in female rats, and tended to have a similar effect on Arc expression in male rats. Neonatal inflammatory pain significantly decreased the interval between two sucrose meals in female but not in male rats. Morphine administration at the time of insult attenuated the effects of injury on sucrose intake. Collectively, these findings indicate that one brief episode of inflammatory pain on the day of birth has a long long-lasting, sex-dependent impact on intake of a palatable food in adulthood.
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Affiliation(s)
- Yoko O Henderson
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA 30302, United States.
| | - Rebecca Nalloor
- Augusta Biomedical Research Corporation, Charlie Norwood VA Medical Center, 950 15th Street, Augusta, GA 30901, United States.
| | - Almira Vazdarjanova
- Department of Pharmacology and Toxicology, Augusta University, 1120 15th Street, CB 3526, Augusta, GA 30912, United States; VA Research Service, Charlie Norwood VA Medical Center, 950 15th Street, Augusta, GA 30901, United States.
| | - Anne Z Murphy
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA 30302, United States.
| | - Marise B Parent
- Neuroscience Institute, Georgia State University, P.O. Box 5030, Atlanta, GA 30302, United States; Department of Psychology, Georgia State University, P.O. Box 5030, Atlanta, GA 30302, United States.
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Mericq V, Martinez-Aguayo A, Uauy R, Iñiguez G, Van der Steen M, Hokken-Koelega A. Long-term metabolic risk among children born premature or small for gestational age. Nat Rev Endocrinol 2017; 13:50-62. [PMID: 27539244 DOI: 10.1038/nrendo.2016.127] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Accumulating evidence suggests that both the intrauterine environment and growth during early life can influence the development of chronic noncommunicable diseases, such as type 2 diabetes mellitus and cardiovascular disease, in adulthood. Here, we review the available human data supporting increased metabolic risk among children born premature or small for gestational age; the adrenal and pubertal modifications that contribute to this risk; metabolic changes that occur during adolescence and early adulthood; and approaches to potentially modify or decrease risk of metabolic disease. The risks associated with delivery at term or preterm are compared for each period of life. Knowledge of these associations is fundamental for the paediatric community to develop preventive strategies early during postnatal life.
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Affiliation(s)
- Veronica Mericq
- Institute of Maternal and Child Research, University of Chile, Santiago, 8330091, Chile
| | - Alejandro Martinez-Aguayo
- Pediatrics Division, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, 8330074, Chile
| | - Ricardo Uauy
- Pediatrics Division, School of Medicine, Pontificia Universidad Catolica de Chile, Santiago, 8330074, Chile
- Institute of Nutrition and Food Technology, University of Chile, Santiago, 7810851, Chile
| | - German Iñiguez
- Institute of Maternal and Child Research, University of Chile, Santiago, 8330091, Chile
| | - Manouk Van der Steen
- Dutch Growth Research Foundation, 3001 KB Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, 3000 CB Rotterdam, The Netherlands
| | - Anita Hokken-Koelega
- Dutch Growth Research Foundation, 3001 KB Rotterdam, The Netherlands
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, 3000 CB Rotterdam, The Netherlands
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Murphy LT, Skinner AC, Check J, Warner DD, Perrin EM. Parental Perceptions of Weight Status in Preterm Compared with Term Infants. Am J Perinatol 2016; 33:1371-1376. [PMID: 27135952 PMCID: PMC7167256 DOI: 10.1055/s-0036-1583187] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Background Parents of overweight children frequently under-recognize their child's overweight status. We hypothesized that parents of preterm children would be more likely than parents of term children to incorrectly perceive their child's weight. Methods We recruited parents of term and preterm when children were 2 months to 2 years of age. Small for gestational age infants were excluded. We compared parents' perceived weight category with child's actual weight category, based on normative data (underweight, normal weight, or overweight). We based analyses on encounters and adjusted for within-child clustering across repeated measures. Results In the preterm (n = 94) and term (n = 1,263) cohorts, 12 and 13% of children, respectively, were overweight (weight-for-length ≥ 95th percentile). Among parents of overweight children, 91% in the preterm cohort and 90% in the term cohort reported their child as healthy weight. Among healthy weight children (weight-for-length 6th-94th percentile), parents in the preterm cohort were more likely to report their child as underweight compared with parents in the term cohort (24 vs. 7%; p < 0.001). Conclusion Parental perception of weight status was impaired among parents of overweight children regardless of gestational age. However, parents were more likely to perceive their healthy weight child as underweight if their child was preterm.
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Affiliation(s)
- Lindsey T. Murphy
- Pediatrix Group of North Carolina, Moses Cone Neonatology, Greensboro, North Carolina
| | | | - Jennifer Check
- Department of Pediatrics, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina
| | - Diane D. Warner
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Eliana M. Perrin
- Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Morrison KM, Ramsingh L, Gunn E, Streiner D, Van Lieshout R, Boyle M, Gerstein H, Schmidt L, Saigal S. Cardiometabolic Health in Adults Born Premature With Extremely Low Birth Weight. Pediatrics 2016; 138:peds.2016-0515. [PMID: 27590899 DOI: 10.1542/peds.2016-0515] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Young adults born with extreme prematurity have increased blood pressure and insulin resistance. This study documents their metabolic health as they enter their fourth decade of life. The study objective was to compare body composition, glycemia, lipid levels, and blood pressure in adults born with extremely low birth weight (ELBW) versus age- and sex- matched normal birth weight (NBW) control subjects and to examine related previous and current exposures. METHODS The study examines one of the oldest regionally representative cohorts of ELBW subjects (birth weight <1 kg) and NBW individuals born between 1977 and 1982. The primary outcome was dysglycemia (type 2 diabetes or prediabetes) based on results of a 75-g oral glucose tolerance test. Secondary outcomes include body composition, insulin resistance, fasting lipid profile, and blood pressure. Potential predictive factors included birth weight, maternal antenatal corticosteroid exposure, retinopathy of prematurity, growth parameters, and smoking history. RESULTS Adults (mean age, 31.8 years) born ELBW (n = 100) had a higher percent body fat (P = .004) and lower lean mass for height (P = .018) but similar waist circumference (P = .54) and BMI (P = .61) compared with NBW control subjects. ELBW adults had a 4.0-fold (95% confidence interval, 1.53-10.66) increased risk of developing dysglycemia. Adults born ELBW also had higher systolic (P = .004) and diastolic (P = .02) blood pressures compared with NBW control subjects, but there were no differences in lipid profile. CONCLUSIONS By their fourth decade, these adults born extremely premature had increased body fat, lower lean mass, and a 4-fold increased risk of developing dysglycemia.
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Affiliation(s)
| | | | | | | | | | | | | | - Louis Schmidt
- Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario, Canada
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Payal V, Jora R, Sharma P, Gupta PK, Gupta M. Premature birth and insulin resistance in infancy: A prospective cohort study. Indian J Endocrinol Metab 2016; 20:497-505. [PMID: 27366716 PMCID: PMC4911839 DOI: 10.4103/2230-8210.183470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE This study was done to determine the role of prematurity and other variables to predict insulin sensitivity in infancy. SUBJECTS AND METHODS In this prospective study, 36 preterm appropriate for gestational age (AGA), 11 preterm small for gestational age (SGA), and 17 term SGA included as study cohort and 36 term AGA as control cohort. Detailed anthropometry assessment was performed at birth, 3, 6, and 9 months and at 9 months, fasting plasma glucose and serum insulin was done. Insulin resistance was determined by using homeostasis model assessment version 2. RESULTS It is found that preterm AGA (mean difference 0.617, 95% confidence interval [CI]; 0.43-0.80, P = 0.0001), preterm SGA (mean difference 0.764, 95% CI; 0.44-1.09, P = 0.0001), and term AGA (mean difference 0.725, 95% CI; 0.49-0.96, P = 0.0001) group had significantly higher insulin resistance than control. There was no significant difference in between preterm SGA and preterm AGA (mean difference 0.147 95% CI; -0.13-0.42, P = 0.927). In multiple regression models, SGA status (β =0.505) was more significant predictor of insulin resistance index than gestational age (β = -0.481), weight-for-length (β =0.315), and ponderal index (β = -0.194). CONCLUSION Preterm birth is a risk factor for the future development of insulin resistance which may develop as early as infancy.
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Affiliation(s)
- Vikas Payal
- Department of Pediatrics, Dr. S.N. Medical College, Umaid Hospital, Jodhpur, Rajasthan, India
| | - Rakesh Jora
- Department of Pediatrics, Dr. S.N. Medical College, Umaid Hospital, Jodhpur, Rajasthan, India
| | - Pramod Sharma
- Department of Pediatrics, Dr. S.N. Medical College, Umaid Hospital, Jodhpur, Rajasthan, India
| | - Pradeep Kumar Gupta
- Department of Pediatrics, Dr. S.N. Medical College, Umaid Hospital, Jodhpur, Rajasthan, India
| | - Mukesh Gupta
- Department of Pediatrics, Dr. S.N. Medical College, Umaid Hospital, Jodhpur, Rajasthan, India
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DeFreitas MJ, Katsoufis CP, Abitbol CL. Cardio-renal consequences of low birth weight and preterm birth. PROGRESS IN PEDIATRIC CARDIOLOGY 2016. [DOI: 10.1016/j.ppedcard.2016.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Sharafi M, Duffy VB, Miller RJ, Winchester SB, Huedo-Medina TB, Sullivan MC. Dietary behaviors of adults born prematurely may explain future risk for cardiovascular disease. Appetite 2016; 99:157-167. [PMID: 26792768 PMCID: PMC4762713 DOI: 10.1016/j.appet.2016.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Revised: 12/15/2015] [Accepted: 01/07/2016] [Indexed: 12/30/2022]
Abstract
Being born prematurely associates with greater cardiovascular disease (CVD) risk in adulthood. Less understood are the unique and joint associations of dietary patterns and behaviors to this elevated risk among adults who are born prematurely. We aimed to model the associations between term status, dietary and lifestyle behaviors with CVD risk factors while accounting for the longitudinal effects of family protection, and medical or environmental risks. In wave-VIII of a longitudinal study, 23-year olds born prematurely (PT-adults, n = 129) and full term (FT-adults, n = 38) survey-reported liking for foods/beverages and activities, constructed into indexes of dietary quality and sensation-seeking, dietary restraint and physical activity. Measured CVD risk factors included fasting serum lipids and glucose, blood pressure and adiposity. In bivariate relationships, PT-adults reported lower dietary quality (including less affinity for protein-rich foods and higher affinity for sweets), less liking for sensation-seeking foods/activities, and less restrained eating than did FT-adults. In comparison to nationally-representative values and the FT-adults, PT-adults showed greater level of CVD risk factors for blood pressure and serum lipids. In structural equation modeling, dietary quality completely mediated the association between term status and HDL-cholesterol (higher quality, lower HDL-cholesterol) yet joined term status to explain variability in systolic blood pressure (PT-adults with lowest dietary quality had highest blood pressures). Through lower dietary quality, being born prematurely was indirectly linked to higher cholesterol/HDL, higher LDL/HDL and elevated waist/hip ratios. The relationship between dietary quality and CVD risk was strongest for PT-adults who had developed greater cumulative medical risk. Protective environments failed to attenuate relationships between dietary quality and elevated CVD risk among PT-adults. In summary, less healthy dietary behaviors contribute to elevated CVD risk among young adults who are born prematurely.
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Affiliation(s)
- Mastaneh Sharafi
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Valerie B Duffy
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA.
| | - Robin J Miller
- School of Nursing, University of Connecticut, Storrs, CT, USA
| | - Suzy B Winchester
- Brown Center for Study of Children at Risk Women & Infants Hospital, Providence, RI, USA; College of Nursing, University of Rhode Island, Kingston, RI, USA
| | - Tania B Huedo-Medina
- Department of Allied Health Sciences, University of Connecticut, Storrs, CT, USA
| | - Mary C Sullivan
- College of Nursing, University of Rhode Island, Kingston, RI, USA
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Zhou Y, Gu P, Shi W, Li J, Hao Q, Cao X, Lu Q, Zeng Y. MicroRNA-29a induces insulin resistance by targeting PPARδ in skeletal muscle cells. Int J Mol Med 2016; 37:931-8. [PMID: 26936652 PMCID: PMC4790643 DOI: 10.3892/ijmm.2016.2499] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Accepted: 02/10/2016] [Indexed: 12/03/2022] Open
Abstract
Intrauterine growth retardation (IUGR) induces metabolic syndrome, which is often characterized by insulin resistance (IR), in adults. Previous research has shown that microRNAs (miRNAs or miRs) play a role in the target genes involved in this process, but the mechanisms remain unclear. In the present study, we examined miRNA profiles using samples of skeletal muscles from both IUGR and control rat offspring whose mothers were fed either a protein-restricted diet or a diet which involved normal amounts of protein during pregnancy, respectively. miR-29a was found to be upregulated in the skeletal muscles of IUGR offspring. The luciferase reporter assay confirmed the direct interaction between miR-29a and peroxisome proliferator-activated receptor δ (PPARδ). Overexpression of miR-29a in the skeletal muscle cell line C2C12 suppressed the expression of its target gene PPARδ, which, in turn, influenced the expression of its coactivator, peroxisome proliferator-activated receptor-γ coactivator-1α (PGC-1α). Thus, PPARδ/PGC-1α-dependent signals together reduced insulin-dependent glucose uptake and adenosine triphosphate (ATP) production. Overexpression of miR-29a also caused a decrease in levels of glucose transporter 4 (GLUT4), the most important glucose transporter in skeletal muscle, which partially induced a decrease insulin-dependent glucose uptake. These findings provide evidence for a novel micro-RNA-mediated mechanism of PPARδ regulation, and we also noted the IR-promoting actions of miR-29a in skeletal muscles of IUGR.
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Affiliation(s)
- Yuehua Zhou
- Department of Obstetrics and Gynecology of Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200036, P.R. China
| | - Pingqing Gu
- Department of Clinical Laboratory, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Weijie Shi
- Department of Obstetrics and Gynecology of Xinghua People's Hospital, Xinghua, Jiangsu 225700, P.R. China
| | - Jingyun Li
- Department of Clinical Laboratory, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Qun Hao
- Department of Obstetrics and Gynecology, Nanjing General Hospital of PLA, Nanjing, Jiangsu 210002, P.R. China
| | - Xiaomei Cao
- Duman High School, Singapore 436895, Republic of Singapore
| | - Qin Lu
- Department of Obstetrics and Gynecology of Tongren Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200036, P.R. China
| | - Yu Zeng
- Department of Clinical Laboratory, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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Sohn JA, Kim EK, Lee JA, Choi CW, Kim HS, Kim BI, Choi JH. Neurodevelopmental Outcome According to Prenatal and Postnatal Growth Patterns in Preterm Infants. NEONATAL MEDICINE 2016. [DOI: 10.5385/nm.2016.23.2.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Jin A Sohn
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Ee-Kyung Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jin A Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Chang Won Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Han-Suk Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Beyong Il Kim
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
| | - Jung-Hwan Choi
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea
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Ong KK, Kennedy K, Castañeda‐Gutiérrez E, Forsyth S, Godfrey KM, Koletzko B, Latulippe ME, Ozanne SE, Rueda R, Schoemaker MH, Beek EM, Buuren S, Fewtrell M. Postnatal growth in preterm infants and later health outcomes: a systematic review. Acta Paediatr 2015; 104:974-86. [PMID: 26179961 PMCID: PMC5054880 DOI: 10.1111/apa.13128] [Citation(s) in RCA: 196] [Impact Index Per Article: 21.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 05/20/2015] [Accepted: 07/09/2015] [Indexed: 11/30/2022]
Abstract
UNLABELLED In preterm infants, poor postnatal growth is associated with adverse neurocognitive outcomes; conversely, rapid postnatal growth is supposedly harmful for future development of metabolic diseases. CONCLUSION In this systematic review, observational studies reported consistent positive associations between postnatal weight or head growth and neurocognitive outcomes; however, there was limited evidence from the few intervention studies. Evidence linking postnatal weight gain to later adiposity and other cardiovascular disease risk factors in preterm infants was also limited.
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Affiliation(s)
- Ken K. Ong
- MRC Epidemiology Unit University of Cambridge Cambridge UK
| | | | | | | | - Keith M. Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre University of Southampton and University Hospital Southampton NHS Foundation Trust Southampton UK
| | | | | | - Susan E. Ozanne
- Metabolic Research Laboratories Institute of Metabolic Sciences University of Cambridge Cambridge UK
| | | | | | - Eline M. Beek
- Nutricia Research Danone Nutricia Early Life Nutrition Singapore Singapore
| | - Stef Buuren
- University of Utrecht Utrecht The Netherlands
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Abstract
Epigenetic regulation of gene expression allows the organism to respond/adapt to environmental conditions without changing the gene coding sequence. Epigenetic modifications have also been found to control gene expression in various diseases, including diabetes. Epigenetic changes induced by hyperglycemia in multiple target organs contribute to metabolic memory of diabetic complications. The long-lasting development of diabetic complications even after achieving glucose control has been partly attributed to epigenetic changes in target cells. Specific epigenetic drugs might rescue chromatin conformation associated to hyperglycemia possibly slowing down the onset of diabetes-related complications. The current review will describe the updated epigenetics in diabetes that can be used to personalize a more focused treatment.
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Affiliation(s)
- Adriana Fodor
- University of Medicine & Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Angela Cozma
- University of Medicine & Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Eddy Karnieli
- Institute of Endocrinology, Diabetes & Metabolism, Rambam Medical Center, Haifa, Israel
- Galil Center for Personalized Medicine & Medical Informatics, Rappaport Faculty of Medicine, Technion, Haifa, Israel
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Mahizir D, Briffa JF, Hryciw DH, Wadley GD, Moritz KM, Wlodek ME. Maternal obesity in females born small: Pregnancy complications and offspring disease risk. Mol Nutr Food Res 2015; 60:8-17. [DOI: 10.1002/mnfr.201500289] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/05/2015] [Accepted: 07/07/2015] [Indexed: 12/16/2022]
Affiliation(s)
- Dayana Mahizir
- Department of Physiology; The University of Melbourne; Parkville Victoria Australia
| | - Jessica F. Briffa
- Department of Physiology; The University of Melbourne; Parkville Victoria Australia
| | - Deanne H. Hryciw
- Department of Physiology; The University of Melbourne; Parkville Victoria Australia
| | - Glenn D. Wadley
- Centre for Physical Activity and Nutrition Research; School of Exercise and Nutrition Sciences; Deakin University; Burwood Victoria Australia
| | - Karen M. Moritz
- School of Biomedical Sciences; University of Queensland; St. Lucia Queensland Australia
| | - Mary E. Wlodek
- Department of Physiology; The University of Melbourne; Parkville Victoria Australia
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Berndt C, Schweizer R, Ranke MB, Binder G, Martin DD. Height, muscle, fat and bone response to growth hormone in short children with very low birth weight born appropriate for gestational age and small for gestational age. Horm Res Paediatr 2015; 82:81-8. [PMID: 24969628 DOI: 10.1159/000358520] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 01/08/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Growth hormone (GH) treatment is approved for short children born SGA but not for AGA. Our aim was to study the effect of GH in short VLBW SGA and AGA children. METHODS The study group comprised 44 prepubertal short children with a birth weight <1,500 g: 27 AGA (12 females) and 17 SGA (6 females). Mean values at GH start were (AGA, SGA): age 6.94, 7.14 years, height standard deviation score (SDS) -3.33, -3.33, and GH dose (mean ± SD) 54 ± 12, 51 ± 11 µg/kg/day. Arm and calf cross-sectional muscle area using peripheral quantitative computer tomography, body composition data using dual-energy X-ray absorptiometry and body impedance assessment, maximal isometric grip force and skin fold thickness, IGF-1 and IGFBP-3 were measured at the start and after 12 months of GH. RESULTS At GH start, both groups had similar characteristics with low height, weight, height velocity, muscle mass, bone thickness and content. The first year of GH treatment led to changes in muscle area SDS (AGA, SGA) -2.23 to -0.73 (p = 0.0010), -3.18 to -1.17 (p = 0.060) (AGA vs. SGA p = 0.61), fat area SDS -1.06 to -1.83 (p = 0.054), -0.62 to -1.75 (p = 0.12) (AGA vs. SGA p = 0.65) and height velocity SDS -0.0015 to 4.2 (p < 0.0001), -0.18 to 3.3 (p < 0.0001) (AGA vs. SGA p = 0.36). CONCLUSIONS Growth, muscle and fat mass are similarly impaired in short prepubertal AGA and SGA VLBW children. The children born AGA show a similar or better response to GH compared to those born SGA. These results reveal the arbitrary nature of using the criterion 'SGA' for eligibility to GH treatment in children born with a birth weight <1,500 g.
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Affiliation(s)
- Cornelia Berndt
- Paediatric Endocrinology and Diabetology, University Children's Hospital, Tübingen, Germany
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40
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Á Rogvi R, Forman JL, Greisen G. Prematurity, smallness-for-gestational age and later hospital admissions: a nation-wide registry study. Early Hum Dev 2015; 91:299-306. [PMID: 25813556 DOI: 10.1016/j.earlhumdev.2015.02.010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Revised: 01/28/2015] [Accepted: 02/23/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Being born premature or small for gestational age (SGA) is known to be associated with diseases later in life, such as gestational diabetes, hypertension and pre-eclampsia. In this study we examined the association between being born premature or SGA and all diseases diagnosed during hospital admissions later in life. METHODS Using Danish nation-wide registries we created a cohort of 1,348,106 persons born 1974-1996 and assessed all unique diagnoses registered in the Danish Patient Registry (DPR) for hospital admissions in the period 1994-2007 (n=27,910,558). We determined the odds ratios for persons born premature or SGA using multivariate logistic regression. RESULTS A total of 15,059 unique ICD-10 diagnosis codes were represented in the period. Only diagnoses used at least 100 times were included in the analysis (n=4175). Of these 838 showed an odds ratio that was statistically significantly different from unity for people born premature or SGA. After correcting for multiple testing, 250 remained significant. The diagnoses covered diseases in most organ systems, including cardiovascular, endocrinological, infectious, neurological/neurosurgical, obstetric, orthopedic, psychiatric, lung & urological diseases, and occurred throughout childhood and early adulthood. Novel findings included increased risks for delayed puberty, neurofibromatosis type 1 and ileus and decreased risks of mononucleosis, peritonsillar abscesses, chronic hypothyroidism and several types of fractures and contusions later in life. CONCLUSION Being born premature or SGA was associated with significantly altered risks of being admitted to a hospital with a wide range of diseases later in life, affecting almost all organ systems throughout childhood and early adulthood. Our findings may motivate testing in other cohorts and search for novel mechanisms of pathogenesis.
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Affiliation(s)
- Rasmus Á Rogvi
- Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark.
| | - Julie Lyng Forman
- Department of Biostatistics, Copenhagen University, Copenhagen, Denmark
| | - Gorm Greisen
- Department of Neonatology, Copenhagen University Hospital, Copenhagen, Denmark
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41
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Abstract
Low birth weight serves as a crude proxy for impaired growth during fetal life and indicates a failure for the fetus to achieve its full growth potential. Low birth weight can occur in response to numerous etiologies that include complications during pregnancy, poor prenatal care, parental smoking, maternal alcohol consumption, or stress. Numerous epidemiological and experimental studies demonstrate that birth weight is inversely associated with blood pressure and coronary heart disease. Sex and age impact the developmental programming of hypertension. In addition, impaired growth during fetal life also programs enhanced vulnerability to a secondary insult. Macrosomia, which occurs in response to maternal obesity, diabetes, and excessive weight gain during gestation, is also associated with increased cardiovascular risk. Yet, the exact mechanisms that permanently change the structure, physiology, and endocrine health of an individual across their lifespan following altered growth during fetal life are not entirely clear. Transmission of increased risk from one generation to the next in the absence of an additional prenatal insult indicates an important role for epigenetic processes. Experimental studies also indicate that the sympathetic nervous system, the renin angiotensin system, increased production of oxidative stress, and increased endothelin play an important role in the developmental programming of blood pressure in later life. Thus, this review will highlight how adverse influences during fetal life and early development program an increased risk for cardiovascular disease including high blood pressure and provide an overview of the underlying mechanisms that contribute to the fetal origins of cardiovascular pathology.
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Affiliation(s)
- Barbara T Alexander
- Department of Physiology and Biophysics, Women's Health Research Center, Center for Cardiovascular-Renal Research, University of Mississippi Medical Center, Jackson, Mississippi, USA
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42
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Ramel SE, Gray HL, Davern BA, Demerath EW. Body composition at birth in preterm infants between 30 and 36 weeks gestation. Pediatr Obes 2015; 10:45-51. [PMID: 24470220 DOI: 10.1111/j.2047-6310.2013.00215.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Revised: 11/04/2013] [Accepted: 11/19/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND The American Academy of Pediatrics calls for aggressive management of preterm infants to achieve body composition approximating that of the healthy infant in utero. Air displacement plethysmography (ADP) has been validated for assessment of body composition in preterm infants and could be used to monitor their nutritional status during hospitalization. Comparative datasets on body composition at birth among healthy, live-born preterm infants are lacking. OBJECTIVE The aim of this study is to provide the first descriptive fat mass (FM) and fat-free mass (FFM) data from healthy newborn preterm infants at birth as a proxy for healthy in utero body composition. METHODS Body mass and volume were obtained using ADP within 72 h of birth in 98 singleton, appropriate-for-gestational-age preterm infants. FM and FFM were calculated using the Fomon equation. RESULTS Measurement with ADP was feasible and well tolerated by infants as young as 30 weeks gestation and <72 h of age. FFM and FM increased linearly over the gestational age range period at rates of 171 and 46 g week(-1) , respectively. Mean values obtained by ADP by gestational week were similar to the previously published reference data from chemical analysis on stillbirths. CONCLUSIONS Body composition assessment using ADP is feasible in newborn preterm infants and provides group estimates similar to that of the reference fetus. In the future, integrating body composition information into the nutritional management of preterm infants may help to identify new strategies to optimize growth and development in this vulnerable population.
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Affiliation(s)
- S E Ramel
- Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA
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van der Pal-de Bruin KM, van der Pal SM, Verloove-Vanhorick SP, Walther FJ. Profiling the preterm or VLBW born adolescent; implications of the Dutch POPS cohort follow-up studies. Early Hum Dev 2015; 91:97-102. [PMID: 25590235 DOI: 10.1016/j.earlhumdev.2014.12.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2014] [Revised: 09/29/2014] [Accepted: 12/17/2014] [Indexed: 10/24/2022]
Abstract
In 1983, data of a unique nationwide cohort of 1338 very preterm (<32 weeks of gestation) or VLBW (birth weight<1500g) infants in the Netherlands was collected and followed at several ages until they reached the age of 19 years. At 19 years of age a more extensive follow-up study was done, including questionnaires, tests on a computer and a full physical exam. These studies provide insight into how Dutch adolescents at 19 years of age, who were born very preterm or with a very low birth weight (VLBW), reach adulthood. At 19 years, 705 POPS participants participated (74% of 959 still alive). Outcome measures at 19 years included: physical outcomes (e.g. blood pressure), cognition, behavior, quality of life, and impact of handicaps. The POPS participants showed more impairments on most outcome measures at various ages, compared to norm data. Major handicaps remained stable as the children grew older, but minor handicaps and disabilities increased. At 19 years of age, only half (47.1%) of the survivors had no disabilities and no minor or major handicaps. Especially those born small for gestational age (SGA) seem most vulnerable. These long-term results help to support preterm and SGA born children and adolescents in reaching independent adulthood, and stress the need for long term follow-up studies and to promote prevention of disabilities and of preterm birth itself.
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Affiliation(s)
| | | | - S P Verloove-Vanhorick
- TNO Child Health, Leiden, The Netherlands; Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
| | - F J Walther
- Leiden University Medical Center, Department of Pediatrics, Leiden, The Netherlands
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44
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Abstract
How early life events program adult disease is undergoing a transition from the broad field of maternal malnutrition to the current relevant issues of food deserts and prematurity. Although many adult diseases and morbidities associate with various early life events and programming, the morbidities of insulin resistance, cardiovascular disease, and obesity seem to be common end points of many early life events despite potential confounders.
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Affiliation(s)
- Robert H Lane
- Department of Pediatrics, Children's Hospital of Wisconsin, Medical College of Wisconsin, Suite 720, PO Box 1997, Milwaukee, WI 53201-1997, USA.
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45
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van Dommelen P, van der Pal SM, Bennebroek Gravenhorst J, Walther FJ, Wit JM, van der Pal de Bruin KM. The effect of early catch-up growth on health and well-being in young adults. ANNALS OF NUTRITION AND METABOLISM 2014; 65:220-6. [PMID: 25413661 DOI: 10.1159/000364884] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
AIM To study the effect of catch-up growth in the 1st year on cognition, health-related quality of life (HRQoL), problem behavior and growth in young adults. METHODS We included individuals without severe complications and born small for gestational age (SGA; n = 228 for weight, n = 203 for length) or with a low head circumference (HC, n = 178) or a low weight adjusted for length (n = 64) in the Collaborative Project on Preterm and SGA Infants. Neonatal growth was standardized (standard deviation scores for gestational age, SDSGA) according to GA-specific reference charts. Catch-up growth was defined as SDSGA at 1 year of age adjusted for SDSGA at birth. Cognition was defined by the Multicultural Capacity Test-Intermediate Level, HRQoL by the London Handicap Scale (LHS) and the Health Utility Index Mark 3 categorized into 4 levels (Multi-Attribute Utility, MAU), and problem behavior by the Young Adult Self-Report. We adjusted for potential confounders. RESULTS Most adults were born preterm (93.7%). A higher catch-up growth in the 1st year was associated with better cognition (B = 2.57, 95% CI 0.08-5.05 for weight), less disabilities according to the LHS (B = 2.06, 95% CI 0.35-3.78 for HC) and the MAU (OR = 0.67, 95% CI 0.48-0.95 for HC) and higher final height (B = 0.33, 95% CI 0.18-0.47 for weight; B = 0.41, 95% 0.28-0.55 for length, and B = 0.18, 95% CI 0.04-0.33 for HC) in young adulthood. CONCLUSION There are long-term benefits of catch-up growth.
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46
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Bayman E, Drake AJ, Piyasena C. Prematurity and programming of cardiovascular disease risk: a future challenge for public health? Arch Dis Child Fetal Neonatal Ed 2014; 99:F510-4. [PMID: 25135955 DOI: 10.1136/archdischild-2014-306742] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
There is substantial epidemiological evidence linking low birth weight with adult cardiometabolic disease risk factors. This has led to the concept of 'early life programming' or the 'developmental origins of disease' which proposes that exposure to adverse conditions during critical stages of early development results in compensatory mechanisms predicted to aid survival. There is growing evidence that preterm infants, many of whom are of low birth weight, are also at increased risk of adult cardiometabolic disease. In this article, we provide a broad overview of the evidence linking preterm birth and cardiovascular disease risk and discuss potential consequences for public health.
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Affiliation(s)
| | - Amanda J Drake
- Endocrinology Unit, University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
| | - Chinthika Piyasena
- Endocrinology Unit, University/British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, The Queen's Medical Research Institute, Edinburgh, UK
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47
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Childhood obesity and insulin resistance: how should it be managed? CURRENT TREATMENT OPTIONS IN CARDIOVASCULAR MEDICINE 2014; 16:351. [PMID: 25293340 DOI: 10.1007/s11936-014-0351-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OPINION STATEMENT Concomitant with the rise in global pediatric obesity in the past decades, there has been a significant increase in the number of children and adolescents with clinical signs of insulin resistance. Given insulin resistance is the important link between obesity and the associated metabolic abnormalities and cardiovascular risk, clinicians should be aware of high risk groups and treatment options. As there is no universally accepted biochemical definition of insulin resistance in children and adolescents, identification and diagnosis of insulin resistance usually relies on clinical features such as acanthosis nigricans, polycystic ovary syndrome, hypertension, dyslipidemia, and nonalcoholic fatty liver disease. Treatment for reducing insulin resistance and other obesity-associated comorbidities should focus on changes in health behaviors to achieve effective weight management. Lifestyle interventions incorporating dietary change, increased physical activity, and decreased sedentary behaviors, with the involvement of family and adoption of a developmentally appropriate approach, should be used as the first line treatment. Current evidence suggests that the primary objective of dietary interventions should be to reduce total energy intake and a combination of aerobic and resistance training should be encouraged. Metformin can be used in conjunction with a lifestyle intervention program in obese adolescents with clinical insulin resistance to achieve weight loss and to improve insulin sensitivity. Ongoing evaluation and research are required to explore optimal protocol and long-term effectiveness of lifestyle interventions, as well as to determine whether the improvements in insulin sensitivity induced by lifestyle interventions and weight loss will lead to a clinical benefit including reduced cardiovascular morbidity and mortality.
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48
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Ruiz-Narváez EA, Palmer JR, Gerlovin H, Wise LA, Vimalananda VG, Rosenzweig JL, Rosenberg L. Birth weight and risk of type 2 diabetes in the black women's health study: does adult BMI play a mediating role? Diabetes Care 2014; 37:2572-8. [PMID: 25147255 PMCID: PMC4140161 DOI: 10.2337/dc14-0731] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To assess the association of birth weight with incident type 2 diabetes, and the possible mediating influence of obesity, in a large cohort of U.S. black women. RESEARCH DESIGN AND METHODS The Black Women's Health Study is an ongoing prospective study. We used Cox proportional hazards models to estimate incidence rate ratios (IRRs) and 95% CI for categories of birth weight (very low birth weight [<1,500 g], low birth weight [1,500-2,499 g], and high birth weight [≥4,000 g]) in reference to normal birth weight (2,500-3,999 g). Models were adjusted for age, questionnaire cycle, family history of diabetes, caloric intake, preterm birth, physical activity, years of education, and neighborhood socioeconomic status with and without inclusion of terms for adult BMI. RESULTS We followed 21,624 women over 16 years of follow-up. There were 2,388 cases of incident diabetes. Women with very low birth weight had a 40% higher risk of disease (IRR 1.40 [95% CI 1.08-1.82]) than women with normal birth weight; women with low birth weight had a 13% higher risk (IRR 1.13 [95% CI 1.02-1.25]). Adjustment for BMI did not appreciably change the estimates. CONCLUSIONS Very low birth weight and low birth weight appear to be associated with increased risk of type 2 diabetes in African American women, and the association does not seem to be mediated through BMI. The prevalence of low birth weight is especially high in African American populations, and this may explain in part the higher occurrence of type 2 diabetes.
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Affiliation(s)
- Edward A Ruiz-Narváez
- Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Julie R Palmer
- Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Hanna Gerlovin
- Slone Epidemiology Center at Boston University, Boston, MA Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Lauren A Wise
- Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Varsha G Vimalananda
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA
| | - James L Rosenzweig
- Section of Endocrinology, Diabetes, and Nutrition, Boston University School of Medicine, Boston, MA
| | - Lynn Rosenberg
- Slone Epidemiology Center at Boston University, Boston, MA Department of Epidemiology, Boston University School of Public Health, Boston, MA
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49
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Abstract
The first infants to experience modern pre- and neonatal care are now in their thirties, an age at which the incidence of cardiometabolic disease is low. However, data from cohorts born preterm prior to the introduction of modern care suggest an increased risk of type 2 diabetes. For young adult cohorts of former very small or very preterm infants, there is accumulating evidence of increased risk factors for later cardiovascular disease, including higher blood pressure, lower lean body mass, impaired glucose regulation, and perhaps a more atherogenic lipid profile. Regarding lifestyle, adults born very small or very preterm undertake less non-conditioning physical activity and may have a lower intake of fruit and milk products. Any intervention reducing risk factors, in particular blood pressure and low physical activity, would have a substantial potential to reduce the lifetime disease burden in small preterm infants. There are now enough data to warrant an expert evaluation of the level of evidence for cardiometabolic disease in individuals born very small or very preterm, which has possible public health implications.
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50
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Abstract
The outcomes of very low birth weight survivors born in the early post-neonatal intensive care era have now been reported to young adulthood in several longitudinal cohort studies, and more recently from large Scandinavian national databases. The latter reports corroborate the findings that despite disabilities, a significant majority of very low birth weight survivors are leading productive lives, and are functioning better than expected. This is reassuring, but there are still concerns about future psychopathology, cardiovascular and metabolic problems as they approach middle age. Although these findings may not be directly applicable to the current survivors of modern neonatal intensive care, they do provide a yardstick by which to project the outcomes of future survivors until more contemporaneous data are available.
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Affiliation(s)
- Saroj Saigal
- Neonatal Follow-up Program, McMaster University, Hamilton, Ontario, Canada.
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