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Andersen ML, Jølving LR, Iachina M, Anru PL, Stenager E, Knudsen T, Nørgård BM. Neonatal outcomes in women with Multiple Sclerosis - Influence of disease activity: A Danish nationwide cohort study. Mult Scler Relat Disord 2024; 85:105549. [PMID: 38518505 DOI: 10.1016/j.msard.2024.105549] [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: 10/31/2023] [Revised: 02/20/2024] [Accepted: 03/10/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND Maternal Multiple Sclerosis (MS) has been associated with an increased risk of adverse birth outcomes. We hypothesized that active disease during conception and pregnancy plays an important role in this context, which this study aims to address. METHODS We used the Danish registers to conduct a nationwide cohort study. Information on maternal disease activity during pregnancy was retrieved using proxies from the linked registers (hospitalization, magnetic resonance imaging of the brain, and use of systemic corticosteroids during pregnancy). Neonates, exposed in utero to maternal disease activity constituted the exposed cohort and the unexposed cohort constituted neonates without in utero exposure to maternal disease activity. The examined outcomes were preterm birth, small for gestational age, low 5-minute Apgar score, and major congenital anomalies. In logistic regression models we estimated the odds ratios (OR) with adjustment for confounders such as maternal age, comorbidities, parity, smoking, calendar year of birth, and disease-modifying treatment. RESULTS Among the study population of 2492 children of mothers with MS we identified 273 (11 %) neonates exposed to maternal disease activity during pregnancy, and 2219 (89 %) neonates without exposure to disease activity. The adjusted odds ratios (aOR) for preterm birth, small for gestational age, low 5-minute Apgar score, and major congenital anomalies among children born to women with disease activity during pregnancy were 0.92 (95 % confidence interval (95 % CI) 0.53-1.60), aOR 1.19 (95 % CI 0.62-2.26), aOR 2.57 (95 % CI 0.93-7.15) and aOR 0.93 (95 % CI 0.48-1.83), respectively. CONCLUSIONS Women with MS having disease activity during pregnancy did not have a statistically significantly increased risk of adverse neonatal outcomes compared to women with MS without disease activity, which is overall reassuring results. We believe, that this will be useful knowledge for patients and clinicians in planning a pregnancy and preparing a birth plan.
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Affiliation(s)
- Mette Louise Andersen
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, entrance 216, Odense DK-5000, Denmark; Department of Clinical Research, Research Unit of Clinical Epidemiology, University of Southern Denmark, Denmark; Department of Gynecology and Obstetrics, University Hospital of Sothern Denmark, Esbjerg, Denmark.
| | - Line Riis Jølving
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, entrance 216, Odense DK-5000, Denmark; Department of Clinical Research, Research Unit of Clinical Epidemiology, University of Southern Denmark, Denmark
| | - Maria Iachina
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, entrance 216, Odense DK-5000, Denmark
| | - Pavithra Laxsen Anru
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, entrance 216, Odense DK-5000, Denmark
| | - Egon Stenager
- Department of Regional Research, University of Southern Denmark, Denmark; Multiple Sclerosis Clinic of Southern Jutland, University Hospital of Southern Jutland, Denmark
| | - Torben Knudsen
- Department of Regional Research, University of Southern Denmark, Denmark; Department of Gastroenterology, University Hospital of Southern Jutland, Denmark
| | - Bente Mertz Nørgård
- Center for Clinical Epidemiology, Odense University Hospital, Kløvervænget 30, entrance 216, Odense DK-5000, Denmark; Department of Clinical Research, Research Unit of Clinical Epidemiology, University of Southern Denmark, Denmark
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Нагаева ЕВ. [Short stature due to intrauterine growth retardation. Clinical and hormonal-metabolic features, possibilities of growth-stimulating therapy]. PROBLEMY ENDOKRINOLOGII 2022; 68:4-13. [PMID: 36337013 PMCID: PMC9762449 DOI: 10.14341/probl13178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 10/23/2022] [Indexed: 11/09/2022]
Abstract
The article presents data about short stature due to intrauterine development delay. This type of short stature - separate nosology, unites children born small for gestation age. The majority of them in the first years of life have accelerated growth rates, allowing the child to normalize their weight-growth indicators and catch up in the development of peers. In the absence of an accelerated growth rates, children have a high risk of lagging behind in physical development throughout childhood, achieving low final growth and becoming short adults. In addition, the fact of birth with small body sizes is associated with a number of hormonal and metabolic features, a risk of metabolic syndrome in adult years.It is assumed that the absence of postnatal growth acceleration is due to various damages to the GH-IGF1 axis (partial GH deficiency, partial resistance to GH, partial resistance to IGF1). Growth hormone therapy, initiated early in life, is able to normalize growth rates in childhood and ultimately significantly improve or normalize the final growth of short stature children born small for gestational age.
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Affiliation(s)
- Е. В. Нагаева
- Национальный медицинский исследовательский центр эндокринологии
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Associations of maternal periconceptional alcohol consumption with offspring prehypertension/hypertension at age 6 years: the Growing Up in Singapore Towards healthy Outcomes prospective mother-offspring cohort study. J Hypertens 2022; 40:1212-1222. [PMID: 35703883 DOI: 10.1097/hjh.0000000000003134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate the relationship of the levels of maternal alcohol consumption during the 1 year before pregnancy recognition with childhood cardiorenal, metabolic, and neurocognitive health. METHODS In 1106 women and their children from the Growing Up in Singapore Towards healthy Outcomes mother-offspring cohort, quantity of maternal alcohol consumption in the 12 months prior to pregnancy recognition was categorized as high (≥75th percentile: 1.9 g/day), low (<1.9 g/day), and none, and frequency of alcohol consumption was categorized as high (≥2-3 times/week), low (<2-3 times/week), and none. Offspring MRI-based abdominal fat depot, kidney, and brain volumes, blood pressure, metabolic syndrome score, and cognitive intelligence scores were assessed. Child prehypertension/hypertension at age 6 years was defined using a simplified pediatric threshold of 110/70 mmHg. RESULTS The average maternal alcohol consumption in the year prior to pregnancy recognition was 2.5 g/day, which is lower than the daily maximal limit of one standard drink (10 g) recommended for women by Singapore's Ministry of Health. After adjusting for participant characteristics, alcohol consumption at least 1.9 g/day was associated with over two-fold higher risk (risk ratio = 2.18, P = 0.013) of child prehypertension and 15% greater kidney growth between early infancy and age 6 years (P = 0.040) compared with abstinence. Alcohol consumption was not associated with metabolic and neurocognitive health at age 6-7 years. The associations with high frequency of alcohol consumption were concordant with those obtained for quantity of alcohol consumption. CONCLUSION Maternal self-reported alcohol consumption at least 1.9 g/day prior to pregnancy recognition was associated with increased risk of child prehypertension and rapid kidney growth. Our findings highlight the potential detrimental effects of low periconceptional alcohol consumption, below national guidelines on offspring cardiorenal health.
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Goedegebuure WJ, Van der Steen M, Smeets CCJ, Kerkhof GF, Hokken-Koelega ACS. SGA-born adults with postnatal catch-up have a persistently unfavourable metabolic health profile and increased adiposity at age 32 years. Eur J Endocrinol 2022; 187:15-26. [PMID: 35521698 DOI: 10.1530/eje-21-1130] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 04/13/2022] [Indexed: 11/08/2022]
Abstract
Background Catch-up in weight-for-length in the first year of life results in more insulin resistance, an adverse lipid profile and more fat mass (FM) in 21-year-old adults born small for gestational age (SGA-CU) compared to peers born SGA without catch-up and those born appropriate for gestational age (AGA). The aim of present study was to investigate if the adverse metabolic health profile in the SGA-CU group would worsen or remain stable over the years and to determine the cardiometabolic health at 32 years between the SGA and AGA groups. Methods We longitudinally investigated 287 adults, 170 SGA with catch-up growth (SGA-CU) or persistent short stature (SGA-S) and 117 AGA at ages 21 and 32 years. Insulin sensitivity (Si) and β-cell function were measured by frequently sampled i.v. glucose tolerance test, body composition by dual-energy X-ray absorptiometry (DXA) scan, and abdominal adipose tissue and liver fat fraction by MRI scan. Also, fasting serum lipid levels and blood pressure were measured. Results At age 32 years, SGA-CU had lower Si than AGA (P = 0.030), while SGA-S had similar Si than AGA. FM and trunk fat were higher in SGA-CU than AGA (P = 0.033, P = 0.024, respectively), while SGA-S had lower lean body mass than SGA-CU and AGA (P = 0.001 and P < 0.001, respectively). SGA-CU had significantly higher levels of adverse lipids than AGA. Beta-cell function, visceral fat, liver fat fraction and blood pressure were similar in all groups. Metabolic health parameters in SGA-CU and SGA-S did not worsen compared to AGA during 11 years of follow-up. Gain in weight SDS from birth to age 32 years was associated with a higher risk of developing metabolic syndrome at age 32 years. Conclusion At age 32 years, SGA-CU adults had insulin resistance, higher FM with central adiposity and an adverse lipid profile. Postnatal catch-up growth increases the cardiometabolic risk; therefore, accelerated gain in weight should be prevented in SGA-born children.
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Affiliation(s)
- Wesley Jim Goedegebuure
- Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
| | | | | | - Gerthe Femke Kerkhof
- Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Anita Charlotte Suzanne Hokken-Koelega
- Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
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Guazzarotti L, Mauri S, Santi D, Pogliani L, Zuccotti G. First year metabolic and hormonal behaviour define two different populations of SGA newborn for weight or height. J Endocr Soc 2022; 6:bvac028. [PMID: 35350393 PMCID: PMC8944306 DOI: 10.1210/jendso/bvac028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Indexed: 11/19/2022] Open
Abstract
Abstract
Context
Small for gestational age (SGA) children have a particular metabolic and hormonal pattern at birth that change rapidly.
Objective
To evaluate the linear and weight growth in the first year of life in SGA children.
Design
Prospective, monocentric cohort study.
Setting
Real-world data collected from April 2012 to January 2016.
Patients
SGA newborns uniformly defined by either growth or length lower than -2 standard deviation for gestational age.
Interventions
All children were evaluated for one year after birth, at three days of life, then three, six and 12 months after birth.
Main outcome measures
Anthropometric parameters and biochemical variables, such as blood glucose, insulin, leptin, insulin-like growth factor (IGF)-1, IGF binding protein (IGFBP)3, and HOMA index.
Results
One hundred and thirty-three SGA children were enrolled. Length significantly improved one month after birth, whereas weight significantly increased only three months after birth. Biochemical variables increased during the first year of life, showing a prediction by IGFBP-3 and HOMA-index. Then, the casuistry was divided considering either weight, length or both, showing a different incidence. The biochemical variables changes recorded in the first step were maintained considering SGA children for weight or length, whereas they disappeared when weight and length were considered together.
Conclusions
Our study shows a specific catch-up growth for weight and length in SGA children. Moreover, we highlight that weight and length should be considered as independent parameters in SGA children, defining two different metabolic-hormonal populations with different conceivable predictive role in early catch-up growth and in later growth and metabolic status.
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Affiliation(s)
- Laura Guazzarotti
- Endocrinology Unit, Pediatric Department, University of Padua, Italy
| | - Silvia Mauri
- Pediatric Department, University of Milan “V Buzzi” Children’s Hospital ASST FBF Sacco, Italy
| | - Daniele Santi
- Unit of Endocrinology, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Italy
| | | | - Gianvincenzo Zuccotti
- Pediatric Department, University of Milan “V Buzzi” Children’s Hospital ASST FBF Sacco, Italy
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Bizerea-Moga TO, Pitulice L, Pantea CL, Olah O, Marginean O, Moga TV. Extreme Birth Weight and Metabolic Syndrome in Children. Nutrients 2022; 14:nu14010204. [PMID: 35011079 PMCID: PMC8746946 DOI: 10.3390/nu14010204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 12/29/2021] [Accepted: 12/30/2021] [Indexed: 01/19/2023] Open
Abstract
Small and large birth weights (BWs) for gestational age (GA) represent extremes, but the correlation between extreme BW and metabolic syndrome (MetS) has not been fully elucidated. In this study, we examined this correlation in obese children based on changes in their metabolic profile from childhood to adolescence. A retrospective observational study was performed on 535 obese patients aged 0–18 years in the Clinical and Emergency Hospital for Children “Louis Turcanu” in Timisoara, Romania, based on clinical and biological data from January 2015 to December 2019. We emphasized the links between extreme BW and obesity, extreme BW and cardiometabolic risk, obesity and cardiometabolic risk, and extreme BW, obesity and MetS. Children born large for gestational age (LGA) predominated over those born small for gestational age (SGA). Our findings showed that BW has an independent effect on triglycerides and insulin resistance, whereas obesity had a direct influence on hypertension, impaired glucose metabolism and hypertriglyceridemia. The influences of BW and obesity on the development of MetS and its components are difficult to separate; therefore, large prospective studies in normal-weight patients are needed.
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Affiliation(s)
- Teofana Otilia Bizerea-Moga
- Department XI of Pediatrics—1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania; (T.O.B.-M.); (O.M.)
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
| | - Laura Pitulice
- Department of Biology-Chemistry, West University of Timişoara, Pestallozi 16, 300115 Timişoara, Romania
- Laboratory of Advanced Researches in Environmental Protection, Oituz 4, 300086 Timişoara, Romania
- Correspondence: ; Tel.: +40-744-517-275
| | - Cristina Loredana Pantea
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
| | - Orsolya Olah
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
- Department VIII of Neuroscience—Psychology Discipline, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania
| | - Otilia Marginean
- Department XI of Pediatrics—1st Pediatric Discipline, Center for Research on Growth and Developmental Disorders in Children, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania; (T.O.B.-M.); (O.M.)
- 1st Pediatric Clinic, ‘Louis Țurcanu’ Children’s Clinical and Emergency Hospital, Iosif Nemoianu 2, 300011 Timișoara, Romania; (C.L.P.); (O.O.)
| | - Tudor Voicu Moga
- Department VII of Internal Medicine—Gastroenterology Discipline, Advanced Regional Research Center in Gastroenterology and Hepatology, ‘Victor Babeș’ University of Medicine and Pharmacy Timișoara, Eftimie Murgu Sq no. 2, 300041 Timișoara, Romania;
- Gastroenterology and Hepatology Clinic, ‘Pius Brînzeu’ County Emergency Clinical Hospital, Liviu Rebreanu 156, 300723 Timișoara, Romania
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Ge C, Xu D, Yu P, Fang M, Guo J, Xu D, Qiao Y, Chen S, Zhang Y, Wang H. P-gp expression inhibition mediates placental glucocorticoid barrier opening and fetal weight loss. BMC Med 2021; 19:311. [PMID: 34876109 PMCID: PMC8653610 DOI: 10.1186/s12916-021-02173-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 10/26/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Prenatal adverse environments can cause fetal intrauterine growth retardation (IUGR) and higher susceptibility to multiple diseases after birth, related to multi-organ development programming changes mediated by intrauterine overexposure to maternal glucocorticoids. As a glucocorticoid barrier, P-glycoprotein (P-gp) is highly expressed in placental syncytiotrophoblasts; however, the effect of P-gp on the occurrence of IUGR remains unclear. METHODS Human placenta and fetal cord blood samples of IUGR fetuses were collected, and the related indexes were detected. Pregnant Wistar rats were administered with 30 mg/kg·d (low dose) and 120 mg/kg·d (high dose) caffeine from gestational day (GD) 9 to 20 to construct the rat IUGR model. Pregnant mice were administered with caffeine (120 mg/kg·d) separately or combined with sodium ferulate (50 mg/kg·d) from gestational day GD 9 to 18 to confirm the intervention target on fetal weight loss caused by prenatal caffeine exposure (PCE). The fetal serum/placental corticosterone level, placental P-gp expression, and related indicator changes were analyzed. In vitro, primary human trophoblasts and BeWo cells were used to confirm the effect of caffeine on P-gp and its mechanism. RESULTS The placental P-gp expression was significantly reduced, but the umbilical cord blood cortisol level was increased in clinical samples of the IUGR neonates, which were positively and negatively correlated with the neonatal birth weight, respectively. Meanwhile, in the PCE-induced IUGR rat model, the placental P-gp expression of IUGR rats was decreased while the corticosterone levels of the placentas/fetal blood were increased, which were positively and negatively correlated with the decreased placental/fetal weights, respectively. Combined with the PCE-induced IUGR rat model, in vitro caffeine-treated placental trophoblasts, we confirmed that caffeine decreased the histone acetylation and expression of P-gp via RYR/JNK/YB-1/P300 pathway, which inhibited placental and fetal development. We further demonstrated that P-gp inducer sodium ferulate could reverse the inhibitory effect of caffeine on the fetal body/placental weight. Finally, clinical specimens and other animal models of IUGR also confirmed that the JNK/YB-1 pathway is a co-regulatory mechanism of P-gp expression inhibition, among which the expression of YB-1 is the most stable. Therefore, we proposed that YB-1 could be used as the potential early warning target for the opening of the placental glucocorticoid barrier, the occurrence of IUGR, and the susceptibility of a variety of diseases. CONCLUSIONS This study, for the first time, clarified the critical role and epigenetic regulation mechanism of P-gp in mediating the opening mechanism of the placental glucocorticoid barrier, providing a novel idea for exploring the early warning, prevention, and treatment strategies of IUGR.
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Affiliation(s)
- Caiyun Ge
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Dan Xu
- Department of Pharmacology, Basic Medical School of Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China.,Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Pengxia Yu
- Department of Pharmacology, Basic Medical School of Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Man Fang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Juanjuan Guo
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China.,Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Dan Xu
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China.,Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Yuan Qiao
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China.,Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Sijia Chen
- Department of Pharmacology, Basic Medical School of Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China
| | - Yuanzhen Zhang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China. .,Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China.
| | - Hui Wang
- Department of Obstetrics and Gynaecology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, 430071, China. .,Department of Pharmacology, Basic Medical School of Wuhan University, 185 Donghu Road, Wuchang District, Wuhan, 430071, China. .,Hubei Provincial Key Laboratory of Developmentally Originated Diseases, 185 Donghu Road, Wuchang District, Wuhan, 430071, China.
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8
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Yu X, Yang X, Zhao Y, Luo XP, Liang Y, Wu W, Ying YQ, Ye F, Hou L. A comparison of the growth status, level of blood glucose, and lipid metabolism in small for gestational age and appropriate for gestational age girls with central precocious puberty: a retrospective study. Transl Pediatr 2021; 10:783-789. [PMID: 34012828 PMCID: PMC8107858 DOI: 10.21037/tp-20-366] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To compare the physical development status, level of blood glucose and lipid metabolism in small for gestational age (SGA) and appropriate for gestational age (AGA) groups with central precocious puberty (CPP). METHODS This was a retrospective study. Three hundred and twenty-two girls with CPP were divided into the AGA group (304 cases) and the SGA group (18 cases). Physical index such as height, weight, and body mass index (BMI), as well as sex hormones, adrenal androgens, blood lipid levels, fasting blood glucose, insulin levels, and homeostasis model assessment of insulin resistance (HOMA-IR) were compared between the two groups. RESULTS Height, weight, and BMI in the SGA group were lower than those in the AGA group (P<0.05). The level of LH/FSH, estradiol, testosterone, DHEA and androstenedione had no significant difference between the SGA group and AGA group (P>0.05). The fasting blood glucose, insulin level, HOMA-IR, high-density lipoprotein (HDL) and the average level of triglycerides were similar between these two groups (P>0.05). There was a statistically significant difference in total cholesterol and low-density lipoprotein (LDL) between the two groups (P<0.05). However, the blood lipids and blood glucose in both groups were within the normal range. CONCLUSIONS The height, weight, BMI, serum cholesterol and LDL of girls in SGA with CPP were significantly lower than that of those girls born AGA.
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Affiliation(s)
- Xiao Yu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xi Yang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Zhao
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiao-Ping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Liang
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wei Wu
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan-Qin Ying
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Ye
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Hou
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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9
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Wu D, Zhu J, Wang X, Shi H, Huo Y, Liu M, Sun F, Lan H, Guo C, Liu H, Li T, Jiang L, Hu X, Li T, Xu J, Yao G, Zhu G, Yu G, Chen J. Rapid BMI Increases and Persistent Obesity in Small-for-Gestational-Age Infants. Front Pediatr 2021; 9:625853. [PMID: 34017805 PMCID: PMC8129028 DOI: 10.3389/fped.2021.625853] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 04/06/2021] [Indexed: 12/18/2022] Open
Abstract
Purpose: In order to compensate for the early intrauterine growth restriction, small-for-gestational age (SGA) infants have "catch-up growth" after birth. Increased caloric intake has been suggested for SGA infants conventionally. It is important to determine if the early growth rate of body mass index (BMI) is associated with risk of persistent obesity later in life. In this longitudinal cohort study, we assessed the BMI of a large cohort of children who were SGA at birth to determine their risk of persistent obesity at school age (6-7 years) due to excessive weight gain in the first 3 years of life. Methods: We collected the height and weight data of 23,871 SGA babies. A polynomial function was used to fit the BMI-for-age z-score (BAZ) values of 0-6 years old SGA children and interpolate their growth trajectory. In addition, we screened out 6,959 children from 23,871 children to further evaluate the dynamic changes of early childhood BMI. We divided the school-age children into groups as non-obese (BAZ < 2) and obese (BAZ > 2), and determined the association between changes in BMI and school-age obesity. Results: From the perspective of BMI distribution, the interpolated growth trajectory indicated that SGA children reaching overweight status or developing obesity by 3 years of age, continued to have obesity until school age (R2, 0.65; R2, 0.21). The retrospective analysis showed that children who were overweight and had obesity during school age had a high BMI from early age. By analyzing the changes in early BMI, we found that the fastest growth of SGA children occurred in the early infancy before 6 months and they continued to grow rapidly for a period of time. Interestingly, former SGA children who maintained a near overweight (1 < BAZ < 2) status before the age of 2 maintained an appropriate growth rate and usually did not develop obesity. Conclusions: A rapid increase in BMI during early infancy in former SGA newborns leads to a persistent risk of obesity. The energy intake of SGA infants should appropriately meet the infants' growth needs and early BMI changes should be closely monitored for an optimal integrated management.
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Affiliation(s)
- Dan Wu
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jianzheng Zhu
- School of International and Public Affairs, Shanghai Jiao Tong University, Shanghai, China
| | - Xiulian Wang
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Huiqing Shi
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yanyan Huo
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Meiyan Liu
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Fanfan Sun
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hongyan Lan
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Chong Guo
- Fujian Maternal and Child Health Hospital, Fujian, China
| | - Honghua Liu
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Tingting Li
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Lian Jiang
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xiangying Hu
- Jing'an District Maternal and Child Healthcare Center, Shanghai, China
| | - Tianshu Li
- Huang'pu District Maternal and Child Healthcare Center, Shanghai, China
| | - Jing Xu
- Yang'pu District Maternal and Child Healthcare Center, Shanghai, China
| | - Guoying Yao
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Guowei Zhu
- Xu'hui District Maternal and Child Healthcare Center, Shanghai, China
| | - Guangjun Yu
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jinjin Chen
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Zhao Y, Albrecht E, Sciascia QL, Li Z, Görs S, Schregel J, Metges CC, Maak S. Effects of Oral Glutamine Supplementation on Early Postnatal Muscle Morphology in Low and Normal Birth Weight Piglets. Animals (Basel) 2020; 10:E1976. [PMID: 33126436 PMCID: PMC7692811 DOI: 10.3390/ani10111976] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/23/2020] [Accepted: 10/24/2020] [Indexed: 12/16/2022] Open
Abstract
Adapted nutrition can improve the growth of low birth weight (LBW) piglets. Since maternal milk is thought to provide insufficient glutamine (Gln) for LBW piglets, the current study investigated the influence of Gln supplementation during the early suckling period on development and lipid deposition in skeletal muscle. The weight differences between LBW and normal birth weight (NBW) littermates persisted from birth to slaughter (p < 0.001). However, intramuscular Gln and Ala concentrations were altered in piglets according to the supplementation (p < 0.01). There were larger muscle fibers (p = 0.048) in Gln-supplemented piglets. Capillarization or nuclei number per muscle fiber was not influenced by birth weight (BiW) or Gln supplementation. Abundance of myosin heavy chain (MYH) isoforms was slightly altered by Gln supplementation. LBW piglets had more lipid droplets than NBW piglets at day 5 of life in both muscles (p < 0.01). The differences decreased with age. Adipocyte development increased with age, but was not influenced by BiW or supplementation. The results indicate that BiW differences were accompanied by differences in lipid deposition and muscle fiber structure, suggesting a delayed development in LBW piglets. Supplementation with Gln may support piglets to overcome those disadvantages.
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Affiliation(s)
- Yaolu Zhao
- Institute of Muscle Biology and Growth, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Y.Z.); (S.M.)
| | - Elke Albrecht
- Institute of Muscle Biology and Growth, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Y.Z.); (S.M.)
| | - Quentin L. Sciascia
- Institute of Nutritional Physiology “Oskar Kellner”, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Q.L.S.); (Z.L.); (S.G.); (J.S.); (C.C.M.)
| | - Zeyang Li
- Institute of Nutritional Physiology “Oskar Kellner”, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Q.L.S.); (Z.L.); (S.G.); (J.S.); (C.C.M.)
| | - Solvig Görs
- Institute of Nutritional Physiology “Oskar Kellner”, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Q.L.S.); (Z.L.); (S.G.); (J.S.); (C.C.M.)
| | - Johannes Schregel
- Institute of Nutritional Physiology “Oskar Kellner”, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Q.L.S.); (Z.L.); (S.G.); (J.S.); (C.C.M.)
| | - Cornelia C. Metges
- Institute of Nutritional Physiology “Oskar Kellner”, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Q.L.S.); (Z.L.); (S.G.); (J.S.); (C.C.M.)
| | - Steffen Maak
- Institute of Muscle Biology and Growth, Leibniz Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (Y.Z.); (S.M.)
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11
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12
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Premature birth, low birth weight, small for gestational age and chronic non-communicable diseases in adult life: A systematic review with meta-analysis. Early Hum Dev 2020; 149:105154. [PMID: 32799034 DOI: 10.1016/j.earlhumdev.2020.105154] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 07/31/2020] [Accepted: 08/04/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Individuals who were born prematurely (PT), with low birth weight (LBW), or small for gestational age (SGA) appear to present a set of permanent changes that make them more susceptible to develop chronic non-communicable diseases (CNCD) in adult life. AIM Investigating the association between PT birth, LBW or SGA at birth and CNCD incidence in adult life. METHODS Systematic review with meta-analysis of studies available in three databases - two of them are official (PubMed and Web of Science) and one is gray literature (OpenGrey) - based on pre-established search and eligibility criteria. RESULTS Sixty-four studies were included in the review, 93.7% of them only investigated one of the exposure variables (46.7% LBW, 35.0% PT and 18.3% SGA at birth), whereas 6.3% investigated more than one exposure variable (50.0% LBW and PT; 50.0% SGA and PT). There was association among all exposure variables in the following outcomes: cardiometabolic (CMD) and glycidic metabolism (GMD) disorders, changes in body composition and risk of developing metabolic syndrome (MS). Female sex was identified as risk factor in the exposure-outcome association. Eighteen (18) articles were included in the meta-analysis. There was positive association between LBW and incidence of CMD (OR: 1.25 [95%CI: 1.11; 1.41]; 07 studies), GMD (OR: 1.70 [95%CI: 1.25; 2.30]; 03 studies) and MS (OR: 1.75 [95%CI: 1.27; 2.40]; 02 studies) in adult life. PT was positively associated with CMD (OR: 1.38 [95%CI: 1.27; 1.51]; 05 studies). CONCLUSIONS LBW and PT are associated with CMD and GMD development, as well as with the risk of developing MS in adult life.
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Khanal P, D. Axel AM, Safayi S, Elbrønd VS, Nielsen MO. Prenatal over- and undernutrition differentially program small intestinal growth, angiogenesis, absorptive capacity, and endocrine function in sheep. Physiol Rep 2020; 8:e14498. [PMID: 32597039 PMCID: PMC7322502 DOI: 10.14814/phy2.14498] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/27/2020] [Accepted: 06/02/2020] [Indexed: 12/20/2022] Open
Abstract
The aim was to test the hypothesis that prenatal under- and overnutrition in late gestation can program small intestinal (SI) growth, angiogenesis, and endocrine function to predispose for a hyperabsorptive state, thereby increasing the susceptibility to the adverse effects of an early postnatal obesogenic diet. Twin-pregnant ewes were exposed to adequate (NORM), LOW (50% of NORM), or HIGH (150% energy and 110% protein of NORM) diets through the last trimester (term ~147 days). From 3 days to 6 months of age, their lambs were fed either a moderate (CONV) or a high-carbohydrate high-fat (HCHF) diet. At 6 months of age, responses in plasma metabolites and insulin to refeeding after fasting were determined and then different segments of the SI were sampled at autopsy. Prenatal overnutrition impacts were most abundant in the duodenum where HIGH had increased villus amplification factor and lowered villi thickness with increased IRS-1 and reduced GH-R expressions. In jejunum, HIGH lambs had an increased expression of Lactate gene and amplified when exposed to HCHF postnatally. Specifically, in LOW, sensitivity to HCHF was affected in ileum. Thus, the mismatching LOW-HCHF nutrition increased expressions of angiogenic genes (VEGF, VEGF-R1, ANGPT1, RTK) and increased mucosa layer (tunica mucosa) thickness but reduced muscle layer (Tunica muscularis) thickness. The SI is a target of prenatal nutritional programming, where late gestation overnutrition increased and shifted digestive capacity for carbohydrates toward the jejunum, whereas late gestation undernutrition predisposed for ileal angiogenesis and carbohydrate and fat hyperabsorptive capacity upon subsequent exposure to postnatal obesogenic diet.
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Affiliation(s)
- Prabhat Khanal
- Faculty of Biosciences and AquacultureAnimal Science, Production and Welfare DivisionNord UniversitySteinkjerNorway
| | - Anne Marie D. Axel
- Department of Veterinary and Animal SciencesFaculty of Health and Medical SciencesUniversity of CopenhagenFrederiksbergDenmark
| | | | - Vibeke S. Elbrønd
- Department of Veterinary and Animal SciencesFaculty of Health and Medical SciencesUniversity of CopenhagenFrederiksbergDenmark
| | - Mette O. Nielsen
- Department of Animal ScienceFaculty of Technical SciencesAarhus UniversityTjeleDenmark
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Alonso-Larruscain IS, Ruibal Francisco JL, Granizo Martínez JJ, García-García ML, Fuentes Ferrer ME. Early markers of endocrinometabolic disease in newborns with delayed intrauterine growth. Clin Nutr ESPEN 2019; 34:37-44. [PMID: 31677709 DOI: 10.1016/j.clnesp.2019.09.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 07/05/2019] [Accepted: 09/06/2019] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The adjustments to malnutrition in growth restricted fetus (GRF) that lead to obesity, insulin resistance, diabetes and cardiovascular disease in adulthood are not well known. The most feasible explanation for this association is the hypothesis of catch up. Some studies postulate a greater influence of catch up growth than the low birth weight itself in developing metabolic and cardiovascular disease. MATERIAL AND METHODS This is a prospective cohort study of newborns with intrauterine growth restriction (defined as weight percentile at birth less than 10th) born during a one-year period. Clinical data of patients were recorded (gender, gestational age, data about breastfeeding and anthropometry during follow-up every 3 months). Some details of pregnancy and characteristics of the mother were also registered. Serum biochemical parameters (IGF-1, IGF-BP3, insulin, glucose, total cholesterol, HDL cholesterol, DLD cholesterol, triglycerides, HOMA) were collected at birth from cord blood, 9 and 12 months. Two main comparative groups were established: those GRF who made a catch-up growth (increase in weight Z score higher than 0,67) during the follow-up and those who did not get it. RESULTS 126 GRF children were born in the study period. 125 accepted the inclusion in the study and 67 of them completed the full monitoring for a year; 47 of them made recovery growth and 20 did not. A significant difference between both groups was found in glucose in umbilical cord and triglycerides at 12 months: GRF children with catch up growth showed lower glucose levels (p = 0.03) and higher levels of triglycerides (p = 0.03). There were no statistically significant differences in the rest of laboratory parameters analyzed (IGF-1, IGF-BP3, insulin, glucose, total cholesterol, HDL cholesterol, DLD cholesterol, HOMA at 9 and 12 months or triglycerides at 9 months). CONCLUSIONS Those GRF with catch up growth during the first year of life have early changes in the triglycerides at the end of that period with higher levels than those GRF children without catch up growth. This finding could be useful to develop a tool for early detection of GRF children with higher metabolic risk in order to prevent future pathology.
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Darendeliler F. IUGR: Genetic influences, metabolic problems, environmental associations/triggers, current and future management. Best Pract Res Clin Endocrinol Metab 2019; 33:101260. [PMID: 30709755 DOI: 10.1016/j.beem.2019.01.001] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The children with intrauterine growth restriction (IUGR) especially if they make a catch-up growth in early life have a higher risk for long term problems including short stature and also developing metabolic syndrome, Type 2 diabetes, insulin resistance and cardiovascular diseases. The studies also support that these children may have abnormalities in pubertal timing, adrenarche and reproductive function. The aim of this review was to summarize the published reports mainly on puberty and reproductive functions in children born IUGR at older ages in association with metabolic problems that they encounter. Possible mechanisms explaining these outcomes are discussed. Lastly strategies that may be taken for the prevention of IUGR related morbidities at later life are shortly presented.
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Affiliation(s)
- Feyza Darendeliler
- İstanbul University, Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, İstanbul, Turkey.
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16
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Desai M, Han G, Li T, Ross MG. Programmed Epigenetic DNA Methylation-Mediated Reduced Neuroprogenitor Cell Proliferation and Differentiation in Small-for-Gestational-Age Offspring. Neuroscience 2019; 412:60-71. [PMID: 31153962 DOI: 10.1016/j.neuroscience.2019.05.044] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 05/01/2019] [Accepted: 05/22/2019] [Indexed: 12/28/2022]
Abstract
Small-for-gestational age (SGA) human newborns have an increased risk of hyperphagia and obesity, as well as a spectrum of neurologic and neurobehavioral abnormalities. We have shown that the SGA hypothalamic (appetite regulatory site) neuroprogenitor cells (NPCs) exhibit reduced proliferation and neuronal differentiation. DNA methylation (DNA methyltransferase; DNMT1) regulates neurogenesis by maintaining NPC proliferation and suppressing premature differentiation. Once differentiation ensues, DNMT1 preferentially promotes neuronal and inhibits astroglial fate. We hypothesized that the programmed dysfunction of NPC proliferation and differentiation in SGA offspring is epigenetically mediated via DNMT1. Pregnant rats received either ad libitum food (Control) or were 50% food-restricted to create SGA offspring. Primary hypothalamic NPCs from 1 day old SGA and Controls newborns were cultured and transfected with nonspecific or DNMT1-specific siRNA. NPC proliferation and protein expression of specific markers of NPC (nestin), neuroproliferative transcription factor (Hes1), neurons (Tuj1) and astrocytes (GFAP) were determined. Under basal conditions, SGA NPCs exhibited decreased DNMT1 and reduced proliferation and differentiation, as compared to Controls. In both SGA and Controls, DNMT1 siRNA in complete media inhibited NPC proliferation, consistent with reduced expression of nestin and Hes1. In differentiation media, DNMT1 siRNA decreased expression of Tuj1 but increased GFAP. In vivo data replicated these findings. In SGA offspring, impaired neurogenesis is epigenetically mediated, in part, via reduction in DNMT1 expression and suppression of Hes1 resulting in NPC differentiation. It is likely that the maturation of regions beyond the hypothalamus (e.g., cerebral cortex, hippocampus) may be impacted, contributing to poor cognitive and neurobehavioral competency in SGA offspring.
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Affiliation(s)
- Mina Desai
- Perinatal Research Laboratory, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA; Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Guang Han
- Perinatal Research Laboratory, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA
| | - Tie Li
- Perinatal Research Laboratory, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA
| | - Michael G Ross
- Perinatal Research Laboratory, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Department of Obstetrics and Gynecology, Torrance, CA, USA; Department of Obstetrics and Gynecology, David Geffen School of Medicine, University of California, Los Angeles, CA, USA; Department of Obstetrics and Gynecology, Charles R. Drew University, Los Angeles, CA, USA
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17
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Heidemann LA, Procianoy RS, Silveira RC. Prevalence of metabolic syndrome-like in the follow-up of very low birth weight preterm infants and associated factors. J Pediatr (Rio J) 2019; 95:291-297. [PMID: 29705050 DOI: 10.1016/j.jped.2018.02.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Revised: 01/23/2018] [Accepted: 02/06/2018] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To assess the prevalence of metabolic syndrome-like symptoms in a population of preterm infants with very low birth weight (<1500g) at 2 years of corrected age and identify the occurrence of associated risk factors. METHODS Cross-sectional study during a five-year period, including preterm infants born with very low birth weight evaluated at 2 years of corrected age. Metabolic syndrome-like symptoms was defined by the presence of three or more of these criteria: abdominal circumference≥90th percentile, fasting blood glucose≥100mg/dL, triglycerides≥110mg/dL, HDL cholesterol≤40mg/dL, and blood pressure≥90th percentile. RESULTS A total of 214 preterm infants with birth weight<1500g were evaluated. The prevalence of metabolic syndrome-like symptoms at 2 years of corrected age was 15.1%. Arterial hypertension was present in 57.5%, HDL≤40mg/dL in 29.2%, hypertriglyceridemia in 22.6%, and abdominal circumference above the 90th percentile in 18.8%. Only 3.7% had hyperglycemia. The presence of periventricular leukomalacia was an independent risk factor for arterial hypertension at this age (OR 2.34, 95% CI: 0.079-0.69, p=0.008). Overweight and obesity at 2 years of corrected age were independently associated with metabolic syndrome-like symptoms (OR 2.75, 95% CI: 1.19-6.36, p=0.018). CONCLUSION Metabolic syndrome-like symptoms can be observed in very low birth weight preterm infants as early as 2 years of corrected age. Overweight and early-onset obesity are significant risk factors for metabolic syndrome-like symptoms, which deserves appropriate intervention for this high-risk population.
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Affiliation(s)
- Luciana A Heidemann
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital Moinhos de Vento, Porto Alegre, RS, Brazil
| | - Renato S Procianoy
- Universidade Federal do Rio Grande do Sul (UFRGS), Serviço de Pediatria, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Serviço de Neonatologia, Porto Alegre, RS, Brazil
| | - Rita C Silveira
- Universidade Federal do Rio Grande do Sul (UFRGS), Serviço de Pediatria, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Serviço de Neonatologia, Porto Alegre, RS, Brazil.
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18
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Heidemann LA, Procianoy RS, Silveira RC. Prevalence of metabolic syndrome-like at 2 years of corrected age in very low birth weight preterm infants and associated factors. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2019. [DOI: 10.1016/j.jpedp.2018.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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19
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Finken MJJ, van der Steen M, Smeets CCJ, Walenkamp MJE, de Bruin C, Hokken-Koelega ACS, Wit JM. Children Born Small for Gestational Age: Differential Diagnosis, Molecular Genetic Evaluation, and Implications. Endocr Rev 2018; 39:851-894. [PMID: 29982551 DOI: 10.1210/er.2018-00083] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 06/21/2018] [Indexed: 12/25/2022]
Abstract
Children born small for gestational age (SGA), defined as a birth weight and/or length below -2 SD score (SDS), comprise a heterogeneous group. The causes of SGA are multifactorial and include maternal lifestyle and obstetric factors, placental dysfunction, and numerous fetal (epi)genetic abnormalities. Short-term consequences of SGA include increased risks of hypothermia, polycythemia, and hypoglycemia. Although most SGA infants show catch-up growth by 2 years of age, ∼10% remain short. Short children born SGA are amenable to GH treatment, which increases their adult height by on average 1.25 SD. Add-on treatment with a gonadotropin-releasing hormone agonist may be considered in early pubertal children with an expected adult height below -2.5 SDS. A small birth size increases the risk of later neurodevelopmental problems and cardiometabolic diseases. GH treatment does not pose an additional risk.
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Affiliation(s)
- Martijn J J Finken
- Department of Pediatrics, VU University Medical Center, MB Amsterdam, Netherlands
| | - Manouk van der Steen
- Department of Pediatrics, Erasmus University Medical Center/Sophia Children's Hospital, CN Rotterdam, Netherlands
| | - Carolina C J Smeets
- Department of Pediatrics, Erasmus University Medical Center/Sophia Children's Hospital, CN Rotterdam, Netherlands
| | - Marie J E Walenkamp
- Department of Pediatrics, VU University Medical Center, MB Amsterdam, Netherlands
| | - Christiaan de Bruin
- Department of Pediatrics, Leiden University Medical Center, RC Leiden, Netherlands
| | - Anita C S Hokken-Koelega
- Department of Pediatrics, Erasmus University Medical Center/Sophia Children's Hospital, CN Rotterdam, Netherlands
| | - Jan M Wit
- Department of Pediatrics, Leiden University Medical Center, RC Leiden, Netherlands
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Wang X, Zhu J, Guo C, Shi H, Wu D, Sun F, Shen L, Ge P, Wang J, Hu X, Chen J, Yu G. Growth of infants and young children born small for gestational age: growth restriction accompanied by overweight. J Int Med Res 2018; 46:3765-3777. [PMID: 30009651 PMCID: PMC6136010 DOI: 10.1177/0300060518779305] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Objectives To compare growth profiles of children born small for gestational age (SGA)
with those born the appropriate size for gestational age (AGA), and examine
expected growth patterns for SGA in early childhood. Methods A survey on 23,871 SGA children was conducted in Shanghai. Data were
collected at 1, 2, 4, 6, 8, 10, 12, 18, 24, 36, 48, and 60 months of age
(+30 days). A check-up included assessments of weight, height, and head
circumference. Results At 5 years old, weight, height, and head circumference were lower in SGA
children compared with AGA children. The proportions of overweight and
obesity of SGA children at 4 to 18 months after birth were significantly
higher than those in AGA children, with higher proportions in boys than in
girls. There was no correlation between overweight at 5 years old and
overweight before 2 years old in SGA children. Conclusions Children born SGA remain shorter and lighter, with a smaller head
circumference at 5 years old compared with AGA children. At 4 to 18 months
after birth, there is a high incidence of overweight and obesity in SGA
children. Overweight and obesity in SGA boys are more serious than those in
SGA girls.
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Affiliation(s)
- Xiulian Wang
- 1 Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jianzhen Zhu
- 2 China hospital development Institute, Shanghai Jiao Tong University, Shanghai, China
| | - Chong Guo
- 3 Department of Child Health Care, Fujian Maternity and Children Health Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, China
| | - Huiqing Shi
- 1 Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Dan Wu
- 1 Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Fanfan Sun
- 1 Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Li Shen
- 4 School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Pin Ge
- 3 Department of Child Health Care, Fujian Maternity and Children Health Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, China
| | - Jian Wang
- 5 Department of Child Health Care, Jing'an District maternal and child healthcare center, Shanghai, China
| | - Xiangying Hu
- 5 Department of Child Health Care, Jing'an District maternal and child healthcare center, Shanghai, China
| | - Jinjin Chen
- 1 Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Guangjun Yu
- 1 Department of Child Health Care, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, China
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Poidvin A, Weill A, Ecosse E, Coste J, Carel JC. Risk of Diabetes Treated in Early Adulthood After Growth Hormone Treatment of Short Stature in Childhood. J Clin Endocrinol Metab 2017; 102:1291-1298. [PMID: 28324032 DOI: 10.1210/jc.2016-3145] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 01/05/2017] [Indexed: 12/26/2022]
Abstract
CONTEXT Growth hormone (GH) is known to be diabetogenic, but the risk of diabetes in individuals treated with GH in childhood has been little evaluated, and conflicting results have been obtained. OBJECTIVE To investigate the prevalence of diabetes and gestational diabetes in a population-based cohort of patients treated with GH for short stature in childhood in France. DESIGN, SETTING, AND PARTICIPANTS Participants were a population-based cohort of 5100 children with idiopathic isolated GH deficiency, idiopathic short stature, or short stature in children born short for gestational age who started GH treatment between 1985 and 1996. Data on the delivery of diabetes drugs in 2009 and 2010 were obtained from the French national health insurance database. Cases in patients and controls were identified from diabetes drugs deliveries. MAIN OUTCOME MEASURE The prevalence of diabetes was calculated and compared with that in the general population, determined on the basis of data from the same source, with the same definition. RESULTS At a mean age of 30 years, no difference in the prevalence of treated diabetes (oral drugs or insulin) was found between subjects treated with GH and the general population in France, regardless of sex. Similarly, the risk of insulin-treated gestational diabetes was similar in patients and in the reference population. CONCLUSIONS No difference in the risk of diabetes was found between GH-treated patients and the reference population. These results are reassuring, but further studies with a longer follow-up are required to evaluate the risk of diabetes with age in these patients.
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Affiliation(s)
- Amélie Poidvin
- Université Paris Diderot, Sorbonne Paris Cité, Paris 75019, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert-Debré, Department of Pediatric Endocrinology and Diabetology, and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris 75019, France
- Neuroprotection du cerveau en développement, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris 75019, France
- Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Biostatistics and Epidemiology Unit, and APEMAC Equipe d'Accueil 4360, Paris 75004, France
| | - Alain Weill
- Department of Studies in Public Health, French National Health Insurance, Paris 75986, France
| | - Emmanuel Ecosse
- Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Biostatistics and Epidemiology Unit, and APEMAC Equipe d'Accueil 4360, Paris 75004, France
| | - Joel Coste
- Hôtel Dieu, Assistance Publique-Hôpitaux de Paris, Biostatistics and Epidemiology Unit, and APEMAC Equipe d'Accueil 4360, Paris 75004, France
| | - Jean-Claude Carel
- Université Paris Diderot, Sorbonne Paris Cité, Paris 75019, France
- Assistance Publique-Hôpitaux de Paris, Hôpital Universitaire Robert-Debré, Department of Pediatric Endocrinology and Diabetology, and Centre de Référence des Maladies Endocriniennes Rares de la Croissance, Paris 75019, France
- Neuroprotection du cerveau en développement, INSERM, Unversité Paris Diderot, Sorbonne Paris Cité, Paris 75019, France
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Lind L, Elmståhl S, Ärnlöv J. Change in Body Weight from Age 20 Years Is a Powerful Determinant of the Metabolic Syndrome. Metab Syndr Relat Disord 2017; 15:112-117. [PMID: 28339342 DOI: 10.1089/met.2016.0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Higher body weight is a well-known determinant of the metabolic syndrome (MetS) and its components. It is however less well studied how the change in weight from age 20 years to middle age or old age affects MetS development. METHODS In the community-based EpiHealth (n = 19,000, age range 45 to 75 years, 56% females) and PIVUS (n = 1000, all aged 70 years, 50% females) studies, the participants were asked about their body weight at age 20 years. Data were collected to determine MetS prevalence (NCEP ATP III criteria). RESULTS In EpiHealth, the probability of having MetS increased fairly linearly with increasing weight from age 20 in the obese [odds ratios (OR) 1.04 per kg change in weight, 95% confidence interval (CI) 1.03-1.05, P < 0.0001], as well as in the overweight (OR 1.15, 95% CI 1.14-1.17, P < 0.0001) and normal-weight (OR 1.18, 95% CI 1.14-1.21, P < 0.0001), subjects after adjustment for age, sex, body mass index (BMI) at age 20, alcohol intake, smoking, education, and exercise habits. Also in the PIVUS study, the change in weight over 50 years was related to prevalent MetS (OR 1.08 per kg change in weight, 95% CI 1.06-1.10, P < 0.0001). In both studies, self-reported BMI at age 20 was related to prevalent MetS. CONCLUSION Self-reported weight gain from age 20 was strongly and independently associated with prevalent MetS both in middle age or old age. Interestingly, this relationship was not restricted only to obese subjects. Our data provide additional support for the importance of maintaining a stable weight throughout life.
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Affiliation(s)
- Lars Lind
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
| | - Sölve Elmståhl
- 2 Department of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö University Hospital , Malmö, Sweden
| | - Johan Ärnlöv
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden .,3 School of Health and Social Studies, Dalarna University , Falun, Sweden
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Kuhle S, Maguire B, Ata N, MacInnis N, Dodds L. Birth Weight for Gestational Age, Anthropometric Measures, and Cardiovascular Disease Markers in Children. J Pediatr 2017; 182:99-106. [PMID: 28012695 DOI: 10.1016/j.jpeds.2016.11.067] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/10/2016] [Accepted: 11/23/2016] [Indexed: 01/27/2023]
Abstract
OBJECTIVE To examine the association of birth weight for gestational age with anthropometric measures and cardiometabolic markers in a population-based sample of Canadian children. STUDY DESIGN The study used data from 2016 children aged 6-12 years from the first 2 cycles of the Canadian Health Measures Survey, a population-based survey of Canadian residents. The main exposure was birth weight for gestational age (small [SGA], large [LGA], and appropriate for gestational age [AGA]). The outcomes were anthropometric measures, blood pressure, and laboratory cardiovascular disease markers. The association between the exposure and the outcomes was examined using multiple regression. Analyses were weighted to account for the complex sampling design and for nonresponse. RESULTS SGA infants had lower and LGA infants had higher z scores for anthropometric measures compared with the AGA group but most differences were not statistically significant. There were no differences between the SGA or LGA infants and the AGA group in blood pressure or individual cardiometabolic markers but SGA infants were significantly less likely to have elevated levels of 3 or more components of the metabolic syndrome compared with their AGA peers. CONCLUSIONS Former SGA and LGA infants have lower (SGA) and higher (LGA) body mass index and waist circumference, respectively, than their AGA peers. The known long-term increased cardiovascular disease risk among SGA or LGA infants was not reflected in the blood pressure and laboratory measurements at age 6-12 years.
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Affiliation(s)
- Stefan Kuhle
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.
| | - Bryan Maguire
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada; Department of Mathematics and Statistics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Nicole Ata
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Natasha MacInnis
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Linda Dodds
- Perinatal Epidemiology Research Unit, Departments of Obstetrics and Gynaecology and Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
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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: 129] [Impact Index Per Article: 18.4] [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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Kopec G, Shekhawat PS, Mhanna MJ. Prevalence of diabetes and obesity in association with prematurity and growth restriction. Diabetes Metab Syndr Obes 2017; 10:285-295. [PMID: 28740412 PMCID: PMC5505541 DOI: 10.2147/dmso.s115890] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Intrauterine growth restriction (IUGR) is when fetuses and newborn infants have not reached their true growth potential as genetically defined. Fetuses with IUGR develop in a less than ideal environment that leads to epigenetic changes and marks infants' metabolism for the rest of their lives. Epigenetic changes affect insulin-like growth factor-1 (IGF-1) levels and lead to insulin resistance and ultimately to a metabolic syndrome. The metabolic syndrome is a constellation of illnesses that raise one's risk for type 2 diabetes mellitus, coronary artery disease, and ischemic heart disease, including hypertension, dyslipidemia, central obesity, insulin resistance, and inflammation. The association between IUGR or prematurity and long-term insulin resistance, obesity, hypertension, and metabolic syndrome remains unclear. While studies have shown an association, others have not supported such association. If alteration of intrauterine growth can ultimately lead to the development of metabolic derangements in childhood and adulthood, and if such association is true, then early interventions targeting the health of pregnant women will ensure the health of the population to follow.
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Affiliation(s)
- Gretchen Kopec
- Department of Pediatrics, MetroHealth Medical Centre, Case Western Reserve University, Cleveland, OH, USA
| | - Prem S Shekhawat
- Department of Pediatrics, MetroHealth Medical Centre, Case Western Reserve University, Cleveland, OH, USA
| | - Maroun J Mhanna
- Department of Pediatrics, MetroHealth Medical Centre, Case Western Reserve University, Cleveland, OH, USA
- Correspondence: Maroun J Mhanna, Department of Pediatrics, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109, USA, Tel +1 216 778 1346, Fax +1 216 778 4223, Email
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Jin YY, He MZ, Wu ZY, Huang K, Shen Y, Liang L, Mao JH. Dysregulation of calcium channels decreases parasecretion in pancreatic β-cells in rats born small for gestational age. Growth Factors 2016; 34:159-165. [PMID: 27681688 DOI: 10.3109/08977194.2016.1145677] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the role of intrauterine malnourishment in the development and function of pancreatic islet β-cells. METHODS Whole-cell patch clamping was used to record voltage-gated calcium channel (VGCC)-mediated currents. Insulin secretion was detected by measuring capacitance using a sequence of sine wave stimuli. VGCC currents and insulin secretion were measured in the small for gestational age (SGA) group treated with human recombinant growth hormone (hGH). RESULTS The membrane capacitance in the SGA group (6.4 ± 0.9 fF/Pf) was significantly reduced. Calcium current density and peak current density in the SGA group were also markedly decreased, whereas other measurements of calcium channels were unaltered. Treatment with hGH significantly rescued the membrane capacitance, whereas calcium channels were not affected. CONCLUSION Our data suggest that decreased β-cell secretion is caused by a decreased expression of calcium channels and reduced calcium currents. hGH restores β-cell secretion in SGA animals, possibly independently of VGCC.
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Affiliation(s)
- Yan-Yan Jin
- a Children's Hospital of Zhejiang University School of Medicine , Hangzhou , China
| | - Meng-Zao He
- b Department of Pediatrics , Hangzhou First People's Hospital, Nanjing Medical University , Hangzhou , China
| | - Zhen-Yong Wu
- c Department of Neurobiology , Zhejiang University School of Medicine , Hangzhou , China , and
| | - Ke Huang
- a Children's Hospital of Zhejiang University School of Medicine , Hangzhou , China
| | - Ying Shen
- c Department of Neurobiology , Zhejiang University School of Medicine , Hangzhou , China , and
| | - Li Liang
- d The First Affiliated Hospital, Zhejiang University School of Medicine , Hangzhou , China
| | - Jian-Hua Mao
- a Children's Hospital of Zhejiang University School of Medicine , Hangzhou , China
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Giapros V, Vavva E, Siomou E, Kolios G, Tsabouri S, Cholevas V, Bairaktari E, Tzoufi M, Challa A. Low-birth-weight, but not catch-up growth, correlates with insulin resistance and resistin level in SGA infants at 12 months. J Matern Fetal Neonatal Med 2016; 30:1771-1776. [PMID: 27609490 DOI: 10.1080/14767058.2016.1224838] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To investigate the insulin resistance status in SGA infants at 12 months and its relationship with auxological and metabolic parameters. METHODS One group of 45 SGA and one of 50 appropriate for gestational age infants were followed from birth to the end of the first year of life. At 12 months, skinfold thickness, waist circumference, and blood levels of glucose, insulin, adiponectin, leptin, resistin, visfatin, retinol-binding protein 4, IGFs, lipids profile were determined, and the HOMA-IR index was calculated. RESULTS The SGAs had increased insulin (5.2 ± 2.7 versus 2.9 ± 2.4 μIU/ml, p = 0.012) and HOMA-IR (1.09 ± 0.9 versus 0.59 ± 0.55, p = 0.016). In multiple regression, insulin resistance indices were independently correlated with low-birth-weight (β = -2.92, p = 0.015 for insulin, β = -2.98, p = 0.011 for HOMA-IR) but not with catch-up growth in either height or weight or any other metabolic parameter. Resistin was higher in the SGAs (5.1 ± 2.1 versus 3.9 ± 2.1 ng/ml, p = 0.03) and independently correlated with low-birth-weight but not insulin resistance. Resistin was negatively correlated with total cholesterol (R = -0.33, p = 0.007) and positively with lipoprotein(a) (R = 0.49, p = 0.001). CONCLUSION Low-birth-weight, but not catch-up growth or adiposity tissue hormones, was correlated with insulin resistance at 12 months in non-obese SGA infants. The higher resistin in SGA infants and its correlation with total cholesterol and lipoprotein(a) need further clarification.
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Affiliation(s)
| | | | | | | | | | - Vasileios Cholevas
- c Pediatric Research Laboratory , University of Ioannina , Ioannina , Greece
| | | | - Meropi Tzoufi
- a Neonatal Intensive Care Unit, Child Health Department
| | - Anna Challa
- c Pediatric Research Laboratory , University of Ioannina , Ioannina , Greece
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Matta J, Carette C, Levy Marchal C, Bertrand J, Pétéra M, Zins M, Pujos-Guillot E, Comte B, Czernichow S. Weight for gestational age and metabolically healthy obesity in adults from the Haguenau cohort. BMJ Open 2016; 6:e011367. [PMID: 27580829 PMCID: PMC5013421 DOI: 10.1136/bmjopen-2016-011367] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND An obesity subphenotype, named 'metabolically healthy obese' (MHO) has been recently defined to characterise a subgroup of obese individuals with less risk for cardiometabolic abnormalities. To date no data are available on participants born with small weight for gestational age (SGA) and the risk of metabolically unhealthy obesity (MUHO). OBJECTIVE Assess the risk of MUHO in SGA versus appropriate for gestational age (AGA) adult participants. METHODS 129 young obese individuals (body mass index ≥30 kg/m²) from data of an 8-year follow-up Haguenau cohort (France), were identified out of 1308 participants and were divided into 2 groups: SGA (n=72) and AGA (n=57). Metabolic characteristics were analysed and compared using unpaired t-test. The HOMA-IR index was determined for the population and divided into quartiles. Obese participants within the first 3 quartiles were considered as MHO and those in the fourth quartile as MUHO. Relative risks (RRs) and 95% CI for being MUHO in SGA versus AGA participants were computed. RESULTS The SGA-obese group had a higher risk of MUHO versus the AGA-obese group: RR=1.27 (95% CI 1.10 to 1.6) independently of age and sex. CONCLUSIONS In case of obesity, SGA might confer a higher risk of MUHO compared with AGA.
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Affiliation(s)
| | - Claire Carette
- Nutrition Department, Hôpital Européen Georges-Pompidou, Paris, France
| | - Claire Levy Marchal
- INSERM CIE 05 - Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Julien Bertrand
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Mélanie Pétéra
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Marie Zins
- INSERM, UMS 011, Villejuif, France
- Paris Descartes University, Paris, France
| | - Estelle Pujos-Guillot
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Blandine Comte
- INRA, UMR 1019, UNH, CRNH Auvergne, F-63000 CLERMONT-FERRAND, France
- Clermont Université, Université d'Auvergne, Unité de Nutrition Humaine, BP 10448, F-63000 CLERMONT-FERRAND, France
| | - Sébastien Czernichow
- INSERM, UMS 011, Villejuif, France
- Nutrition Department, Hôpital Européen Georges-Pompidou, Paris, France
- Paris Descartes University, Paris, France
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Matta J, Carette C, Levy Marchal C, Bertrand J, Pétéra M, Zins M, Pujos-Guillot E, Comte B, Czernichow S. Dietary intake in young adults born small or appropriate for gestational age: data from the Haguenau cohort. BMJ Open 2016; 6:e012309. [PMID: 27473954 PMCID: PMC4985857 DOI: 10.1136/bmjopen-2016-012309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Compare the dietary intake of young adults born small for gestational age (SGA) versus those born appropriate for gestational age (AGA). DESIGN Cross-sectional analysis. SETTING Data at the 8-year follow-up Haguenau cohort (France). Data from 229 AGA-born adults and 172 SGA-born adults with available dietary information are presented. METHODS Dietary intake was based on a food questionnaire including 19 items. The χ(2) test was run to compare intake between SGA-born and AGA-born individuals. An a priori score was calculated based on the adherence to recommendations from the French Nutrition and Health Program and included 8 components with the lowest value indicating a lower adherence to recommendations. The score was then divided into quartiles. Relative risks and 95% CIs, controlling for age and sex in multivariate analysis, were calculated in order to determine the risk of belonging to the first versus the second to the fourth quartiles in SGA-born and AGA-born individuals. RESULTS Intakes of SGA-born adults indicated that they consumed more meat, sugar and less fish than AGA-born individuals (all p<0.05). Multivariate analyses with adjustment for age and sex showed that the relative risk of belonging to the first quartile versus the other three quartiles did not disclose any significant difference in SGA-born versus AGA-born participants: RR=0.92 (95% CI 0.65 to 1.30). CONCLUSIONS Aside from the differences found by univariate analyses, no significant differences were obtained in multivariate analyses. Findings suggest that parameters of fetal programming are more associated with the development of metabolic syndrome in adulthood rather than dietary patterns.
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Affiliation(s)
- Joane Matta
- INSERM UMS 011, Population-Based Cohorts, France
| | - Claire Carette
- Nutrition Department, Hôpital Européen Georges-Pompidou, Paris, France
| | - Claire Levy Marchal
- INSERM CIE 05 - Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Julien Bertrand
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Université d'Auvergne, Clermont Université, 63122 Saint-Genès Champanelle, France
| | - Mélanie Pétéra
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Université d'Auvergne, Clermont Université, 63122 Saint-Genès Champanelle, France
| | - Marie Zins
- INSERM UMS 011, Population-Based Cohorts, France
- Paris Descartes University, Paris, France
| | - Estelle Pujos-Guillot
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Université d'Auvergne, Clermont Université, 63122 Saint-Genès Champanelle, France
| | - Blandine Comte
- INRA, UMR 1019, Human Nutrition Unit, CRNH Auvergne, Clermont-Ferrand, France
- Université d'Auvergne, Clermont Université, 63122 Saint-Genès Champanelle, France
| | - Sébastien Czernichow
- INSERM UMS 011, Population-Based Cohorts, France
- Nutrition Department, Hôpital Européen Georges-Pompidou, Paris, France
- Paris Descartes University, Paris, France
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VEJRAZKOVA D, LUKASOVA P, VANKOVA M, BRADNOVA O, VACINOVA G, VCELAK J, CIRMANOVA V, ANDELOVA K, KREJCI H, BENDLOVA B. Gestational Diabetes – Metabolic Risks of Adult Women With Respect to Birth Weight. Physiol Res 2015; 64:S135-45. [DOI: 10.33549/physiolres.933089] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Metabolic disorders such as obesity, insulin resistance and other components of metabolic syndrome (MetS) are connected with birth weight. Low and high birth weight is associated with a higher risk of developing type 2 diabetes mellitus, the mechanism is not clear. In this study, we evaluated the association between birth weight and anthropometric as well as biochemical components of MetS in women with a history of gestational diabetes mellitus (GDM) in comparison with control women. In part of the GDM group, we re-evaluated metabolic changes over 5-8 years. Anthropometry, blood pressure, glucose metabolism during the 3-h oGTT, lipid profile, uric acid, thyroid hormones, and liver enzymes were assessed. From the analyzed components of MetS in adult women we proved the association of low birth weight (birth weight <25th percentile) with glucose processing, in particular among women with a history of GDM. Low birth weight GDM women revealed significantly higher postchallenge insulin secretion and lower peripheral insulin sensitivity. Re-examinations indicate this association persists long after delivery.
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Affiliation(s)
- D. VEJRAZKOVA
- Department of Molecular Endocrinology, Institute of Endocrinology, Prague, Czech Republic
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Left ventricular dimensions, systolic functions, and mass in term neonates with symmetric and asymmetric intrauterine growth restriction. Cardiol Young 2015; 25:301-7. [PMID: 24355690 DOI: 10.1017/s1047951113002199] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Previous studies have demonstrated structural changes in the heart and cardiac dysfunction in foetuses with intrauterine growth restriction. There are no available data that evaluated left ventricular dimensions and mass in neonates with symmetric and asymmetric intrauterine growth restriction. Therefore, we aimed to evaluate left ventricular dimensions, systolic functions, and mass in neonates with symmetric and asymmetric intrauterine growth restriction. We also assessed associated maternal risk factors, and compared results with healthy appropriate for gestational age neonates. METHODS In all, 62 asymmetric intrauterine growth restriction neonates, 39 symmetric intrauterine growth restriction neonates, and 50 healthy appropriate for gestational age neonates were evaluated by transthoracic echocardiography. RESULTS The asymmetric intrauterine growth restriction group had significantly lower left ventricular end-systolic and end-diastolic diameters and posterior wall diameter in systole and diastole than the control group. The symmetric intrauterine growth restriction group had significantly lower left ventricular end-diastolic diameter than the control group. All left ventricular dimensions were lower in the asymmetric intrauterine growth restriction neonates compared with symmetric intrauterine growth restriction neonates (p>0.05), but not statistically significant except left ventricular posterior wall diameter in diastole (3.08±0.83 mm versus 3.54 ±0.72 mm) (p<0.05). Both symmetric and asymmetric intrauterine growth restriction groups had significantly lower relative posterior wall thickness (0.54±0.19 versus 0.48±0.13 versus 0.8±0.12), left ventricular mass (9.8±4.3 g versus 8.9±3.4 g versus 22.2±5.7 g), and left ventricular mass index (63.6±29.1 g/m2 versus 54.5±24.4 g/m2 versus 109±28.8 g/m2) when compared with the control group. CONCLUSIONS Our study has demonstrated that although neonates with both symmetric and asymmetric intrauterine growth restriction had lower left ventricular dimensions, relative posterior wall thickness, left ventricular mass, and mass index when compared with appropriate for gestational age neonates, left ventricular systolic functions were found to be preserved. In our study, low socio-economic level, short maternal stature, and low maternal weight were found to be risk factors to develop intrauterine growth restriction. To our knowledge, our study is the first to evaluate left ventricular dimensions, wall thicknesses, mass, and systolic functions in neonates with intrauterine growth restriction and compare results with respect to asymmetric or symmetric subgroups.
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Malin GL, Morris RK, Riley RD, Teune MJ, Khan KS. When is birthweight at term (≥37 weeks' gestation) abnormally low? A systematic review and meta-analysis of the prognostic and predictive ability of current birthweight standards for childhood and adult outcomes. BJOG 2015; 122:634-42. [PMID: 25601001 PMCID: PMC4413055 DOI: 10.1111/1471-0528.13282] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND Health outcomes throughout the life course have been linked to fetal growth restriction and low birthweight. A variety of measures exist to define low birthweight, with a lack of consensus regarding which predict adverse outcome. OBJECTIVES To evaluate the relationship between birthweight standards and childhood and adult outcomes in term-born infants (≥37 weeks' gestation). SEARCH STRATEGY MEDLINE (1966-January 2011), EMBASE (1980-January 2011), and the Cochrane Library (2011:1) and MEDION were included. SELECTION CRITERIA Studies comprising live term-born infants (gestation ≥37 completed weeks), with weight or other anthropometric measurements recorded at birth along with childhood and adult outcomes. DATA COLLECTION AND ANALYSIS Data were extracted to populate 2 × 2 tables relating birthweight standard with outcome, and meta-analysis was performed where possible. MAIN RESULTS Fifty-nine articles (2 600 383 individuals) were selected. There was no significant relationship between birthweight <2.5 kg (odds ratio [OR] 0.98, 95% confidence intervals [CI] 0.87-1.10) and composite measure of childhood morbidity. Weight <10th centile on the population nomogram showed a small association (OR 1.49, 95% CI 1.02-2.19) for the same outcome. There was no significant association between either of the above measures and adult morbidity. The relationship between other measures and individual outcomes varied. AUTHOR'S CONCLUSIONS The association between low birthweight, by any definition, and childhood and adult morbidity was inconsistent. None of the current standards of low birthweight was a good predictor of adverse outcome.
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Affiliation(s)
- G L Malin
- School of Medicine, The University of Nottingham, Nottingham, UK
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de Jong M, Lafeber HN, Cranendonk A, van Weissenbruch MM. Components of the metabolic syndrome in early childhood in very-low-birth-weight infants. Horm Res Paediatr 2015; 81:43-9. [PMID: 24281139 DOI: 10.1159/000355597] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 09/12/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS Term small-for-gestational-age and preterm born infants have an increased prevalence of metabolic syndrome components already in childhood. Data in very-low-birth-weight (VLBW) children are limited. We investigated the prevalence of metabolic syndrome components in VLBW infants at 2 years of corrected age. METHODS We included 38 children, participating in the Neonatal Insulin Replacement Therapy in Europe (NIRTURE) trial, a randomized controlled trial of early insulin therapy in VLBW infants. Metabolic syndrome components were defined as: body mass index SDS >2; blood pressure (systolic and/or diastolic) ≥ 90th percentile; triglycerides ≥ 0.98 mmol/l; high-density lipoprotein (HDL) cholesterol ≤ 1.03 mmol/l; glucose ≥ 5.6 mmol/l. RESULTS Two children (5%) had three metabolic syndrome components, 13 children (34%) had two components, and 11 children (29%) one component. 63% had raised blood pressure (prevalence higher in boys), 32% low HDL, and 30% high triglycerides (prevalence lower in early insulin group). In children with body mass index SDS <0, insulin-treated children had higher HDL than children with standard care. Systolic blood pressure was correlated with growth between term and 2 years of corrected age. CONCLUSIONS VLBW infants already have a high prevalence of metabolic syndrome components at 2 years of corrected age. Early insulin treatment could have long-term benefits for some of these components.
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Affiliation(s)
- Miranda de Jong
- Department of Pediatrics, Albert Schweitzer Hospital, Dordrecht, The Netherlands
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Stroescu R, Micle I, Bizerea T, Puiu M, Mărginean O, Doroş G. Metabolic monitoring of obese children born small for gestational age. Obes Res Clin Pract 2014; 8:e592-8. [DOI: 10.1016/j.orcp.2014.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2013] [Revised: 12/26/2013] [Accepted: 01/01/2014] [Indexed: 11/25/2022]
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Saggese G, Fanos M, Simi F. SGA children: auxological and metabolic outcomes - the role of GH treatment. J Matern Fetal Neonatal Med 2014; 26 Suppl 2:64-7. [PMID: 24059556 DOI: 10.3109/14767058.2013.832870] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The definition Small for Gestational Age (SGA) describes those newborns weighing and/or measuring in length <-2 SD than expected for their gestational age. These subjects are at higher risk of short stature, neonatal complications, alterations of glucose, lipid metabolism, body composition, bone metabolism and puberty, neurocognitive vulnerabilities and alterations of the GH-IGF-I axis. With regards to growth, in 85-90% of the cases children born SGA experience a period of catch up growth that allows them to achieve an adult stature within normal range. In a 10-15% of the cases, the catch up growth period does not take place and this entails short stature in adulthood. In the latter group, GH treatment may be considered to achieve adult height in the range of genetical target stature. With reference to glucose and lipid metabolism, young adults born SGA and particularly those with early catch up growth are at higher risk of developing insulin resistance, type 2 diabetes mellitus, arterial hypertension, dyslipidemia, overweight, obesity and metabolic syndrome. Subjects born SGA are in need of a correct diagnostic and eventually therapeutic approach.
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Affiliation(s)
- Giuseppe Saggese
- Department of Pediatrics, Pediatric Endocrine Unit, University Hospital of Pisa , Italy
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Milovanovic I, Njuieyon F, Deghmoun S, Chevenne D, Levy-Marchal C, Beltrand J. SGA children with moderate catch-up growth are showing the impaired insulin secretion at the age of 4. PLoS One 2014; 9:e100337. [PMID: 24979613 PMCID: PMC4076235 DOI: 10.1371/journal.pone.0100337] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/23/2014] [Indexed: 01/29/2023] Open
Abstract
Background Being born small for gestational age (SGA) is a risk factor for later development of type 2 diabetes. The development of glucose tolerance disorders in adults involves insulin resistance and impaired insulin secretion. Objective To evaluate insulin secretion and insulin sensitivity in a 4-yr old cohort of SGA. Methods 85 children were prospectively followed from mid-gestation to 4 years of age. Fetal growth velocity (FGV) was measured using ultrasound measurements. Body composition and hormonal profile were measured at birth, 1 and 4 years. Results 23 SGA babies had lower birth weight compared to 62 AGA (−1.9±0.3 vs. −0.6±0.8 z-score; p<0.0001) and they were thinner at birth (ponderal index 24.8±1.8 vs. 26.3±3.1 kg/m3; p = 0.01 and fat mass 11±2.6 vs. 12.9±3.1%; p = 0.01). No significant differences in other measured metabolic and hormonal parameters were observed between two groups at birth. SGA infants experienced an early catch-up growth in weight (mean gain of 1.1±0.6 SD) during the first year of life. At 4 years, SGA children remain lighter than AGA, but with weight z-score in the normal range (−0.1±1.3 vs. 0.5±1.3 z-score; p = 0.05). No excess of fat mass was observed (19±4.8 vs. 19.7±4.1%; p = 0.45). 120-min plasma glucose was significantly higher (6.2±1.1 vs. 5.6±0.9 mmol/l; p = 0.006) and insulinogenic index was significantly lower (0.28±0.15 vs. 0.40±2.4; p = 0.02) in the SGA group at 4-yrs of life contrasting with a preserved insulin sensitivity (QUICKI 0.47±0.09 vs. 0.43±0.05; p = 0.06). Conclusion SGA children with compensatory catch-up growth in first year of life show mild disturbances of glucose tolerance associated to a lower insulinogenic index at 4-yrs of age suggesting impairment of β-cell function.
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Affiliation(s)
- Ivana Milovanovic
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
- * E-mail:
| | - Falucar Njuieyon
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Samia Deghmoun
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Didier Chevenne
- Service de biochimie et hormonologie, Hôpital Robert Debré, Paris, France
| | - Claire Levy-Marchal
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Jacques Beltrand
- Endocrinologie et diabétologie pédiatrique, Hôpital Necker, Paris, France
- Université Paris 5, René Descartes, Paris, France
- INSERM U845, Imagine Affiliated, Paris, France
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Yermachenko A, Dvornyk V. Nongenetic determinants of age at menarche: a systematic review. BIOMED RESEARCH INTERNATIONAL 2014; 2014:371583. [PMID: 25050345 PMCID: PMC4094877 DOI: 10.1155/2014/371583] [Citation(s) in RCA: 113] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/12/2014] [Accepted: 06/06/2014] [Indexed: 02/04/2023]
Abstract
BACKGROUND The acceleration of pubertal development is an important medical and social problem, as it may result in increased morbidity and mortality in later life. This systematic review summarizes relevant data about nongenetic factors, which contribute to age at menarche (AAM), and suggests those which may be the most important. METHODS The available literature from 1980 till July 2013 was searched using PubMed and Google Scholar databases. Finally, 154 papers were selected for the analysis. RESULTS Environmental factors, which may affect AAM, vary in populations of different ethnicity. The prenatal, infancy, and early childhood periods are the most susceptible to these factors. Body weight, high animal protein intake, family stressors (e.g., single parenting), and physical activity seem to influence AAM in most populations. CONCLUSIONS The data about influence of nongenetic factors on AAM are still inconsistent. The factors affecting prenatal and early childhood growth seem to have a larger effect on further sexual maturation. Further studies are needed in order to validate the association between other environmental determinants and AAM in different ethnical groups.
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Affiliation(s)
- Anna Yermachenko
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong
| | - Volodymyr Dvornyk
- School of Biological Sciences, The University of Hong Kong, Pokfulam Road, Pokfulam, Hong Kong
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Ayyavoo A, Derraik JGB, Hofman PL, Cutfield WS. Postterm births: are prolonged pregnancies too long? J Pediatr 2014; 164:647-51. [PMID: 24360995 DOI: 10.1016/j.jpeds.2013.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 10/14/2013] [Accepted: 11/06/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Ahila Ayyavoo
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Center for Growth and Development, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Center for Growth and Development, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand; Gravida: National Center for Growth and Development, Auckland, New Zealand.
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Sepúlveda C, Urquidi C, Pittaluga E, Iñiguez G, Avila A, Carrasco F, Mericq V. Differences in body composition and resting energy expenditure in childhood in preterm children born with very low birth weight. Horm Res Paediatr 2014; 79:347-55. [PMID: 23774886 DOI: 10.1159/000351466] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 04/18/2013] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Rapid early ponderal growth is associated with adverse metabolic risks in young adults born at term. AIM To determine whether there are differences in body composition, resting energy expenditure (REE) and metabolic variables between preterm children born with very low birth weight (VLBW) either appropriate (AGA) or small (SGA) for gestational age and whether these differences are related to an early period of weight gain. METHODS 67 VLBW preterm (40 AGA, 27 SGA). Body composition by DEXA, REE by indirect calorimetry and blood sampling at age 6.7 ± 0.5 years. RESULTS VLBW SGA children were lighter, shorter, had a lower waist and hip circumference, HDL cholesterol and lipid oxidation rates than their AGA counterparts (adjusted for age, sex and BMI). Birth weight correlated negatively with total body and trunk fat mass. In a multivariate linear regression analysis, we found a positive association between weight gain in the first 3 months of life and total and trunk fat at age 6 years and a reciprocal association with REE at age 6 years. In contrast, the weight gain rate at 6-9 months of life was associated with higher REE and lipid oxidation rates at 6 years. A higher weight gain rate at 9-12 months was associated with a higher lean mass at 6 years. CONCLUSION An early fast-pace weight gain in VLBW infants may have detrimental consequences for metabolic health later on.
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Affiliation(s)
- Carolina Sepúlveda
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
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Effects on transcriptional regulation and lipid droplet characteristics in the liver of female juvenile pigs after early postnatal feed restriction and refeeding are dependent on birth weight. PLoS One 2013; 8:e76705. [PMID: 24260100 PMCID: PMC3834034 DOI: 10.1371/journal.pone.0076705] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Accepted: 08/23/2013] [Indexed: 12/22/2022] Open
Abstract
Epidemiological and experimental data indicate that caloric restriction in early postnatal life may improve liver lipid metabolism in low birth weight individuals. The present study investigated transcriptional and metabolic responses to low (U) and normal (N) birth weight (d 75, T1) and postnatal feed restriction (R, 60% of controls, d 98, T2) followed by subsequent refeeding until d 131 of age (T3). Liver tissue studies were performed with a total of 42 female pigs which were born by multiparous German landrace sows. Overall, 194 genes were differentially expressed in the liver of U vs. N (T1) animals with roles in lipid metabolism. The total mean area and number of lipid droplets (LD) was about 4.6- and 3.7 times higher in U compared to N. In U, the mean LD size (µm2) was 24.9% higher. 3-week feed restriction reduced total mean area of LDs by 58.3 and 72.7% in U and N, respectively. A functional role of the affected genes in amino acid metabolism was additionally indicated. This was reflected by a 17.0% higher arginine concentration in the liver of UR animals (vs. NR). To evaluate persistency of effects, analyses were also done after refeeding period at T3. Overall, 4 and 22 genes show persistent regulation in U and N animals after 5 weeks of refeeding, respectively. These genes are involved in e.g. processes of lipid and protein metabolism and glucose homeostasis. Moreover, the recovery of total mean LD area in U and N animals back to the previous T1 level was observed. However, when compared to controls, the mean LD size was still reduced by 23.3% in UR, whereas it was increased in NR (+24.7%). The present results suggest that short-term postnatal feed restriction period programmed juvenile U animals for an increased rate of hepatic lipolysis in later life.
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Duque-Guimarães DE, Ozanne SE. Nutritional programming of insulin resistance: causes and consequences. Trends Endocrinol Metab 2013; 24:525-35. [PMID: 23791137 DOI: 10.1016/j.tem.2013.05.006] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Revised: 05/14/2013] [Accepted: 05/21/2013] [Indexed: 02/06/2023]
Abstract
Strong evidence indicates that adverse prenatal and early postnatal environments have a significant long-term influence on risk factors that result in insulin resistance, type 2 diabetes (T2D), and cardiovascular disease later in life. Here we discuss current knowledge of how maternal and neonatal nutrition influence early growth and the long-term risk of developing insulin resistance in different organs and at the whole-body level. Accumulating evidence supports a role for epigenetic mechanisms underlying this nutritional programming, consisting of heritable changes that regulate gene expression which in turn shapes the phenotype across generations. Deciphering these molecular mechanisms in key tissues and discovering key biological markers may provide valuable insight towards the development of effective intervention strategies.
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Affiliation(s)
- Daniella E Duque-Guimarães
- University of Cambridge Metabolic Research Laboratories and Medical Research Council (MRC) Metabolic Disease Unit, Institute of Metabolic Sciences, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK
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Dessì A, Ottonello G, Fanos V. Physiopathology of intrauterine growth retardation: from classic data to metabolomics. J Matern Fetal Neonatal Med 2013; 25:13-8. [PMID: 23025763 DOI: 10.3109/14767058.2012.714639] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
It is well known that adverse conditions during intrauterine life, such as intrauterine growth restriction (IUGR), can result in permanent changes in the physiology and metabolism of the newborn, which in turn leads to an increased risk of disease in adulthood (fetal origin of adult disease hypothesis). In the first part of this review the epidemiological studies in which a correlation between low birth weight and chronic pathologies in adulthood was observed are reported. The second part of the review is focused on metabolomics studies that have revealed an altered metabolism in IUGR patients compared to controls. Together with more classic biomarkers of IUGR, such as endothelin-1, leptin, protein S100B and visfatin, the new holistic metabolomics approach has assumed a crescent role in the identification of disorders in the neonatal metabolic profile, determined by the interconnection of the different processes.
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Affiliation(s)
- Angelica Dessì
- Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU Cagliari, Italy
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Salihoğlu Ö, Karatekin G, Baksu B, Uslu S, Baksu A, Can G, Nuhoğlu A. Frequency and risk factors of fetal malnutrition among liveborn singleton term neonates using a computerised perinatal database, 2000-2006. J Paediatr Child Health 2012; 48:926-30. [PMID: 22897800 DOI: 10.1111/j.1440-1754.2012.02520.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM The aim of this study was to determine the frequency, risk factors and anthropometric measurements of fetally malnourished, liveborn singleton term neonates. METHODS The computed delivery room data of 11.741 liveborn singleton term neonates was used to compare malnourished and nourished newborns. RESULTS Of the total subjects, 577 (4.9%) were malnourished. There were no differences between the groups with regard to gender distribution, Apgar scores, maternal parity, smoking during pregnancy and type of delivery. Maternal age and neonatal gestational age (GA) were significantly lower in malnourished newborns (P < 0.001). Birthweight (BW), birth length (BL) and head circumference (HC) were significantly lower in the malnourished group compared with well-nourished group (P < 0.001). Mean BW (g) was 2724.7 ± 17.0 in the malnourished group versus 3234.3 ± 3.8 in the well-nourished group; BL (cm) was 47.8 ± 0.1 in malnourished versus 49.5 ± 0.0 in well-nourished neonates; HC (cm) was 33.25 ± 0.1 in the malnourished versus 34.3 ± 0.0 in the well-nourished group. Between the groups, there were significant differences in the ratio of small, appropriate and large for GA (P < 0.001). Of the malnourished newborns, 35.5% were small for GA, 63.3% were appropriate for GA and 1.2% were large for GA. CONCLUSION Fetal malnutrition (FM) still exists despite the advances in current obstetric care. Neonates of adolescent mothers and of low GA are particularly at risk for FM. The BW, BL and HC of fetally malnourished neonates are lower than that of well-nourished neonates. Like term singleton appropriate and small for GA neonates, term singleton large for GA neonates could also have been fetally malnourished.
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Affiliation(s)
- Özgül Salihoğlu
- Department of Neonatology, Şişli Etfal Training and Research Hospital Department of Public Health, Cerrahpaşa Faculty of Medicine, Istanbul, Turkey
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Altın H, Karaarslan S, Karataş Z, Alp H, Şap F, Baysal T. Evaluation of cardiac functions in term small for gestational age newborns with mild growth retardation: a serial conventional and tissue Doppler imaging echocardiographic study. Early Hum Dev 2012; 88:757-64. [PMID: 22591553 DOI: 10.1016/j.earlhumdev.2012.04.003] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Revised: 04/05/2012] [Accepted: 04/24/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND The aim of this study is to evaluate the cardiac functions of term small for gestational age (SGA) babies with mild growth retardation by echocardiography during the postnatal period. METHODS AND RESULTS Thirty term SGA (2271±207 g/38-41 weeks (mean 39.5 weeks)) and 30 term AGA (3298±338 g/38-41 weeks (mean 39 weeks)) newborns as the control group, with normal general health status and with no nutritional problems were evaluated at three time points, on the 3rd postnatal day, at the 3rd and the 6th months. In the initial analysis, heart rate, left ventricular end diastolic diameter index (LVEdDI), cardiac index (CI), all E/A, Em/Am and E/Em ratios, pulsed wave Doppler myocardial performance index (MPI), and tissue Doppler imaging MPI values were higher in SGA babies than the control group. In the last analysis, only heart rate, LVEdDI and CI values were different between SGA and control groups. CONCLUSIONS Systolic and diastolic cardiac dysfunctions were determined in SGA babies with mild growth retardation during the first 6 months of postnatal period. Any disease that affects the hemodynamic stability of these patients during postnatal period may lead to early progressive deterioration in cardiac functions. Furthermore, many of the cardiac functions of these babies have been improved about the 6th month period, and high levels of heart rate and LVEdDI may be suggested as an indicator of cardiac remodeling.
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Affiliation(s)
- Hakan Altın
- Necmettin Erbakan University, Meram School of Medicine Hospital, Department of Pediatric Cardiology, Konya, Turkey.
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Kerkhof GF, Leunissen RWJ, Hokken-Koelega ACS. Early origins of the metabolic syndrome: role of small size at birth, early postnatal weight gain, and adult IGF-I. J Clin Endocrinol Metab 2012; 97:2637-43. [PMID: 22564668 PMCID: PMC3410262 DOI: 10.1210/jc.2012-1426] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND The relationship between low birth weight and increased risk for metabolic syndrome (MetS) in later life has been frequently described, but mechanisms underlying this association remain unknown. METHODS In 280 young adults of the PROGRAM study, aged 18-24 yr, we investigated associations of birth weight, gain in weight for length during early life, and adult IGF-I sd score (SDS), with number of MetS components (ordinal regression analyses), prevalence of MetS components and MetS (logistic regression analyses), and other metabolic parameters (linear regression analyses). Revised criteria of the National Cholesterol Educational Program (Adult Treatment Panel III) were used to determine components of MetS. The other metabolic parameters were C-reactive protein, insulin sensitivity, trunk fat mass, total cholesterol, and low-density lipoprotein cholesterol. RESULTS More gain in weight for length SDS in the first 3 months of life was significantly associated with an increased number of MetS components [odds ratio (OR) = 1.34], prevalence of low high-density lipoprotein cholesterol (OR = 1.49), prevalence of MetS (OR = 2.51), increased C-reactive protein levels, and lower insulin sensitivity (P = 0.007) at the age of 21 yr. Low birth weight SDS was associated with lower insulin sensitivity (P = 0.036), but low birth weight SDS and adult IGF-I SDS were not significantly associated with any of the MetS components or MetS prevalence at 21 yr. CONCLUSION Our study demonstrates that higher gain in weight for length in the first 3 months of life is associated with a higher prevalence of MetS at 21 yr, whereas low birth weight and low adult IGF-I are not.
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Affiliation(s)
- Gerthe F Kerkhof
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus Medical Center/Sophia Children’s Hospital, 3015 GJ Rotterdam, The Netherlands.
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Harville EW, Srinivasan S, Chen W, Berenson GS. Is the metabolic syndrome a "small baby" syndrome?: the bogalusa heart study. Metab Syndr Relat Disord 2012; 10:413-21. [PMID: 22831273 DOI: 10.1089/met.2012.0031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Metabolic syndrome has been called a "small baby syndrome," but other analyses suggest that postnatal growth is more important than birthweight, or that large babies are also at risk. The aim of this analysis was to examine whether there was a relationship between both low and high birthweight and metabolic syndrome, using multiple definitions of metabolic syndrome, and to determine whether this relationship varied by body size across the life course. METHODS Data from the Bogalusa Heart Study, a study of cardiovascular disease in children and young adults, were linked to birth certificate data. Metabolic syndrome was defined by the National Cholesterol Education Program, the International Diabetes Foundation, and the World Health Organization (WHO) definition. Small-for-gestational-age (SGA) was defined as birthweight <10(th) percentile by sex for gestational age and large-for-gestational-age (LGA) as birthweight >90(th) percentile. Birthweight-for-gestational-age was also examined as a continuous predictor. Chi-squared tests and logistic regression were used to examine the relationship between birth size and metabolic syndrome. RESULTS Higher birthweight-for-gestational-age was associated with a reduced risk of metabolic syndrome, especially by the WHO definition. After adjustment for body mass index (BMI), categorized birthweight was associated with metabolic syndrome, with the protective associations with LGA being stronger than the positive associations with SGA. Among the individual components of metabolic syndrome, higher waist circumference was associated with both SGA and LGA after BMI was controlled for. Effects of SGA and BMI at any age were largely independent rather than interactive. CONCLUSIONS SGA is associated with some, but not all, components of metabolic syndrome. The relationship between SGA and metabolic syndrome is partially confounded by later BMI.
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Affiliation(s)
- Emily W Harville
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA.
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Abstract
Intrauterine growth restriction (IUGR) is prevalent worldwide and affects children and adults in multiple ways. These include predisposition to type 2 diabetes mellitus, the metabolic syndrome, cardiovascular disease, persistent reduction in stature, and possibly changes in the pattern of puberty. A review of recent literature confirms that the metabolic effects of being born small for gestational age are evident in the very young, persist with age, and are amplified by adiposity. Furthermore, the pattern of growth in the first few years of life has a significant bearing on a person's later health, with those that show increasing weight gain being at the greatest risk for future metabolic dysfunction. Treatment with exogenous human GH is used to improve height in children who remain short after being small for gestational age at birth, but the response of individuals remains variable and difficult to predict. The mechanisms involved in the metabolic programming of IUGR children are just beginning to be explored. It appears that IUGR leads to widespread changes in DNA methylation and that specific "epigenetic signatures" for IUGR are likely to be found in various fetal tissues. The challenge is to link such alterations with modifications in gene expression and ultimately the metabolic abnormalities of adulthood, and it represents one of the frontiers for research in the field.
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Affiliation(s)
- Steven D Chernausek
- Department of Pediatrics, University of Oklahoma Health Sciences Center, 1200 North Phillips Avenue, Suite 4500, Oklahoma City, Oklahoma 73104-4600, USA.
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Krupp D, Johner SA, Kalhoff H, Buyken AE, Remer T. Long-term dietary potential renal acid load during adolescence is prospectively associated with indices of nonalcoholic fatty liver disease in young women. J Nutr 2012; 142:313-9. [PMID: 22223573 DOI: 10.3945/jn.111.150540] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Nonalcoholic fatty liver disease (NAFLD), frequently already present in young subjects, has been linked to reduced growth hormone levels and signaling. Similar hormonal changes occur during metabolic acidosis (MA), which may thus contribute to an increased NAFLD risk. Because subclinical MA can be diet induced, we aimed to examine whether a higher diet-dependent acid load during adolescence is prospectively associated with several currently used NAFLD surrogates in young adulthood. Dietary acidity during adolescence (boys:10-15 y, girls: 9-14 y) was calculated as potential renal acid load (PRAL) from at least three 3-d weighed dietary records according to a published algorithm considering dietary protein and minerals in 145 healthy participants. Routine measurements derived from blood analysis and anthropometric data in participants' young adulthood (18-25 y) were used to determine the NAFLD surrogates alanine-aminotransferase (ALT), hepatic steatosis index (HSI), and fatty liver index (FLI). Sex-stratified linear regression models, adjusted for dietary fiber, saturated fat, protein, and adolescent BMI SD scores, were run with PRAL as the independent variable. Dietary PRAL during puberty was positively associated with ALT (P = 0.02), HSI (P = 0.002), and FLI (P = 0.005) in adult females but not males. Females with an adolescent dietary acid load in the highest tertile had 3.5, 4.4, and 4.5 higher values of ALT, HSI, and FLI as adults, respectively, compared to females with the lowest PRAL. The present findings suggest that higher dietary acidity in adolescence may be prospectively associated with hepatic lipid accumulation in females. Whether this relationship is due to the higher proton load or rather represents an unhealthy dietary pattern requires further investigation.
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Affiliation(s)
- Danika Krupp
- Department of Nutrition and Health, Research Institute of Child Nutrition, Rheinische Friedrich-Wilhelms-University Bonn, Dortmund, Germany.
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Endocrine pancreas development: effects of metabolic and intergenerational programming caused by a protein-restricted diet. Pancreas 2012; 41:1-9. [PMID: 22173830 DOI: 10.1097/mpa.0b013e3182236320] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Experimental studies have demonstrated an association between low birth weight and the later development of type 2 diabetes. This association could be a result of the programming process that affects pancreatic beta-cell development due to poor fetal nutrition. This mechanism may not be limited to the first generation. In rodents, endocrine cells of the pancreas are derived from cells of the endodermal dorsal and ventral anlage that migrate and gather in clusters in a process termed isletogenesis. Islet development occurs relatively late in gestation, and islets undergo substantial remodeling immediately after birth under the regulation of a transcription factor network. Furthermore, the offspring of mice fed a protein-restricted diet exhibit a reduced pancreatic beta-cell mass at birth, lower vascularization, increased apoptosis rate, and changes in glucose metabolism in later life. Although the mechanisms underlying these relationships are unclear, it has been hypothesized that in utero nutritional conditions affect epigenetic patterns of gene transcription that persist throughout life and subsequent generations. We aimed to review the process of the formation of the endocrine pancreas in rodents, the consequences of a protein-restricted diet on offspring, and the transgenerational effects of this insult on the incidence of type 2 diabetes.
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