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Pai SR, Padmanabha R, Kamalakar S, Aravind JV, Puttaswamy D, Pn Rao S, Jois SK, Kamath A, Kuriyan R. Comparison of growth patterns in the first year of life between term small for gestational age and appropriate for gestational age South Indian infants. BMJ Paediatr Open 2024; 8:e002477. [PMID: 38719565 PMCID: PMC11086450 DOI: 10.1136/bmjpo-2023-002477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Accepted: 04/08/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Early life growth trajectories of Indian small for gestational age (SGA) infants are sparse. This study aimed to compare longitudinal growth in appropriate for gestational age (AGA) and SGA infants during their first year of life. METHODS Apparently healthy term infants (52 SGA, 154 AGA) were recruited at birth and followed up till 1 year. Parental, sociodemographic characteristics and feeding patterns were recorded. Anthropometric measurements were assessed at birth, 3, 6, 9 and 12 months of age; Z scores and growth velocity at 3-month intervals were computed. Longitudinal measurements were compared between the two groups, using the two-way Friedmans test. Median regression with mixed effects was used to adjust covariates; p value <0.05 was considered statistically significant. RESULT AGA infants had significantly higher median weight (kg) (2.87 (2.67, 3.04) vs 2.39 (2.25, 2.54)) at birth, (7.08 (6.50, 7.54) vs 6.49 (6.13, 6.78)) at 6 months, (8.64 (7.92, 9.14) vs 7.90 (7.36, 8.54)) at 12 months, median length (cm) ((48.10 (47.20, 49.30) vs 46.75 (45.43, 47.50)) at birth, (65.50 (64.23, 66.98) vs 63.33 (62.26, 65.28)) at 6 months, (73.30 (71.58, 74.66) vs 71.55 (70.00, 73.30)) at 12 months. SGA infants had comparable weight velocity at all intervals except 9-12 months (6.62 (6.45, 6.79) vs (6.70 (6.51, 6.85)), being significantly higher than AGA infants. Differences in skinfold thicknesses between groups were observed only at birth. Exclusivity of breast feeding was significantly higher at 3 months in AGA, compared to SGA infants (80.9% vs 57.8%). Length velocity was comparable at all ages between groups. Sexual dimorphism was observed in the growth velocities of both groups. CONCLUSION SGA infants grew in parallel to AGA infants, having significantly lower anthropometric measurements at all time points. However, growth velocities were similar; SGA infants had significantly higher weight velocity from 9 to 12 months. Longitudinal studies beyond 1 year of age, using body composition are needed to determine the quality of growth in Indian infants.
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Affiliation(s)
- Shruti R Pai
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Ramya Padmanabha
- Division of Nutrition, St John's Research Institute, (Centre for Doctoral Studies, Manipal Academy of Higher Education (MAHE) and Recognised Research Centre of Mysore University), St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Sanjana Kamalakar
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Jini V Aravind
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Deepa Puttaswamy
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
| | - Suman Pn Rao
- Department of Neonatology, St John's Medical College Hospital, Bengaluru, Karnataka, India
| | - Srinivas K Jois
- Department of Obstetrics and Gynaecology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Asha Kamath
- Department of Data Science, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Rebecca Kuriyan
- Division of Nutrition, St John's Research Institute, St. John's National Academy of Health Sciences, Bengaluru, Karnataka, India
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Casirati A, Somaschini A, Somaschini M. Decoding the Association Between Body Composition in Preterm Birth and Hypertension in Childhood. JAMA Pediatr 2023; 177:1238-1239. [PMID: 37695618 DOI: 10.1001/jamapediatrics.2023.3516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Affiliation(s)
- Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Masiakwala E, Nyati LH, Norris SA. The association of intrauterine and postnatal growth patterns and nutritional status with toddler body composition. BMC Pediatr 2023; 23:342. [PMID: 37415119 PMCID: PMC10324124 DOI: 10.1186/s12887-023-04155-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Accepted: 06/24/2023] [Indexed: 07/08/2023] Open
Abstract
BACKGROUND Growth patterns may be indicative of underlying changes in body composition. However, few studies have assessed the association of growth and body composition in poorly resourced regions experiencing the double-burden of malnutrition exists. Thus, the aims of this study were to investigate the association of intrauterine and postnatal growth patterns with infant body composition at 2 years in a middle-income country. METHODS Participants were from the International Atomic Energy Agency Multicentre Body Composition Reference study. Fat mass (FM), fat free mass (FFM), Fat mass index (FMI), fat free mass index (FFMI), and percentage fat mass (%FM) were measured in 113 infants (56 boys and 57 girls), from Soweto, South Africa, using deuterium dilution from 3 to 24 months. Birthweight categories were classified using the INTERGROWTH-21 standards as small (SGA), appropriate (AGA), and large-for gestational age (LGA). Stunting (> -2 SDS) was defined using the WHO child growth standards. Birthweight z-score, conditional relative weight and conditional length at 12 and 24 mo were regressed on body composition at 24 mo. RESULTS There were no sex differences in FM, FFM, FMI and FFMI between 3 and 24 mo. SGA and AGA both had significantly higher %FM than LGA at 12 mo. LGA had higher FM at 24 mo. Children with stunting had lower FM (Mean = 1.94, 95% CI; 1.63-2.31) and FFM (Mean = 5.91, 95% CI; 5.58-6.26) at 12 mo than non-stunting, while the reverse was true for FFMI (Mean = 13.3, 95% CI; 12.5-14.2) at 6 mo. Birthweight and conditionals explained over 70% of the variance in FM. CRW at both 12 and 24 mo was positively associated with FM and FMI. CRW at 12 mo was also positively associated with FMI, while CH at 24 mo was negatively associated with both FFMI and FMI in boys. CONCLUSION Both LGA and SGA were associated with higher body fat suggesting that both are disadvantaged nutritional states, likely to increase the risk of obesity. Growth patterns through infancy and toddler period (1-2 years) are indicative of body fat, while growth patterns beyond infancy are less indicative of fat-free mass.
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Affiliation(s)
- Elizabeth Masiakwala
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa.
| | - Lukhanyo H Nyati
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa
- Interprofessional Education Unit, Faculty of Community and Health Sciences, University of the Western Cape, Cape Town, South Africa
| | - Shane A Norris
- SAMRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, 7 York Rd, Parktown, Johannesburg, 2193, South Africa
- School of Human Development and Health, University of Southampton, Southampton, UK
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Body composition at 4 to 7 years of age in children born <32 weeks gestational age or 1500 g: A cohort study. Early Hum Dev 2022; 173:105659. [PMID: 36007453 DOI: 10.1016/j.earlhumdev.2022.105659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/16/2022] [Accepted: 08/17/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Small for gestational age preterm infants show differences in body composition when compared to those appropriate for gestational age at term, which have consequences on metabolism. AIM To compare growth and body composition of children born small and appropriate for gestational age between 4 and 7 years. METHOD A Cohort of small and appropriate for gestational age infants <32 weeks or 1500 g were followed at term and 3 months corrected ages and at 4 to 7 years. Body composition assessment by air displacement plethysmography and anthropometry were performed at all moments. Differences between the two groups were assessed using t-student and Chi-square tests. RESULTS Ninety-four infants were included at term (26 small and 68 appropriate for gestational age); 88 at 3 months (24 small and 64 appropriate for gestational age) and 47 between 4 and 7 years (11 small and 36 appropriate for gestational age). At term, small for gestational age infants had lower fat-free mass, fat mass, weight and length compared with those appropriate for gestational age (p < 0.001). At 3 months, fat-free mass (grams) remained lower in small for gestational age group (p < 0.001). Between 4 and 7 years, body composition and anthropometry were similar between the groups. CONCLUSION Between 4 and 7 years, children born small and appropriate for gestational age had similar body composition. New long-term longitudinal studies are necessary to understand the influence of fat-free mass and fat mass in the first months of age on body composition throughout life.
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Casirati A, Somaschini A, Perrone M, Vandoni G, Sebastiani F, Montagna E, Somaschini M, Caccialanza R. Preterm birth and metabolic implications on later life: A narrative review focused on body composition. Front Nutr 2022; 9:978271. [PMID: 36185669 PMCID: PMC9521164 DOI: 10.3389/fnut.2022.978271] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Preterm newborn infants are characterized by low body weight and lower fat mass at birth compared with full-term newborn neonates. Conversely, at term corrected age, body fat mass is more represented in preterm newborn infants, causing a predisposition to developing metabolic syndrome and cardiovascular diseases in later life with a different risk profile in men as compared with women. Postnatal growth is a complex change in anthropometric parameters and body composition. Both quantity and quality of growth are regulated by several factors such as fetal programming, early nutrition, and gut microbiota. Weight gain alone is not an optimal indicator of nutritional status as it does not accurately describe weight quality. The analysis of body composition represents a potentially useful tool to predict later metabolic and cardiovascular risk as it detects the quality of growth by differentiating between fat and lean mass. Longitudinal follow-up of preterm newborn infants could take advantage of body composition analysis in order to identify high-risk patients who apply early preventive strategies. This narrative review aimed to examine the state-of-the-art body composition among born preterm children, with a focus on those in the pre-school age group.
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Affiliation(s)
- Amanda Casirati
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
- *Correspondence: Amanda Casirati,
| | - Alberto Somaschini
- Division of Cardiology and Cardiac Intensive Care Unit, San Paolo Hospital, Savona, Italy
| | - Michela Perrone
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giulia Vandoni
- Clinical Nutrition, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Federica Sebastiani
- Endocrinology and Metabolic Diseases, Azienda USL IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Elisabetta Montagna
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Childhood obesity and adverse cardiometabolic risk in large for gestational age infants and potential early preventive strategies: a narrative review. Pediatr Res 2022; 92:653-661. [PMID: 34916624 DOI: 10.1038/s41390-021-01904-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 11/08/2021] [Accepted: 11/30/2021] [Indexed: 02/08/2023]
Abstract
Accumulating evidence indicates that obesity and cardiometabolic risks become established early in life due to developmental programming and infants born as large for gestational age (LGA) are particularly at risk. This review summarizes the recent literature connecting LGA infants and early childhood obesity and cardiometabolic risk and explores potential preventive interventions in early infancy. With the rising obesity rates in women of childbearing age, the LGA birth rate is about 10%. Recent literature continues to support the higher rates of obesity in LGA infants. However, there is a knowledge gap for their lifetime risk for adverse cardiometabolic outcomes. Potential factors that may modify the risk in early infancy include catch-down early postnatal growth, reduction in body fat growth trajectory, longer breastfeeding duration, and presence of a healthy gut microbiome. The early postnatal period may be a critical window of opportunity for active interventions to mitigate or prevent obesity and potential adverse metabolic consequences in later life. A variety of promising candidate biomarkers for the early identification of metabolic alterations in LGA infants is also discussed. IMPACT: LGA infants are the greatest risk category for future obesity, especially if they experience rapid postnatal growth during infancy. Potential risk modifying secondary prevention strategies in early infancy in LGA infants include catch-down early postnatal growth, reduction in body fat growth trajectory, longer breastfeeding duration, and presence of a healthy gut microbiome. LGA infants may be potential low-hanging fruit targets for early preventive interventions in the fight against childhood obesity.
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Lach LE, Chetta KE, Ruddy-Humphries AL, Ebeling MD, Gregoski MJ, Katikaneni LD. Body Composition and "Catch-Up" Fat Growth in Healthy Small for Gestational Age Preterm Infants and Neurodevelopmental Outcomes. Nutrients 2022; 14:3051. [PMID: 35893903 PMCID: PMC9332383 DOI: 10.3390/nu14153051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/08/2022] [Accepted: 07/22/2022] [Indexed: 11/25/2022] Open
Abstract
To examine the growth and body composition of small for gestational age (SGA) and appropriate for gestational age (AGA) very low birth weight infants (VLBW) and their outpatient neurodevelopmental outcomes. From 2006-2012, VLBW infants (n = 57 of 92) admitted to the Neonatal Intensive Care Unit (NICU) had serial air displacement plethysmography (ADP) scans and were followed as outpatients. Serial developmental testing (CAT/CLAMS, Peabody Gross Motor Scales) and anthropometrics were obtained from n = 37 infants (29 AGA and 8 SGA) and analyzed via repeated measures analyses of variances. The percentage of body fat, percentage of lean mass, and weight gain were statistically significant between SGA and AGA groups at the first ADP assessment. There was no difference between the two groups in outpatient neurodevelopmental testing. Weight gain as "catch-up" body fat accrual occurs by 67 weeks of PMA. This catch-up growth is associated with normal SGA preterm neurodevelopment as compared to AGA preterm infants.
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Affiliation(s)
- Laura E. Lach
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA; (K.E.C.); (A.L.R.-H.); (M.D.E.); (L.D.K.)
| | - Katherine E. Chetta
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA; (K.E.C.); (A.L.R.-H.); (M.D.E.); (L.D.K.)
| | - Amy L. Ruddy-Humphries
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA; (K.E.C.); (A.L.R.-H.); (M.D.E.); (L.D.K.)
| | - Myla D. Ebeling
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA; (K.E.C.); (A.L.R.-H.); (M.D.E.); (L.D.K.)
| | - Mathew J. Gregoski
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA;
| | - Lakshmi D. Katikaneni
- Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, SC 29425, USA; (K.E.C.); (A.L.R.-H.); (M.D.E.); (L.D.K.)
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Hernández-Ruiz Á, Madrigal C, Soto-Méndez MJ, Gil Á. Challenges and perspectives of the double burden of malnutrition in Latin America. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ARTERIOSCLEROSIS 2022; 34 Suppl 1:S3-S16. [PMID: 35153111 DOI: 10.1016/j.arteri.2021.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 11/22/2021] [Indexed: 06/14/2023]
Abstract
Nutrition is a key factor in the development of non-communicable chronic diseases (NCCDs), especially cardiovascular diseases (CVD) and their risk factors. The "double burden of malnutrition" (DBM) is the coexistence of undernutrition and overnutrition in the same population across the life-course. In Latin America, the transition from a predominantly underweight to an overweight and obese population has increased more rapidly than in other regions in the world. Undernutrition and the micronutrient deficiencies particularly iron, zinc, and vitamins A and D, present high heterogeneity in Latin American countries, and are currently considered important public health problems. In this region, NCCDs account for 50% of the disability-adjusted life-years, led by CVD. The most prevalent cardiovascular risk factors are overweight, obesity, hypertension, dyslipidemia and type 2 diabetes mellitus. Because of the cost of treatment and the potential years of life lost due to premature death, CVD is known to affect the poorest segments of the population, affecting communities, and governments. More than 80% of CVD deaths occur in low- and middle-income countries. The persistence of damage in some cells due to undernutrition may explain certain findings regarding the increase in NCCD. These aspects together with epigenetic changes have highlighted the importance of a lifelong approach to nutritional policy development. Reducing DBM requires major societal interventions in public health and nutrition to achieve holistic change that can be sustained over the long term and spread throughout the global food system. The implementation of effective state policies of double impact actions should influence both sides of the burden and be considered an urgent priority, considering country-specific inequalities and socio-demographic differences in the Latin American region, using diverse and multidisciplinary strategies.
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Affiliation(s)
- Ángela Hernández-Ruiz
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain
| | - Casandra Madrigal
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain; Department of Nutrition and Food Science, Faculty of Pharmacy, University of Granada, Granada, Spain
| | - María José Soto-Méndez
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain
| | - Ángel Gil
- Iberoamerican Nutrition Foundation (FINUT), Av. Del Conocimiento 12, 3.ª pta., Armilla 18016, Granada, Spain; Department of Biochemistry and Molecular Biology II University of Granada, University of Granada, Granada, Spain; Institute of Nutrition and Food Technology "José Mataix," Biomedical Research Center, University of Granada, Granada, Spain; Biosanitary Research Institute IBS.GRANADA, Granada University Hospital Complex, Granada, Spain; CIBEROBN (Physiopathology of Obesity and Nutrition), Instituto de Salud Carlos III, Madrid, Spain.
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Manapurath R, Gadapani B, Pereira-da-Silva L. Body Composition of Infants Born with Intrauterine Growth Restriction: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14051085. [PMID: 35268060 PMCID: PMC8912478 DOI: 10.3390/nu14051085] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 03/01/2022] [Accepted: 03/02/2022] [Indexed: 12/24/2022] Open
Abstract
Intrauterine growth restriction (IUGR) may predispose metabolic diseases in later life. Changes in fat-free mass (FFM) and fat mass (FM) may explain this metabolic risk. This review studied the effect of IUGR on body composition in early infancy. Five databases and included studies from all countries published from 2000 until August 2021 were searched. Participants were IUGR or small-for-gestational age (SGA) infants, and the primary outcomes were FFM and FM. Eighteen studies met the inclusion criteria, of which seven were included in the meta-analysis of primary outcomes. Overall, intrauterine growth-restricted and SGA infants were lighter and shorter than normal intrauterine growth and appropriate-for-gestational age infants, respectively, from birth to the latest follow up. They had lower FFM [mean difference −429.19 (p = 0.02)] and FM [mean difference −282.9 (p < 0.001)]. The issue of whether lower FFM and FM as reasons for future metabolic risk in IUGR infants is intriguing which could be explored in further research with longer follow-up. This review, the first of its kind can be useful for developing nutrition targeted interventions for IUGR infants in future.
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Affiliation(s)
- Rukman Manapurath
- Maternal and Child Health (Nutrition), Society for Applied Studies, Centre for Health Research and Development, 45-Kalusarai, New Delhi 110016, India;
| | - Barsha Gadapani
- Maternal and Child Health (Implementation Research), Society for Applied Studies, Centre for Health Research and Development, 45-Kalusarai, New Delhi 110016, India;
| | - Luís Pereira-da-Silva
- Comprehensive Health Research Centre, Medicine of Woman, Childhood and Adolescence, NOVA Medical School|Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Campo dos Mártires da Pátria, Nr 130, 1169-056 Lisbon, Portugal
- NICU, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Rua Jacinta Marto, 1169-045 Lisbon, Portugal
- Correspondence: ; Tel.: +351-917235528
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Metabolic-endocrine disruption due to preterm birth impacts growth, body composition, and neonatal outcome. Pediatr Res 2022; 91:1350-1360. [PMID: 34040160 PMCID: PMC9197767 DOI: 10.1038/s41390-021-01566-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 04/19/2021] [Accepted: 04/22/2021] [Indexed: 02/05/2023]
Abstract
Despite optimized nutrition, preterm-born infants grow slowly and tend to over-accrete body fat. We hypothesize that the premature dissociation of the maternal-placental-fetal unit disrupts the maintenance of physiological endocrine function in the fetus, which has severe consequences for postnatal development. This review highlights the endocrine interactions of the maternal-placental-fetal unit and the early perinatal period in both preterm and term infants. We report on hormonal levels (including tissue, thyroid, adrenal, pancreatic, pituitary, and placental hormones) and nutritional supply and their impact on infant body composition. The data suggest that the premature dissociation of the maternal-placental-fetal unit leads to a clinical picture similar to panhypopituitarism. Further, we describe how the premature withdrawal of the maternal-placental unit, neonatal morbidities, and perinatal stress can cause differences in the levels of growth-promoting hormones, particularly insulin-like growth factors (IGF). In combination with the endocrine disruption that occurs following dissociation of the maternal-placental-fetal unit, the premature adaptation to the extrauterine environment leads to early and fast accretion of fat mass in an immature body. In addition, we report on interventional studies that have aimed to compensate for hormonal deficiencies in infants born preterm through IGF therapy, resulting in improved neonatal morbidity and growth. IMPACT: Preterm birth prematurely dissociates the maternal-placental-fetal unit and disrupts the metabolic-endocrine maintenance of the immature fetus with serious consequences for growth, body composition, and neonatal outcomes. The preterm metabolic-endocrine disruption induces symptoms resembling anterior pituitary failure (panhypopituitarism) with low levels of IGF-1, excessive postnatal fat mass accretion, poor longitudinal growth, and failure to thrive. Appropriate gestational age-adapted nutrition alone seems insufficient for the achievement of optimal growth of preterm infants. Preliminary results from interventional studies show promising effects of early IGF-1 supplementation on postnatal development and neonatal outcomes.
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Rallis D, Balomenou F, Tzoufi M, Giapros V. A systematic review indicates an association between birth weight and body fat in childhood. Acta Paediatr 2021; 110:2023-2039. [PMID: 33682216 DOI: 10.1111/apa.15834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 02/28/2021] [Accepted: 03/03/2021] [Indexed: 12/14/2022]
Abstract
AIM To summarise the existing evidence regarding the body fat of small or large for gestation subjects, evaluated from birth up to 18 years of age. METHODS The PRISMA guidelines were adopted for the current systematic review, including studies having evaluated body fat with bioelectrical impedance analysis, air displacement plethysmography, dual-energy X-ray absorptiometry or magnetic resonance imaging. RESULTS A total of 31 studies was included. The balance of evidence suggests that small for gestation infants have decreased fat mass at birth; postnatally they experience increased adiposity. In the long term, however, the evidence is inconclusive, since some studies suggest that foetal-restricted children with increased catch-up growth are at increased risk of fat accumulation, whereas other studies suggest a neutral or even negative association. Large for gestation infants have increased fat mass at birth, but in the long term, they have a lower body fat ratio, especially when they develop a catch-down growth. CONCLUSION Some studies suggested that foetal-restricted children with increased catch-up growth are at increased risk of later adiposity, while other studies suggested a neutral or negative association. Given that the evidence is inconclusive, further studies are warranted. Large for gestation subjects have lower body fat when they develop catch-down growth.
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Affiliation(s)
- Dimitrios Rallis
- Neonatal Intensive Care Unit University of Ioannina, School of Medicine Ioannina Greece
| | - Foteini Balomenou
- Neonatal Intensive Care Unit University of Ioannina, School of Medicine Ioannina Greece
| | - Meropi Tzoufi
- Department of Paediatrics University of Ioannina, School of Medicine Ioannina Greece
| | - Vasileios Giapros
- Neonatal Intensive Care Unit University of Ioannina, School of Medicine Ioannina Greece
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Asiedu B, Nyakudya TT, Lembede BW, Chivandi E. Early-life exposure to alcohol and the risk of alcohol-induced liver disease in adulthood. Birth Defects Res 2021; 113:451-468. [PMID: 33577143 DOI: 10.1002/bdr2.1881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/13/2021] [Accepted: 01/19/2021] [Indexed: 11/10/2022]
Abstract
Alcohol consumption remains prevalent among pregnant and nursing mothers despite the well-documented adverse effects this may have on the offspring. Moderate-to-high levels of alcohol consumption in pregnancy result in fetal alcohol syndrome (FAS) disorders, with brain defects being chief among the abnormalities. Recent findings indicate that while light-to-moderate levels may not cause FAS, it may contribute to epigenetic changes that make the offspring prone to adverse health outcomes including metabolic disorders and an increased propensity in the adolescent-onset of drinking alcohol. On the one hand, prenatal alcohol exposure (PAE) causes epigenetic changes that affect lipid and glucose transcript regulating genes resulting in metabolic abnormalities. On the other hand, it can program offspring for increased alcohol intake, enhance its palatability, and increase acceptance of alcohol's flavor through associative learning, making alcohol a plausible second hit for the development of alcohol-induced liver disease. Adolescent drinking results in alcohol dependence and abuse in adulthood. Adolescent drinking results in alcohol dependence and abuse in adulthood. Alterations on the opioid system, particularly, the mu-opioid system, has been implicated in the mechanism that induces increased alcohol consumption and acceptance. This review proposes a mechanism that links PAE to the development of alcoholism and eventually to alcoholic liver disease (ALD), which results from prolonged alcohol consumption. While PAE may not lead to ALD development in childhood, there are chances that it may lead to ALD in adulthood.
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Affiliation(s)
- Bernice Asiedu
- Faculty of Health Sciences, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Trevor Tapiwa Nyakudya
- Department of Physiology, Faculty of Health Sciences, School of Medicine, University of Pretoria, Gezina, South Africa
| | - Busisani Wiseman Lembede
- Faculty of Health Sciences, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Eliton Chivandi
- Faculty of Health Sciences, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
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13
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Association between birthweight, cardiovascular risk factors, and depression in young Mexican adults. NUTR HOSP 2021; 38:833-838. [PMID: 34120446 DOI: 10.20960/nh.03547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Background: the aim of this study was to investigate the association between birthweight, cardiovascular disease (CVD) risk factors, and depression in young Mexican adults. Methods: birthweight reports, family history of CVD and diabetes-related diseases, anthropometrics, serum lipid profile (total cholesterol [TC], triglycerides [TG], high-density lipoprotein-cholesterol [HDL-C], low-density lipoprotein-cholesterol [LDL-C], and very-low density lipoprotein-cholesterol [VLDL-C]), and depressive symptoms were measured in 778 subjects of the UP-AMIGOS cohort study. To investigate the association between birthweight categories and CVD risk factors and depression, a one-way analysis of variance with post-hoc test was performed of quantitative variables, and 2 test for qualitative variables. Results: mean age was 17.8 years and 469 (60.3 %) of patients were female (n = 469, 60.3 %). The percentage of patients with low birthweight (LBW) was 8.1 % (n = 63), and 3.3 % (n = 26) reported high birthweight (HBW). Young adults with HBW were associated with elevated diastolic blood pressure (DBP), and high weight and body mass index (BMI) when compared to LBW subjects, the difference being statically significant (p < 0.05). Birthweight had no significant association with depression (p > 0.67). Conclusion: the findings from this population-based study revealed a positive relation between birthweight categories and some CVD risk factors. Depression was not related to birthweight.
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Maeyama T, Ida S, Onuma S, Shoji Y, Yamamoto T, Etani Y, Kawai M. Fat distribution in short-stature children born small for gestational age. Pediatr Int 2020; 62:1351-1356. [PMID: 32521070 DOI: 10.1111/ped.14337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/08/2020] [Accepted: 06/04/2020] [Indexed: 12/01/2022]
Abstract
BACKGROUND Children born small for gestational age (SGA) with catch-up growth are at high risk for developing obesity; however, the characteristics of body composition, especially fat distribution, before and after growth hormone (GH) treatment in SGA children without catch-up growth remains largely unknown. METHODS Anthropometric characteristics, body composition by dual-energy X-ray absorption, and fat distribution by computed tomography at the umbilical level were examined in 27 prepubertal short-stature children born SGA before and 1 year after GH treatment. RESULTS Before GH treatment, short-stature SGA children had lean phenotypes, and both visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT) were significantly lower than the age- and sex-matched Japanese reference values. Growth hormone treatment significantly increased height standard deviation scores (SDS), without affecting body mass index SDS. Percentage fat mass decreased with GH treatment; however, fat mass was not altered. Both VAT and SAT were significantly lower than the reference values after GH treatment. The ratio of VAT over SAT significantly increased by GH treatment. CONCLUSIONS Both VAT and SAT were within or below the age- and sex-matched Japanese reference values in short-stature children born SGA before and after GH treatment, indicating that GH treatment may not have unfavorable effects on adiposity in short-stature children born SGA, although it may alter fat distribution.
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Affiliation(s)
- Takatoshi Maeyama
- Department of Gastroenterology Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Shinobu Ida
- Department of Gastroenterology Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Shinsuke Onuma
- Department of Gastroenterology Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Yasuko Shoji
- Department of Gastroenterology Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Takehisa Yamamoto
- Department of Bone and Mineral Research, Research Institute, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Yuri Etani
- Department of Gastroenterology Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan
| | - Masanobu Kawai
- Department of Gastroenterology Nutrition and Endocrinology, Osaka Women's and Children's Hospital, Izumi, Osaka, Japan.,Department of Pediatrics, Minoh City Hospital, Minoh, Osaka, Japan
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Novel sex-specific influence of parental factors on small-for-gestational-age newborns. Sci Rep 2020; 10:19226. [PMID: 33154528 PMCID: PMC7644766 DOI: 10.1038/s41598-020-76196-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 10/23/2020] [Indexed: 11/09/2022] Open
Abstract
Since fetal programming is sex-specific, there may also be sex-specific in parental influences on newborn birth weight. We aimed to investigate the influence of parental factors on small-for-gestational-age (SGA) infants of different sexes. Based on a pre-pregnancy cohort, multivariate logistic regression was used. 2275 couples were included for analysis. Significant associations were observed among paternal height, pre-pregnancy body mass index (BMI), and SGA in male infants; among maternal height, pre-pregnancy BMI, and SGA in female infants, and among other maternal factors and SGA in both male and female infants. Such sex specificity may be related to genetic, epigenetic, or hormonal influences between parents and infants. In conclusion, there is a sex specificity in the effect of parental height and pre-pregnancy BMI on SGA. The data suggest that future studies on infants should consider the sex-specific differences between the effects of genetic or environmental factors and infants.
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Arisaka O, Ichikawa G, Koyama S, Sairenchi T. Childhood obesity: rapid weight gain in early childhood and subsequent cardiometabolic risk. Clin Pediatr Endocrinol 2020; 29:135-142. [PMID: 33088012 PMCID: PMC7534524 DOI: 10.1297/cpe.29.135] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/06/2020] [Indexed: 12/19/2022] Open
Abstract
Dynamic changes in body weight have long been recognized as important indicators of risk
for human health. Many population-based observational studies have shown that rapid weight
gain during infancy, including a catch-up growth phenomenon or adiposity rebound in early
childhood, predisposes a person to the development of obesity, type 2 diabetes, and
cardiovascular diseases later in life. However, a consensus has not been established
regarding which period of weight gain contributes to future risks. This review evaluates
recent evidence on the relationship between early rapid growth and future obesity and
cardiometabolic risk, with a focus on the differential significance of rapid weight gain
in infancy and early childhood. Although there is a need for attention to childhood growth
during early infancy before 1 yr of age as it may be related to future obesity, emerging
evidence strongly suggests that toddlers showing an increase in body mass index (BMI)
before 3 yr of age, a period normally characterized by decreased BMI, are prone to
developing later cardiometabolic risk.
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Affiliation(s)
- Osamu Arisaka
- Department of Pediatrics, Nasu Red Cross Hospital, Tochigi, Japan.,Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Go Ichikawa
- Department of Pediatrics, Nasu Red Cross Hospital, Tochigi, Japan.,Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Satomi Koyama
- Department of Pediatrics, Dokkyo Medical University School of Medicine, Tochigi, Japan
| | - Toshimi Sairenchi
- Department of Public Health, Dokkyo Medical University School of Medicine, Tochigi, Japan
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Cooper DM, Girolami GL, Kepes B, Stehli A, Lucas CT, Haddad F, Zalidvar F, Dror N, Ahmad I, Soliman A, Radom-Aizik S. Body composition and neuromotor development in the year after NICU discharge in premature infants. Pediatr Res 2020; 88:459-465. [PMID: 31926484 PMCID: PMC7351612 DOI: 10.1038/s41390-020-0756-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 12/27/2019] [Accepted: 01/01/2020] [Indexed: 11/08/2022]
Abstract
BACKGROUND Hypothesis: neuromotor development correlates to body composition over the first year of life in prematurely born infants and can be influenced by enhancing motor activity. METHODS Forty-six female and 53 male infants [27 ± 1.8 (sd) weeks] randomized to comparison or exercise group (caregiver provided 15-20 min daily of developmentally appropriate motor activities) completed the year-long study. Body composition [lean body and fat mass (LBM, FM)], growth/inflammation predictive biomarkers, and Alberta Infant Motor Scale (AIMS) were assessed. RESULTS AIMS at 1 year correlated with LBM (r = 0.32, p < 0.001) in the whole cohort. However, there was no effect of the intervention. LBM increased by ~3685 g (p < 0.001)); insulin-like growth factor-1 (IGF-1) was correlated with LBM (r = 0.36, p = 0.002). IL-1RA (an inflammatory biomarker) decreased (-75%, p < 0.0125). LBM and bone mineral density were significantly lower and IGF-1 higher in the females at 1 year. CONCLUSIONS We found an association between neuromotor development and LBM suggesting that motor activity may influence LBM. Our particular intervention was ineffective. Whether activities provided largely by caregivers to enhance motor activity in prematurely born infants can affect the interrelated (1) balance of growth and inflammation mediators, (2) neuromotor development, (3) sexual dimorphism, and/or (4) body composition early in life remains unknown.
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Affiliation(s)
- Dan M Cooper
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA.
| | - Gay L Girolami
- Department of Physical Therapy, University of Illinois at Chicago, Chicago, IL, USA
| | - Brenda Kepes
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Annamarie Stehli
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Candice Taylor Lucas
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Fadia Haddad
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Frank Zalidvar
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Nitzan Dror
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
| | - Irfan Ahmad
- Children's Hospital of Orange County, Orange, CA, USA
| | | | - Shlomit Radom-Aizik
- Pediatric Exercise and Genomics Research Center, UC Irvine School of Medicine, Irvine, CA, USA
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Burggren WW. Phenotypic Switching Resulting From Developmental Plasticity: Fixed or Reversible? Front Physiol 2020; 10:1634. [PMID: 32038303 PMCID: PMC6987144 DOI: 10.3389/fphys.2019.01634] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022] Open
Abstract
The prevalent view of developmental phenotypic switching holds that phenotype modifications occurring during critical windows of development are "irreversible" - that is, once produced by environmental perturbation, the consequent juvenile and/or adult phenotypes are indelibly modified. Certainly, many such changes appear to be non-reversible later in life. Yet, whether animals with switched phenotypes during early development are unable to return to a normal range of adult phenotypes, or whether they do not experience the specific environmental conditions necessary for them to switch back to the normal range of adult phenotypes, remains an open question. Moreover, developmental critical windows are typically brief, early periods punctuating a much longer period of overall development. This leaves open additional developmental time for reversal (correction) of a switched phenotype resulting from an adverse environment early in development. Such reversal could occur from right after the critical window "closes," all the way into adulthood. In fact, examples abound of the capacity to return to normal adult phenotypes following phenotypic changes enabled by earlier developmental plasticity. Such examples include cold tolerance in the fruit fly, developmental switching of mouth formation in a nematode, organization of the spinal cord of larval zebrafish, camouflage pigmentation formation in larval newts, respiratory chemosensitivity in frogs, temperature-metabolism relations in turtles, development of vascular smooth muscle and kidney tissue in mammals, hatching/birth weight in numerous vertebrates,. More extreme cases of actual reversal (not just correction) occur in invertebrates (e.g., hydrozoans, barnacles) that actually 'backtrack' along normal developmental trajectories from adults back to earlier developmental stages. While developmental phenotypic switching is often viewed as a permanent deviation from the normal range of developmental plans, the concept of developmental phenotypic switching should be expanded to include sufficient plasticity allowing subsequent correction resulting in the normal adult phenotype.
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Affiliation(s)
- Warren W. Burggren
- Developmental Integrative Biology, Department of Biological Sciences, University of North Texas, Denton, TX, United States
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19
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Risk factors for postdischarge growth retardation among very-low-birth-weight infants: A nationwide registry study in Taiwan. Pediatr Neonatol 2019; 60:641-647. [PMID: 30982695 DOI: 10.1016/j.pedneo.2019.03.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 01/11/2019] [Accepted: 03/14/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Very-low-birth-weight (VLBW) infants have a high risk of postdischarge growth retardation (GR). Continued GR might exert negative long-term effects on their health. This study examined the prevalence and the risk factors for postdischarge GR among VLBW infants in Taiwan. METHODS Nationwide data from the Taiwan Premature Infant Follow-up Network between 2007 and 2011 were analyzed. Infants with a gestational age (GA) < 37 weeks and birth body weight (BBW) < 1500 g were enrolled. They were followed up after discharge at the corrected ages of 6, 12, and 24 months. Associations between postdischarge GR at the follow-ups and possible risk factors were analyzed. RESULTS The prevalence of postdischarge GR among 2124 VLBW infants was 17.3%, 19.4%, and 13.8% at the corrected age (CA) of 6, 12, and 24 months, respectively. The significant perinatal factors of postdischarge GR were being small for gestational age (SGA) and extremely low birth weight (ELBW). ELBW infant with extra-uterine growth retardation (EUGR) at discharge or longer length of hospital stay (LOS) had poorer growth outcomes. Among non-ELBW infants, EUGR at discharge and surgical necrotizing enterocolitis (NEC) were the main influencing factors of unfavorable growth outcomes. RDS with surfactant therapy had a positive effect of postdischarge growth outcomes in ELBW infants. CONCLUSION Postdischarge GR is still a serious problem in Taiwan. Being SGA and ELBW and EUGR were significant risk factors for postdischarge GR throughout the first two years of life in VLBW infants. An integrated and organized team for postdischarge care as well as scheduled follow-ups, detailed nutritional education, and thorough inspection are necessary.
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Aneesh M, Ghugre PS. Anthropometry, body fat and central adiposity in LBW and NBW Indian children aged 3.5 to 4 years. Early Hum Dev 2019; 139:104885. [PMID: 31518866 DOI: 10.1016/j.earlhumdev.2019.104885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Revised: 09/02/2019] [Accepted: 09/04/2019] [Indexed: 01/21/2023]
Abstract
BACKGROUND India has a high prevalence of low birth weight. Evidence indicates that poor fetal growth and rapid postnatal weight gain are associated with adiposity. OBJECTIVES (i) To study the differences between the anthropometry, body fat measures of LBW and NBW children and (ii) To find out if there is any relationship between birth weight, change in weight SD and body fat measures of these children. STUDY DESIGN Cross-sectional study. SUBJECTS We studied 396 children aged between 3.5 and 4 years who were beneficiaries of government-run anganwadis in urban slums of Mumbai city, India. OUTCOME MEASURES Birth weight, current weight, height, skinfold thicknesses and waist circumference. Change in weight SD and body fat (%) were calculated. WHOAnthro was used to compute the z scores. Parent's education, income and breastfeeding history was recorded. RESULTS The mean change in weight SD of LBW and NBW groups were 1.01 ± 1.4 and -0.73 ± 1.13 respectively (p < 0.001). LBW children were lighter and shorter than NBW ones but had similar body fat (%) and central adiposity measures. In LBW and NBW children, birth weight Z score and change in weight SD were positively related to body fat (%) and waist circumference. CONCLUSION Children in this study belonged to low socioeconomic section. Despite this, LBW displayed a tendency towards accumulating body fat particularly, abdominal fat for lower body weight. Birth weight and postnatal weight change predict body fat and waist circumference in LBW and NBW children.
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Affiliation(s)
- Mitravinda Aneesh
- Department of Food Science and Nutrition, S.N.D.T. Women's University, Mumbai, Maharashtra, India.
| | - Padmini S Ghugre
- Department of Food Science and Nutrition, S.N.D.T. Women's University, Mumbai, Maharashtra, India
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21
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Larsson A, Ottosson P, Törnqvist C, Olhager E. Body composition and growth in full-term small for gestational age and large for gestational age Swedish infants assessed with air displacement plethysmography at birth and at 3-4 months of age. PLoS One 2019; 14:e0207978. [PMID: 31091240 PMCID: PMC6519902 DOI: 10.1371/journal.pone.0207978] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2018] [Accepted: 04/26/2019] [Indexed: 11/29/2022] Open
Abstract
Background Being born small for gestational age (SGA) or large for gestational age (LGA) has short and long term metabolic consequences. There is a growing interest in the extent to which body composition, both in the short and the long term, differs in infants born at the extremes of these birth weights. Methods Body composition in 25 SGA and 25 LGA infants were assessed during the first days of life and at 3–4 months of age using air displacement plethysmography. Results SGA infants had significantly lower body fat (%) at birth compared to LGA infants. SGA infants increased their body weight and length at a significantly higher rate between birth and 3–4 months than LGA infants. Fat mass (g) in SGA infants increased 23 times between birth and 3–4 months of age compared to 2.8 times for LGA infants. At 3–4 months of age LGA infants reached a threshold in body fat (%) while SGA infants were still gaining body fat (%). Conclusion Several significant differences have been identified between SGA and LGA infants, indicating that the effects of intrauterine life continues to play an important role in body composition and growth during the first 3–4 months of life.
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Affiliation(s)
- Anna Larsson
- Division of Paediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Peter Ottosson
- Division of Paediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Caroline Törnqvist
- Division of Paediatrics, Department of Clinical and Experimental Medicine, Faculty of Health Science, Linkoping University, Linkoping, Sweden
| | - Elisabeth Olhager
- Division of Paediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden
- * E-mail:
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Early-life growth of preterm infants and its impact on neurodevelopment. Pediatr Res 2019; 85:283-292. [PMID: 30140070 DOI: 10.1038/s41390-018-0139-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Revised: 06/08/2018] [Accepted: 07/26/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Increasing numbers of preterm-born children survive nowadays, and improving long-term health and neurodevelopment is becoming more important. Early-life growth has been linked to neurodevelopmental outcomes. We aimed to study whether this association has changed with time. METHODS We studied two cohorts of preterm-born children (gestational age ≤32 weeks and/or birth weight ≤1500 g) from 1983 (n = 708) and 2003-2006 (n = 138), respectively. We distinguished four early-life growth patterns at 3 months corrected age: appropriate for gestational age (AGA) with or without growth restriction (AGA GR+/AGA GR-), and small for gestational age (SGA) with or without catch-up growth (SGA CUG+/SGA CUG-). Intelligence quotient (IQ), neuromotor function, and behavior were assessed at ages 19 and 8 years, respectively, for the cohorts. RESULTS In the 2003-2006 cohort, less children had early-life GR. In both cohorts, SGA CUG- subjects had unfavorable growth trajectories and neurodevelopmental outcomes (IQ β -6.5, 95% confidence interval (CI) -9.8; -3.2, P < 0.001; neuromotor score β -1.9%, 95% CI -3.2; -0.6, P = 0.005), while SGA CUG+ subjects were comparable to adequately grown subjects. CONCLUSION Although the incidence of adverse growth patterns decreased between the cohorts, possibly indicating improvements in care over time, the impact of these growth patterns on neurodevelopmental outcomes was not significantly different. Achieving adequate early-life growth may be crucial for improving neurodevelopmental outcomes, especially for preterms born SGA.
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Abranches ADD, Soares FVM, Villela LD, Méio MDBB, Zin OA, Gomes Junior S, Moreira MEL. Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Abranches ADD, Soares FVM, Villela LD, Méio MDBB, Zin OA, Gomes Junior SC, Moreira MEL. Energy expenditure, growth, and nutritional therapy in appropriate and small for gestational age preterm infants. J Pediatr (Rio J) 2018; 94:652-657. [PMID: 29121495 DOI: 10.1016/j.jped.2017.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/19/2017] [Accepted: 08/28/2017] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To evaluate the resting energy expenditure, growth, and quantity of energy and macronutrients intake in a group of preterm newborns. METHODS The cohort study was performed with appropriate and small for gestational age preterm infants (birth weight lower than 1500g or gestational age<32 weeks). Resting energy expenditure was measured using indirect calorimetry on the 7th, 14th, 21st, and 28th days of life, and at discharge. Length, head circumference and body weight were assessed weekly. Nutritional therapy was calculated during the hospital stay and the information for each type of food was recorded in software that calculates the total amount of energy and macronutrients. RESULTS 61 preterm infants were followed; 43 appropriate and 18 small for gestational age infants. There was no statistical difference for resting energy expenditure between the groups, and it increased from the first to the fourth week of life (appropriate: 26.3% and small: 21.8%). Energy intake in the first two weeks of life was well below the energy requirement. CONCLUSION Considering that the results demonstrate high energy expenditure during the first weeks of life, there is an evident need to provide the best quality of nutrition for each child in the first weeks of life so that preterm infants with or without intrauterine growth restriction can achieve their maximum potential for growth and development.
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Affiliation(s)
- Andrea Dunshee de Abranches
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Departamento Neonatologia, Rio de Janeiro, RJ, Brazil.
| | - Fernanda Valente Mendes Soares
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Unidade de Pesquisa Clínica, Rio de Janeiro, RJ, Brazil
| | - Letícia Duarte Villela
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Departamento Neonatologia, Rio de Janeiro, RJ, Brazil
| | - Maria Dalva Barbosa Baker Méio
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Unidade de Pesquisa Clínica, Rio de Janeiro, RJ, Brazil
| | - Olivia Araújo Zin
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Unidade de Pesquisa Clínica, Rio de Janeiro, RJ, Brazil
| | - Saint-Clair Gomes Junior
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Unidade de Pesquisa Clínica, Rio de Janeiro, RJ, Brazil
| | - Maria Elisabeth Lopes Moreira
- Fundação Oswaldo Cruz (Fiocruz), Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira (IFF), Unidade de Pesquisa Clínica, Rio de Janeiro, RJ, Brazil
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Shi H, Yang X, Wu D, Wang X, Li T, Liu H, Guo C, Wang J, Hu X, Yu G, Chen J. Insights into infancy weight gain patterns for term small-for-gestational-age babies. Nutr J 2018; 17:97. [PMID: 30373572 PMCID: PMC6206641 DOI: 10.1186/s12937-018-0397-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 09/19/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Too fast or slow weight gain in infancy is bad for health in later life. In this study, we aim to investigate the optimal weight gain pattern during the first 2 y of life for term small-for-gestational-age (SGA) infants. METHOD We employed data from a longitudinal, community-based cohort study on the growth and development of SGAs collected between 2004 and 2010 in Shanghai, China. Latent class growth analysis (LCGA) was applied to identify weight gain patterns among 3004 SGAs. BMI curves for each latent class from 1 mo to 5 y were produced through mixed-effects regression analysis. Multivariable regression was performed to examine the association between various classes and adverse outcomes (overweight/obesity/ malnutrition) during 2-5 y. RESULT Five weight gain patterns aged 0-2 y of 3004 term SGAs were identified and labeled as follows--class 1: excessively rapid catch-up growth (10.7%); class 2: rapid catch-up growth (19.7%); class 3: appropriate catch-up growth (55.7%); class 4: slow catch-up growth (10.2%); class 5: almost no catch-up growth (3.7%). A decreasing age at adiposity rebound (AR) and an increasing BMI value were observed from class 5 to 1. Class 1 and 2 showed an early appearance of AR (< 4 y). SGAs in class 1 and 2 had a higher BMI in 2-5 y of life. After adjustment for potential confounding variables, class 1 and 2 were found to have an increased risk of being overweight/ obese. At the same time, we found the risk of malnutrition was especially prominent among SGAs in classes 4 and 5. CONCLUSION Our results suggest that for term SGA infants, catch-up growth that crossing two centile levels, that is, from < 10th to the interval between 25th and 50th (ΔWAZ> 1.28) in the first several months, along with on track growth and maintenance at a median level by age 2 may be the optimal catch-up growth trajectory, minimizing risk of childhood adverse health outcomes.
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Affiliation(s)
- Huiqing Shi
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Road 355, Putuo district, Shanghai, 200062, China
| | - Xiaodong Yang
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Road 355, Putuo district, Shanghai, 200062, China
| | - Dan Wu
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Road 355, Putuo district, Shanghai, 200062, China
| | - Xiulian Wang
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Road 355, Putuo district, Shanghai, 200062, China
| | - Tingting Li
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Road 355, Putuo district, Shanghai, 200062, China
| | - Honghua Liu
- Dongying People's Hospital, Dongcheng South First Road 317, Dongying, 257091, China
| | - Chong Guo
- Maternal and Children Hospital, Daoshan Road 18, Gulou District, Fuzhou, 350001, China
| | - Jian Wang
- Jing'an District Maternal and Child Healthcare Center of Shanghai, 1297 Kangding Road, Shanghai, 200072, China
| | - Xiangying Hu
- Jing'an District Maternal and Child Healthcare Center of Shanghai, 1297 Kangding Road, Shanghai, 200072, China
| | - Guangjun Yu
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Road 355, Putuo district, Shanghai, 200062, China.
| | - Jinjin Chen
- Shanghai Children's Hospital, Shanghai Jiao Tong University, Luding Road 355, Putuo district, Shanghai, 200062, China.
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Villela LD, Méio MDBB, Gomes Junior SCS, de Abranches AD, Soares FVM, Moreira MEL. Body composition in preterm infants with intrauterine growth restriction: a cohort study. J Perinat Med 2018; 46:804-810. [PMID: 29408800 DOI: 10.1515/jpm-2017-0175] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/03/2018] [Indexed: 02/05/2023]
Abstract
AbstractAims:The comparison of body composition parameters between the small for gestational age (SGA) and appropriate for gestational age (AGA) at term, 1, 3 and 5 months corrected ages in very preterm infants.Methods:This cohort study included 92 preterm infants at term age, younger than 32 weeks or <1500 g, classified in two groups: SGA and AGA. Anthropometry and body composition, estimated by air displacement plethysmography, were evaluated at the corrected ages: term and 1, 3, and 5 months. We used the lean mass/fat mass index (LM/FM) at each time point and the weight, length and head circumference SDS gain between the time points.Results:At term age, the SGA preterm infants had less lean mass (g), fat mass (g) and percent fat mass but a greater LM/FM index than AGA infants (P<0.001). At 1 month corrected age the LM/FM index and percent fat mass between the groups became similar. Lower lean mass persisted up to 3 months in the SGA group [4004 g (3256–4595) vs. 4432 g (3190–6246), P<0.001]. During the first month corrected age, the weight SDS gain was higher in SGA preterm infants when compared to AGA preterm infants. However, the SGA preterm infants remained lighter, shorter and with smaller head circumferences than the AGA preterm infants until 3 months of corrected age.Conclusions:The greater lean tissue deficits and an earlier “catch-up” in fat in the SGA group can reflect growth patterns variability since the early life.
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Affiliation(s)
- Letícia Duarte Villela
- Departamento de Neonatologia, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Avenida Rui Barbosa, 716. Bloco 2 - Unidade de Pesquisa Clínica, Bairro Flamengo, Rio de Janeiro/RJ, CEP: 22250-020, Brazil, Tel./Fax: +(21) 2554-1918, E-mail:
| | - Maria Dalva Barbosa Baker Méio
- Pós-graduação em Pesquisa Aplicada à Saúde da Criança, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | - Saint Clair S Gomes Junior
- Public Health and Clinical Researcher of Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | - Andrea Dunshee de Abranches
- Unidade de Pesquisa Clínica, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
| | | | - Maria Elisabeth Lopes Moreira
- Head of Unidade de Pesquisa Clínica, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, FIOCRUZ, Rio de Janeiro, Brazil
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Chen S, Liu Z, Zhu H, Yang H, Gong F, Wang L, Jiang Y, Yan C, Li J, Wang Q, Pan H. Height at three months can indicate overweight at two years in catch-up growth of small for gestational age infants. Sci Rep 2018; 8:13411. [PMID: 30194331 PMCID: PMC6128850 DOI: 10.1038/s41598-018-29698-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 07/10/2018] [Indexed: 01/08/2023] Open
Abstract
This study aimed to find an indicator at three months to predict overweight and short stature at two years in small for gestational age (SGA) infants. A total of 468 SGA infants and 4642 appropriate for gestational age (AGA) infants were included. Weight and height were measured at birth, three months and two years. Logistic regression and receiver operating characteristic (ROC) curves were performed for the catch-up growth. As compared to AGA infants, the weight of SGA infants was lower and the length/height was shorter at birth, three months, and two years. The weight of the catch-up group was significantly greater at birth and two years. The length/height of the catch-up group was greater at three months and two years. Trajectories of weight standard deviation score (SDS) and height SDS showed that the overweight group (BMI over the 85th percentile) had a shorter length/height SDS but a higher rate of the change in weight SDS during catch-up growth. The multivariate logistic regression indicated that that height at three months was an independent factor for prediction of catch-up growth at two years. The area under curve (AUC) was 0.801 with the 95% confidence interval (CI) from 0.726 to 0.876. Therefore, height at three months can predict overweight at two years.
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Affiliation(s)
- Shi Chen
- Department of Endocrinology, Key Lab of Endocrinology, National Commission of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China
| | - Zeyu Liu
- Department of Radiology, PUMCH, CAMS & PUMC, Beijing, 100730, China
| | - Huijuan Zhu
- Department of Endocrinology, Key Lab of Endocrinology, National Commission of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China
| | - Hongbo Yang
- Department of Endocrinology, Key Lab of Endocrinology, National Commission of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China
| | - Fengying Gong
- Department of Endocrinology, Key Lab of Endocrinology, National Commission of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China
| | - Linjie Wang
- Department of Endocrinology, Key Lab of Endocrinology, National Commission of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China
| | - Yu Jiang
- School of Public Health, PUMC, Beijing, 100730, China
| | - Chengsheng Yan
- Hebei Center for Women and Children's Health, Shijiazhuang, 050031, China
| | - Jianqiang Li
- School of Software Engineering, Beijing University of Technology, Beijing, 100124, China
| | - Qing Wang
- Tsinghua National Laboratory for Info. Science and Technology, Tsinghua University, Beijing, 100084, China
| | - Hui Pan
- Department of Endocrinology, Key Lab of Endocrinology, National Commission of Health, Peking Union Medical College Hospital (PUMCH), Chinese Academe of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing, 100730, China.
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Oxygen-Induced Retinopathy from Recurrent Intermittent Hypoxia Is Not Dependent on Resolution with Room Air or Oxygen, in Neonatal Rats. Int J Mol Sci 2018; 19:ijms19051337. [PMID: 29724000 PMCID: PMC5983662 DOI: 10.3390/ijms19051337] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/26/2018] [Accepted: 04/27/2018] [Indexed: 12/24/2022] Open
Abstract
Preterm infants often experience intermittent hypoxia (IH) with resolution in room air (RA) or hyperoxia (Hx) between events. Hypoxia is a major inducer of vascular endothelial growth factor, which plays a key role in normal and aberrant retinal angiogenesis. This study tested the hypothesis that neonatal IH which resolved with RA is less injurious to the immature retina than IH resolved by Hx between events. Newborn rats were exposed to: (1) Hx (50% O2) with brief hypoxia (12% O2); (2) RA with 12% O2; (3) Hx with RA; (4) Hx only; or (5) RA only, from P0 to P14. Pups were examined at P14 or placed in RA until P21. Retinal vascular and astrocyte integrity; retinal layer thickness; ocular and systemic biomarkers of angiogenesis; and somatic growth were determined at P14 and P21. All IH paradigms resulted in significant retinal vascular defects, disturbances in retinal astrocyte template, retinal thickening, and photoreceptor damage concurrent with elevations in angiogenesis biomarkers. These data suggest that the susceptibility of the immature retina to changes in oxygen render no differences in the outcomes between RA or O2 resolution. Interventions and initiatives to curtail O2 variations should remain a high priority to prevent severe retinopathy.
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Hong YH, Chung S. Small for gestational age and obesity related comorbidities. Ann Pediatr Endocrinol Metab 2018; 23:4-8. [PMID: 29609443 PMCID: PMC5894558 DOI: 10.6065/apem.2018.23.1.4] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Accepted: 03/15/2018] [Indexed: 12/19/2022] Open
Abstract
Infant born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature and metabolic alterations in later life. The result of SGA followed by rapid weight gain during early postnatal life has been associated with increased long-term risks for central obesity, insulin resistance, impaired glucose tolerance, type 2 diabetes, hypertension, increased fat mass, and cardiovascular disease. We should carefully monitor their weight during infancy and childhood to prevent excessive rates of weight gain. 'Healthy catch up growth' may decreased the risk of obesity-related comorbidities in SGA. Establishing the optimal growth patterns in SGA to minimize short- and long-term risks is important, and further studies will be needed. This review discusses recent studies concentrating on obesity-related morbidities in SGA infants that may provide insight into growth monitoring.
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Affiliation(s)
- Yong Hee Hong
- Department of Pediatrics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University School of Medicine, Bucheon, Korea
| | - Sochung Chung
- Department of Pediatrics, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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30
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Villela LD, Méio MDBB, de Matos Fonseca V, de Abranches AD, Junior SCG, da Costa ACC, Murta MM, Nehab SRG, Soares FVM, Moreira MEL. Growth and body composition of preterm infants less than or equal to 32 weeks: Cohort study. Early Hum Dev 2018; 117:90-95. [PMID: 29360048 DOI: 10.1016/j.earlhumdev.2018.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 12/08/2017] [Accepted: 01/10/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Extremely preterm infants with weights less than the 10th percentile at discharge have a fat-free mass deficit. AIM To analyze the relationship of weight Z-scores less than -2SD at term age with fat-free mass and fat mass at term age and at 1 and 3 months of corrected age in very preterm infants. STUDY DESIGN COHORT STUDY: Subjects: Sixty-six preterm infants born before or at 32 weeks gestation with birth weight equal or greater than the 10th percentile for age were included at term age. They were classified according to weight Z-score as either: "term (-)" (n = 18) if weight Z-scores were less -2SD or "term (+)" (n = 48) if the weight Z-scores were equal or greater than -2SD at term age. OUTCOME MEASURES Growth and body composition by an air displacement plethysmography system and bioimpedance were assessed at term age and 1 and 3 months of corrected age. RESULTS Lower fat-free mass persisted up to 3 months in the "term (-)" group [4137 g (645) vs 4592 g (707), p < .01]. Fat mass was lower in the "term (-)" group at term and at 1 month but was similar at 3 months of corrected age [1295 g (774) vs 1477 g (782), p = .109]. Weight, length and head circumference Z-scores were lower in the "term (-)" group compared to those in the "term (+)" group. CONCLUSIONS The lean tissue deficits were maintained in the "term (-)" group while the differences in body fat percentage were not.
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Prenatal vitamin D status and offspring's growth, adiposity and metabolic health: a systematic review and meta-analysis. Br J Nutr 2018; 119:310-319. [PMID: 29321080 DOI: 10.1017/s0007114517003646] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
In this systematic review and meta-analysis of observational studies, we aimed to estimate the associations between prenatal vitamin D status and offspring growth, adiposity and metabolic health. We searched the literature in human studies on prenatal vitamin D status and offspring growth in PubMed, up to July 2017. Studies were selected according to their methodological quality and outcomes of interest (anthropometry, fat mass and diabetes in offspring). The inverse variance method was used to calculate the pooled mean difference (MD) with 95 % CI for continuous outcomes, and the Mantel-Haenszel method was used to calculate the pooled OR with 95 % CI for dichotomous outcomes. In all, thirty observational studies involving 35 032 mother-offspring pairs were included. Vitamin D status was evaluated by circulating 25-hydroxyvitamin D (25(OH)D) level. Low vitamin D status was based on each study's cut-off for low 25(OH)D levels. Low prenatal vitamin D levels were associated with lower birth weight (g) (MD -100·69; 95 % CI -162·25, -39·13), increased risk of small-for-gestational-age (OR 1·55; 95 % CI 1·16, 2·07) and an elevated weight (g) in infant at the age of 9 months (g) (MD 119·75; 95 % CI 32·97, 206·52). No associations were observed between prenatal vitamin D status and other growth parameters at birth, age 1 year, 4-6 years or 9 years, nor with diabetes type 1. Prenatal vitamin D may play a role in infant adiposity and accelerated postnatal growth. The effects of prenatal vitamin D on long-term metabolic health outcomes in children warrant future studies.
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Fujimoto M, Sonoyama YK, Fukushima K, Imamoto A, Miyahara F, Miyahara N, Nishimura R, Yamada Y, Miura M, Adachi K, Nanba E, Hanaki K, Kanzaki S. Increased IRS2 mRNA Expression in SGA Neonates: PCR Analysis of Insulin/IGF Signaling in Cord Blood. J Endocr Soc 2017; 1:1408-1416. [PMID: 29264464 PMCID: PMC5695653 DOI: 10.1210/js.2017-00294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/29/2017] [Indexed: 12/28/2022] Open
Abstract
Context: Hypoglycemia is the most common metabolic problem among small-for-gestational-age (SGA) neonates. However, the pathological mechanism and insulin/ insulin-like growth factor (IGF) signaling axis in neonates remain unknown. Objective: To determine the insulin/IGF axis in neonates, we analyzed the messenger RNA (mRNA) expression of insulin/IGF signaling in fetal umbilical cord blood. Setting: The Perinatal Medical Center of Tottori University Hospital. Participants: Fifty-two [42 appropriate-for-gestational-age (AGA) and 10 SGA] neonates. Interventions: Immediately collected cord blood was placed into a PAXgene Blood RNA Tube. Total RNA from the blood was purified using reagents provided in the PAXgene Blood RNA Kit within 4 days, and reverse transcription polymerase chain reaction (PCR) was performed. Main Outcome Measure: Quantitative real-time PCR analysis was applied to evaluate the mRNA expression of insulin receptor (INSR), IGF-I receptor (IGF1R), insulin receptor substrate 1 (IRS1), IRS2, and glucose transporters (SLC2A2 and SLC2A4). β-Actin was used as a control gene. Results: Serum glucose and IGF-I levels in SGA neonates were significantly lower. The cord serum insulin levels were similar between AGA and SGA neonates. The IRS2 mRNA expression was significantly higher in SGA than in AGA neonates (P < 0.05). The IRS2 mRNA expression was significantly higher in hypoglycemic SGA neonates than in normoglycemic SGA neonates. Conclusions: We determined that intrauterine growth restriction induces increased IRS2 mRNA expression in cord blood, without hyperinsulinemia. The increased expression of IRS2 mRNA might be associated with abnormal glucose metabolism in SGA neonates. Our findings might lead to the elucidation of abnormal glucose metabolism in SGA neonates.
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Affiliation(s)
- Masanobu Fujimoto
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Yuki Kawashima Sonoyama
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Kenji Fukushima
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Aya Imamoto
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Fumiko Miyahara
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Naoki Miyahara
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Rei Nishimura
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Yuko Yamada
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Mazumi Miura
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Kaori Adachi
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University, Yonago, Japan 683-8504
| | - Eiji Nanba
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University, Yonago, Japan 683-8504
| | - Keiichi Hanaki
- Department of Women's and Children's Family Nursing, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
| | - Susumu Kanzaki
- Division of Pediatrics and Perinatology, Tottori University Faculty of Medicine, Yonago, Japan 683-8504
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Ravlić S, Škrobot Vidaček N, Nanić L, Laganović M, Slade N, Jelaković B, Rubelj I. Mechanisms of fetal epigenetics that determine telomere dynamics and health span in adulthood. Mech Ageing Dev 2017; 174:55-62. [PMID: 28847485 DOI: 10.1016/j.mad.2017.08.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Revised: 08/18/2017] [Accepted: 08/21/2017] [Indexed: 01/11/2023]
Abstract
Advances in epigenetics now enable us to better understand environmental influences on the genetic background of human diseases. This refers especially to fetal development where an adverse intrauterine environment impacts oxygen and nutrient supply to the fetus. Recently, differences in telomere length and telomere loss dynamics among individuals born with intrauterine growth restriction compared to normal controls have been described. In this paper we propose possible molecular mechanisms that (pre)program telomere epigenetics during pregnancy. This programming sets differences in telomere lengths and dynamics of telomere shortening in adulthood and therefore dictates the dynamics of aging and morbidity in later life.
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Affiliation(s)
- Sanda Ravlić
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
| | - Nikolina Škrobot Vidaček
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
| | - Lucia Nanić
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
| | - Mario Laganović
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Neda Slade
- Laboratory for Protein Dynamics, Division of Molecular Medicine, RBI, Zagreb, Croatia.
| | - Bojan Jelaković
- Department for Nephrology, Hypertension, Dialysis and Transplantation, University Hospital Centre Zagreb, Zagreb, Croatia.
| | - Ivica Rubelj
- Laboratory for Molecular and Cellular Biology, Division of Molecular Biology, RBI, Zagreb, Croatia.
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Chen S, Zhu R, Zhu H, Yang H, Gong F, Wang L, Jiang Y, Lian BQ, Yan C, Li J, Wang Q, Zhang SK, Pan H. The prevalence and risk factors of preterm small-for-gestational-age infants: a population-based retrospective cohort study in rural Chinese population. BMC Pregnancy Childbirth 2017; 17:237. [PMID: 28728571 PMCID: PMC5520343 DOI: 10.1186/s12884-017-1412-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 07/05/2017] [Indexed: 12/23/2022] Open
Abstract
Background Preterm birth and small for gestational age (SGA) are strong indicators of neonatal adverse outcomes. With the growing importance of preterm SGA infants, we aim to evaluate the prevalence and risk factors for preterm SGA in China. Method We analyzed the data of parents and infants from a population-based cohort research of the free National Pre-pregnancy Checkups Project (NPCP) in rural China. Only singleton live births that occurred between 24 weeks +0 days and 36 weeks +6 days of pregnancy were included in this study. SGA was defined as birth weight less than the 10th percentile of the reference birth-weight-for-gestational-age population. A multiple logistic regression model was built using the statistically significant variables from the 371 variables in the questionnaire. Results A total of 11,474 singleton, preterm, live-birth infants were included. Of the total infants, 317 (2.77%) were preterm SGA infants. A higher risk of preterm SGA infants was observed among mothers who were on oral contraceptives (OR: 8.162, 95% CI: 1.622–41.072), mothers who had syphilis (OR: 12.800, 95% CI: 1.250–131.041), and mothers with a high eosinophil percentage (OR: 13.292, 95% CI: 1.282–135.796). Maternal intake of folic acid at least 3 months before pregnancy (OR: 0.284, 95% CI:0.124–0.654) and paternal intake of egg and meat (OR: 0.097,95% CI:0.030–0.315) were protective factors. Compared with North China, the incidence of preterm SGA infants was higher in South China. Conclusion Preterm SGA infants were associated with both maternal and paternal factors.
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Affiliation(s)
- Shi Chen
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, No.1, Shuaifuyuan Road, Beijing, Dongcheng district, 100730, China
| | - Rong Zhu
- Intern of medicine, PUMCH, Beijing, 100730, China.,Department of Gynaecology and Obsterics, Peking University First Hospital, Beijing, 100034, China
| | - Huijuan Zhu
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, No.1, Shuaifuyuan Road, Beijing, Dongcheng district, 100730, China
| | - Hongbo Yang
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, No.1, Shuaifuyuan Road, Beijing, Dongcheng district, 100730, China
| | - Fengying Gong
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, No.1, Shuaifuyuan Road, Beijing, Dongcheng district, 100730, China
| | - Linjie Wang
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, No.1, Shuaifuyuan Road, Beijing, Dongcheng district, 100730, China
| | - Yu Jiang
- School of public health, PUMC, Beijing, 100730, China
| | - Bill Q Lian
- University of Massachusetts Medical Center, 55 Lake Ave., North Worcester, MA, 01655, USA
| | - Chengsheng Yan
- Hebei Center for women and children's health, Shijiazhuang, 050031, China
| | - Jianqiang Li
- School of Software Engineering, Beijing University of Technology, Beijing, 100124, China
| | - Qing Wang
- Tsinghua National Laboratory for Info. Science and Technology, Tsinghua University, Beijing, 100084, China
| | - Shi-Kun Zhang
- Research association for women and children's health, Beijing, 100081, China
| | - Hui Pan
- Department of Endocrinology, Key Laboratory of Endocrinology of Ministry of Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Peking Union Medical College Hospital, No.1, Shuaifuyuan Road, Beijing, Dongcheng district, 100730, China.
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Abstract
PURPOSE OF THE REVIEW Evidence is rapidly accumulating implicating gut dysbiosis in hypertension (HTN). However, we are far from understanding whether this is a cause or consequence of HTN, and how to best translate this fundamental knowledge to advance the management of HTN. This review aims to summarize recent advances in the field, illustrate the connections between the gut and hypertension, and establish that the gut microbiota (GM)-gut interaction is centrally positioned for consideration as an innovative approach for HTN therapeutics. RECENT FINDINGS Animal models of HTN have shown that gut pathology occurs in HTN, and provides some clues to mechanisms linking the dysbiosis, gut pathology, and HTN. Circumstantial evidence links gut dysbiosis and HTN. Gut pathology, apparent in animal HTN models, has not been fully investigated in hypertensive patients. Objective evidence and an understanding of mechanisms could have a major impact for new antihypertensive therapies and/or improved applications of current ones.
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Affiliation(s)
- Elaine M Richards
- Departments of Physiology and Functional Genomics, University of Florida, PO Box 100274, Gainesville, FL, 32610-0274, USA
| | - Carl J Pepine
- Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, Florida, USA
| | - Mohan K Raizada
- Departments of Physiology and Functional Genomics, University of Florida, PO Box 100274, Gainesville, FL, 32610-0274, USA.
| | - Seungbum Kim
- Departments of Physiology and Functional Genomics, University of Florida, PO Box 100274, Gainesville, FL, 32610-0274, USA
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Response to 'In-utero exposure to tenofovir is associated with impaired fetal and infant growth' by Denneman et al. AIDS 2017; 31:595-596. [PMID: 28118235 DOI: 10.1097/qad.0000000000001338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Liu C, Wu B, Lin N, Fang X. Insulin resistance and its association with catch-up growth in Chinese children born small for gestational age. Obesity (Silver Spring) 2017; 25:172-177. [PMID: 27865057 DOI: 10.1002/oby.21683] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 08/08/2016] [Accepted: 08/25/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To assess insulin resistance and β-cell function from birth to age 4 years and to examine their associations with catch-up growth (CUG) in Chinese small-for-gestational-age (SGA) children. METHODS Weight and height were measured yearly from birth to age 4 years, and transformed into age- and gender-adjusted SD scores. Fasting serum insulin and glucose were measured, and fasting insulin resistance and β-cell function were estimated using the homeostasis model assessment (HOMA). RESULTS The mean HOMA-IR of the SGA group was significantly lower than that of the appropriate-for-gestational-age (AGA) group at ages 2 and 3 years old, and the mean HOMA% of the SGA group was significantly lower than that of the AGA group at age 4 years old. At 4 years of age, HOMA for insulin resistance was positively correlated with the height gain and SD of height gain between 0 and 5 months, and HOMA% was positively correlated with the weight gain and SD of weight gain between 6 and 12 months in SGA children. CONCLUSIONS SGA children with CUG show a greater propensity to develop insulin resistance than AGA children between ages 2 and 4 years old. HOMA parameters are related to CUG in the first year of life.
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Affiliation(s)
- Chunhua Liu
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
| | - Baiyan Wu
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
| | - Niyang Lin
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
| | - Xiaoyi Fang
- Department of Pediatrics, The First Affiliated Hospital of Shantou University Medical College, Shantou, China. Correspondence: Chunhua Liu
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Hellmuth C, Uhl O, Standl M, Demmelmair H, Heinrich J, Koletzko B, Thiering E. Cord Blood Metabolome Is Highly Associated with Birth Weight, but Less Predictive for Later Weight Development. Obes Facts 2017; 10:85-100. [PMID: 28376503 PMCID: PMC5644937 DOI: 10.1159/000453001] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 10/27/2016] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND/AIMS Fetal metabolism may be changed by the exposure to maternal factors, and the route to obesity may already set in utero. Cord blood metabolites might predict growth patterns and later obesity. We aimed to characterize associations of cord blood with birth weight, postnatal weight gain, and BMI in adolescence. METHODS Over 700 cord blood samples were collected from infants participating in the German birth cohort study LISAplus. Glycerophospholipid fatty acids (GPL-FA), polar lipids, non-esterified fatty acids (NEFA), and amino acids were analyzed with a targeted, liquid chromatography-tandem mass spectrometry based metabolomics platform. Cord blood metabolites were related to growth factors by linear regression models adjusted for confounding variables. RESULTS Cord blood metabolites were highly associated with birth weight. Lysophosphatidylcholines C16:1, C18:1, C20:3, C18:2, C20:4, C14:0, C16:0, C18:3, GPL-FA C20:3n-9, and GPL-FA C22:5n-6 were positively related to birth weight, while higher cord blood concentrations of NEFA C22:6, NEFA C20:5, GPL-FA C18:3n-3, and PCe C38:0 were associated with lower birth weight. Postnatal weight gain and BMI z-scores in adolescents were not significantly associated with cord blood metabolites after adjustment for multiple testing. CONCLUSION Potential long-term programming effects of the intrauterine environment and metabolism on later health cannot be predicted with profiling of the cord blood metabolome.
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Affiliation(s)
- Christian Hellmuth
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Childrenʼs Hospital, University of Munich Medical Center, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Olaf Uhl
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Childrenʼs Hospital, University of Munich Medical Center, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Marie Standl
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Hans Demmelmair
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Childrenʼs Hospital, University of Munich Medical Center, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Joachim Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University of Munich Medical Center, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Berthold Koletzko
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Childrenʼs Hospital, University of Munich Medical Center, Ludwig-Maximilians-Universität München, Munich, Germany
- *Prof. Dr. Berthold Koletzko, Division of Metabolic and Nutritional Medicine, Dr. von Hauner Childrenʼs Hospital, University of Munich Medical Center, Ludwig-Maximilians-Universität München, Lindwurmstraße 4, 80337 Munich, Germany,
| | - Elisabeth Thiering
- Division of Metabolic and Nutritional Medicine, Dr. von Hauner Childrenʼs Hospital, University of Munich Medical Center, Ludwig-Maximilians-Universität München, Munich, Germany
- Institute of Epidemiology I, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
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Blakstad EW, Moltu SJ, Nakstad B, Veierød MB, Strømmen K, Júlíusson PB, Almaas AN, Rønnestad AE, Brække K, Drevon CA, Iversen PO. Enhanced nutrition improves growth and increases blood adiponectin concentrations in very low birth weight infants. Food Nutr Res 2016; 60:33171. [PMID: 27914187 PMCID: PMC5136127 DOI: 10.3402/fnr.v60.33171] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 10/12/2016] [Accepted: 11/04/2016] [Indexed: 12/27/2022] Open
Abstract
Background Adequate nutrient supply is essential for optimal postnatal growth in very low birth weight (VLBW, birth weight<1,500 g) infants. Early growth may influence the risk of metabolic syndrome later in life. Objective To evaluate growth and blood metabolic markers (adiponectin, leptin, and insulin-like growth factor-1 (IGF-1)) in VLBW infants participating in a randomized nutritional intervention study. Design Fifty VLBW infants were randomized to an enhanced nutrient supply or a standard nutrient supply. Thirty-seven infants were evaluated with growth measurements until 2 years corrected age (CA). Metabolic markers were measured at birth and 5 months CA. Results Weight gain and head growth were different in the two groups from birth to 2 years CA (weight gain: pinteraction=0.006; head growth: pinteraction=0.002). The intervention group improved their growth z-scores after birth, whereas the control group had a pronounced decline, followed by an increase and caught up with the intervention group after discharge. At 5 months CA, adiponectin concentrations were higher in the intervention group and correlated with weight gain before term (r=0.35) and nutrient supply (0.35≤r≤0.45). Leptin concentrations correlated with weight gain after term and IGF-1 concentrations with length growth before and after term and head growth after term (0.36≤r≤0.53). Conclusion Enhanced nutrient supply improved early postnatal growth and may have prevented rapid catch-up growth later in infancy. Adiponectin concentration at 5 months CA was higher in the intervention group and correlated positively with early weight gain and nutrient supply. Early nutrition and growth may affect metabolic markers in infancy. Clinical Trial Registration (ClinicalTrials.gov) no.: NCT01103219
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Affiliation(s)
- Elin W Blakstad
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway;
| | - Sissel J Moltu
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Neonatal Intensive Care, Women and Children's Division, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Britt Nakstad
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway
| | - Marit B Veierød
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Oslo Centre of Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Kenneth Strømmen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Pétur B Júlíusson
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Astrid N Almaas
- Department of Pediatric and Adolescent Medicine, Akershus University Hospital, Lørenskog, Norway.,Institute of Clinical Medicine, Campus Ahus, University of Oslo, Oslo, Norway.,Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Arild E Rønnestad
- Department of Neonatal Intensive Care, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Kristin Brække
- Department of Neonatal Intensive Care, Women and Children's Division, Oslo University Hospital, Ullevål, Oslo, Norway
| | - Christian A Drevon
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Per O Iversen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
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Smazal AL, Kavars AB, Carlson SJ, Colaizy TT, Dagle JM. Peripherally inserted central catheters optimize nutrient intake in moderately preterm infants. Pediatr Res 2016; 80:185-9. [PMID: 27057735 DOI: 10.1038/pr.2016.73] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 02/02/2016] [Indexed: 12/25/2022]
Abstract
BACKGROUND While very preterm (<32 wk gestation) infants are routinely provided intensive nutritional support via central line, clinical practice varies for nutrient delivery in infants born moderately preterm (32-34 wk gestation). We sought to define the impact of nutritional support via peripherally inserted central catheter (PICC) on nutrient delivery in the first 2 wk of life and growth by discharge. METHODS Data were extracted from the records of 187 infants born between 32 and 34 6/7 wk gestation and admitted to the University of Iowa Children's Hospital between April 2012 and December 2013. Records of all feedings, weights, and PICC placements were collected. The growth outcomes at discharge for infants who received nutrition via PICC were compared to those who did not. RESULTS In the first week of life, newborns who received nutrition via PICC line received 17.6 more kilocalories (confidence interval (CI): 12.5-22.7, P < 0.001) and 1.2 more grams protein per kilogram body weight per day (CI: 0.9-1.4, P < 0.001) compared to control infants. By discharge, the PICC group had gained 302 g more body weight (P < 0.001). CONCLUSION This study demonstrates superior nutrient intake and growth in the first 2 wk of life for infants who received nutrition via PICC line.
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Affiliation(s)
- Anne L Smazal
- Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Anne B Kavars
- Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | - Susan J Carlson
- Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | - Tarah T Colaizy
- Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | - John M Dagle
- Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
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Suvorov A, Vandenberg LN. To Cull or Not To Cull? Considerations for Studies of Endocrine-Disrupting Chemicals. Endocrinology 2016; 157:2586-94. [PMID: 27175970 PMCID: PMC4929555 DOI: 10.1210/en.2016-1145] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The power of animal models is derived from the ability to control experimental variables so that observed effects may be unequivocally attributed to the factor that was changed. One variable that is difficult to control in animal experiments is the number and composition of offspring in a litter. To account for this variability, artificial equalization of the number of offspring in a litter (culling) is often used. The rationale for culling, however, has always been controversial. The Developmental Origins of Health and Disease concept provides a new context to evaluate the pros and cons of culling in laboratory animal studies, especially in the context of endocrine-disrupting chemicals. Emerging evidence indicates that culling, especially of large litters, can drastically change the feeding status of a pup, which can result in compensatory growth with long-term consequences for the animal, including increased risk of cardio-metabolic diseases. Similarly, culling of litters to intentionally bias sex ratios can alter the animal's behavior and physiology, with effects observed on a wide range of outcomes. Thus, in an attempt to control for variability in developmental rates, culling introduces an uncontrolled or confounding variable, which itself may affect a broad spectrum of health-related consequences. Variabilities in culling protocols could be responsible for differences in responses to endocrine-disrupting chemicals reported across studies. Because litter sex composition and size are vectors that can influence both prenatal and postnatal growth, they are essential considerations for the interpretation of results from laboratory animal studies.
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Affiliation(s)
- Alexander Suvorov
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts 01003
| | - Laura N Vandenberg
- Department of Environmental Health Sciences, School of Public Health and Health Sciences, University of Massachusetts Amherst, Amherst, Massachusetts 01003
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Cho WK, Suh BK. Catch-up growth and catch-up fat in children born small for gestational age. KOREAN JOURNAL OF PEDIATRICS 2016; 59:1-7. [PMID: 26893597 PMCID: PMC4753194 DOI: 10.3345/kjp.2016.59.1.1] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/15/2015] [Accepted: 08/20/2015] [Indexed: 12/17/2022]
Abstract
Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects.
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Affiliation(s)
- Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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El-Mazary AAM, Nasif KA, Abdel-Hakeem GL, Sherif T, Farouk E, El-Gezawy EM. Adiponectin, leptin and insulin levels at birth and in early postnatal life in neonates with hypoxic ischemic encephalopathy. J Diabetes Metab Disord 2015; 14:87. [PMID: 26629481 PMCID: PMC4666056 DOI: 10.1186/s40200-015-0219-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 11/30/2015] [Indexed: 01/05/2023]
Abstract
Background Hypoxic ischemic encephalopathy (HIE) occurs in one to three per 1000 live full-term births. Fifteen to twenty percent will die in the postnatal period, and an additional 25 % will develop severe and permanent neuropsychological sequalae. The control of growth and nutritional status in the fetus and neonate is a complex mechanism, in which also hormones produced by adipose tissue, such as adiponectin and leptin are involved. The aim of this study was to measure the levels of adiponectin, leptin and insulin in neonates with HIE at birth and in early postnatal life and comparing them with normal healthy AGA and SGA neonates Methods This study carried out on 80 full-term neonates born in Minia university hospital during the period from May 2013 to December 2014. They were divided into group I included 25 neonates with HIE and group II included 55 normal healthy neonates (30 appropriate for gestational age (AGA) and 25 small for gestational age (SGA)). Weight, length, head circumference, body mass index (BMI), glucose, adiponectin, leptin and insulin levels were measured for all neonates. Adiponectin, leptin and insulin levels were compared between neonates with HIE and normal healthy neonates as well as between AGA and SGA neonates at birth, 2nd and 6th days of life. Results Adiponectin and leptin levels were significantly higher at birth then began to decrease during the first postnatal week in all neonates while insulin level increased during the same period. Serum adiponectin levels were significantly lower while serum leptin and insulin levels were significantly higher in neonates with HIE than healthy neonates. In all neonates, the serum adiponectin level was positively correlated at birth with weight, length, BMI and leptin levels but not with insulin level. In neonates with HIE, serum adiponectin level was not correlated with weight, BMI, leptin level or insulin level. In all neonates, the serum leptin level was positively correlated at birth with body weight, height and BMI. In neonates with HIE serum leptin levels were not correlated with weight, BMI or insulin level after birth. There were no correlations between either leptin or adiponectin serum levels or any of the studied parameters in neonates with HIE Conclusions Neonates who are suffering from HIE had lower serum levels of adiponectin and higher serum levels of leptin and insulin than normal healthy neonates at birth and during the early postnatal period. The decline of leptin and increased the insulin levels after birth in all neonates may be important for the stimulation of feeding behavior and the acquisition of energy homeostasis during the early postnatal life. Positive significant correlations between adiponectin, leptin, body weight and body mass indices were present in normal healthy neonates but not in neonates with HIE reflecting the effect of hypoxia on the regulatory mechanisms controlling the adipose tissue functions.
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Affiliation(s)
| | - Khalid A Nasif
- Biochemistry Department, Faculty of Medicine, Minia University, Minya, Egypt
| | | | - Tahra Sherif
- Clinical pathology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Ebtesam Farouk
- Clinical pathology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
| | - Ebtesam M El-Gezawy
- Clinical pathology Department, Faculty of Medicine, Assuit University, Assuit, Egypt
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Villela LD, Mendes Soares FV, Abranches ADD, GOMES Junior SC, Méio MDBB, Moreira MEL. Antropometria e composição corporal de recém-nascidos pré-termo na idade gestacional e no peso equivalente ao termo. REV NUTR 2015. [DOI: 10.1590/1415-52732015000600005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJETIVO: Analisar o crescimento e a composição corporal de recém-nascidos pré-termo na idade gestacional corrigida de termo e ao alcançarem um peso entre 3,0 e 3,5 kg. MÉTODOS: Estudo longitudinal, realizado no Instituto Fernandes Figueira, Rio de Janeiro, com 39 recém-nascidos pré-termo e que apresentaram muito baixo peso ao nascer. Medidas antropométricas e água corporal total foram avaliadas no primeiro, no sétimo e no dia da recuperação do peso de nascimento, na idade gestacional corrigida do termo e em torno de três semanas de idade gestacional corrigida (correspondente ao tempo de vida para alcançar um peso entre 3,0 e 3,5 kg). O grupo de referência foi constituído por 32 recém-nascidos a termo, adequados para a idade gestacional, avaliados no segundo dia de vida. Considerou-se restrição de crescimento o escore-Z menor do que -2 para peso, comprimento e perímetro cefálico. RESULTADOS: Na idade de termo, 71,8% dos recém-nascidos pré-termo apresentaram restrição do crescimento para peso, 61,5% para comprimento e 25,6% para perímetro cefálico. Com três semanas de idade gestacional corrigida, esses recém-nascidos apresentaram a prega cutânea tricipital e a circunferência abdominal estatisticamente maiores que o grupo de referência enquanto o comprimento e a porcentagem de água corporal total foram menores. CONCLUSÃO: Os recém-nascidos pré-termo apresentaram perfil antropométrico e de água corporal diferente dos recém--nascidos a termo, sugerindo acúmulo de gordura. Houve recuperação do crescimento entre a idade de termo e três semanas de idade corrigida, sendo mais evidente esse crescimento em relação ao perímetro cefálico e peso.
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Hansen-Pupp I, Hellgren G, Hård AL, Smith L, Hellström A, Löfqvist C. Early Surge in Circulatory Adiponectin Is Associated With Improved Growth at Near Term in Very Preterm Infants. J Clin Endocrinol Metab 2015; 100:2380-7. [PMID: 25825949 DOI: 10.1210/jc.2015-1081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
CONTEXT Adiponectin enhances insulin sensitivity and may play a role in fetal and postnatal growth. OBJECTIVE This study aimed to determine whether early postnatal adiponectin concentration change is related to postnatal growth in very preterm infants. SETTING, DESIGN, AND PATIENTS This was an in-hospital, prospective, longitudinal cohort study of 52 preterm infants with a gestational age (GA) of 26.0 ± 1.9 (SD) weeks and birth weight (BW) of 889 ± 284 g. INTERVENTIONS An analysis of adiponectin was performed on cord blood at birth and peripheral blood at 72 hours, day 7, and then weekly until postmenstrual age (PMA) 40 weeks. Weight, length, and head circumference (HC) measurement was performed weekly and SD scores (SDS) calculated. Energy and protein intake was calculated daily from birth until PMA 35 weeks. RESULTS Mean adiponectin concentration increased from 6.8 ± 4.4 μg/mL at 72 hours to 37.4 ± 22.2 μg/mL at 3 weeks; during days 3-21, it was 21.4 ± 12 μg/mL and correlated with GA at birth (r = 0.46, P = .001; BW: r = 0.71, P < .001; BW(SDS): r = 0.42, P = .003). Furthermore, mean adiponectin during days 3-21 correlated with weight(SDS), length(SDS), and HC(SDS) (r = 0.62, 0.65, and 0.62, respectively; all P < .001) at PMA 35 wk). Energy intake (kcal/kg/d) correlated with mean adiponectin during days 3-21 (r = 0.35, P < .013). CONCLUSIONS In very preterm infants, adiponectin concentrations increased markedly in the first 3 weeks, and a greater increase was associated with improved postnatal growth.
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Affiliation(s)
- Ingrid Hansen-Pupp
- Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Gunnel Hellgren
- Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Anna-Lena Hård
- Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Lois Smith
- Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Ann Hellström
- Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
| | - Chatarina Löfqvist
- Department of Pediatrics (I.H.P.), Institute of Clinical Sciences Lund, Lund University and Skane University Hospital, 221 85 Lund, Sweden; Department of Pediatrics, Institute of Clinical Sciences (G.H.), and Department of Ophthalmology, Institute of Neuroscience and Physiology (A.L.H., A.H., C.L.), The Sahlgrenska Academy at University of Gothenburg, 416 85 Gothenburg, Sweden; and Department of Ophthalmology (L.S.), Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts 02115
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Green BB, Armstrong DA, Lesseur C, Paquette AG, Guerin DJ, Kwan LE, Marsit CJ. The Role of Placental 11-Beta Hydroxysteroid Dehydrogenase Type 1 and Type 2 Methylation on Gene Expression and Infant Birth Weight. Biol Reprod 2015; 92:149. [PMID: 25788665 DOI: 10.1095/biolreprod.115.128066] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2015] [Accepted: 03/17/2015] [Indexed: 12/16/2022] Open
Abstract
Maternal stress has been linked to infant birth weight outcomes, which itself may be associated with health later in life. The placenta acts as a master regulator for the fetal environment, mediating intrauterine exposures to stress through the activity of genes regulating glucocorticoids, including the 11beta-hydroxysteroid dehydrogenase (HSD11B) type 1 and 2 genes, and so we hypothesized that variation in these genes will be associated with infant birth weight. We investigated DNA methylation levels at six sites across the two genes, as well as mRNA expression for each, and the relationship to infant birth weight. Logistic regressions correcting for potential confounding factors revealed a significant association between methylation at a single CpG site within HSD11B1 and being born large for gestational age. In addition, our analysis identified correlations between methylation and gene expression, including sex-specific transcriptional regulation of HSD11B2. Our work is one of the first comprehensive views of DNA methylation and expression in the placenta for both HSD11B types 1 and 2, linking epigenetic alterations with the regulation of fetal stress and birth weight outcomes.
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Affiliation(s)
- Benjamin B Green
- Departments of Pharmacology and Toxicology and of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - David A Armstrong
- Departments of Pharmacology and Toxicology and of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Corina Lesseur
- Departments of Pharmacology and Toxicology and of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Alison G Paquette
- Departments of Pharmacology and Toxicology and of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Dylan J Guerin
- Departments of Pharmacology and Toxicology and of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Lauren E Kwan
- Departments of Pharmacology and Toxicology and of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
| | - Carmen J Marsit
- Departments of Pharmacology and Toxicology and of Epidemiology, Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire
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