Reduced foetal growth and growth hormone secretion in adult life

Maternal high protein-diet programs impairment of offspring's bone mass through miR-24-1-5p mediated targeting of SMAD5 in osteoblasts

Maternal nutrition is crucial for the offspring's skeleton development and the onset of osteoporosis later in life. While maternal low protein diet has been shown to regulate bone mass negatively, the effect of a high protein diet (HP) remains unexplored. Here, we found that C57BL/6 mice fed with HP delivered offspring with decreased skeletal mineralization at birth and reduced bone mass throughout their life due to a decline in their osteoblast maturation. A small RNA sequencing study revealed that miR-24-1-5p was highly upregulated in HP group osteoblasts. Target prediction and validation studies identified SMAD-5 as a direct target of miR-24-1-5p. Furthermore, mimic and inhibitor studies showed a negative correlation between miR-24-1-5p expression and osteoblast function. Moreover, ex vivo inhibition of miR-24-1-5p reversed the reduced maturation and SMAD-5 expression in the HP group osteoblasts. Together, we show that maternal HP diminishes the bone mass of the offspring through miR-24-1-5p.

Metabolic Syndrome in Adolescence

Background—

There are well-established predisposing factors for the development of metabolic syndrome (MetS) in childhood or adolescence, but no specific risk profile has been identified as yet. The Prediction of Metabolic Syndrome in Adolescence (PREMA) study was conducted (1) to construct a classification score that could detect children at high risk for MetS in adolescence and (2) to test its predictive accuracy.

Methods and Results—

In the derivation cohort (1270 children), data from natal and parental profile and from initial laboratory assessment at 6 to 8 years of age were used to detect independent predictors of MetS at 13 to 15 years of age according to the International Diabetes Federation definition. In the validation cohort (1091 adolescents), the discriminatory capacity of the derived prediction score was tested on an independent adolescent population. MetS was diagnosed in 105 adolescents in the derivation phase (8%), whereas birth weight <10th percentile (odds ratio, 6.02; 95% confidence interval, 2.53–10.12, P <0.001), birth head circumference <10th percentile (odds ratio, 4.15; 95% confidence interval, 2.04–7.14, P <0.001), and parental overweight or obesity (in at least 1 parent; odds ratio, 3.22; 95% confidence interval, 1.30–5.29, P <0.01) were independently associated with diagnosis of MetS in adolescence. Among adolescents in the validation cohort (86 [8%] with MetS), the presence of all these 3 predictors predicted MetS with a sensitivity of 91% and a specificity of 98%.

Conclusions—

The coexistence of low birth weight, small head circumference, and parental history of overweight or obesity may be useful for detection of children at risk of developing MetS in adolescence.

Maternal undernutrition and endocrine development

Maternal undernutrition, whether it occurs before conception, throughout gestation or during lactation, may lead to physiological adaptations in the fetus that will affect the health of the offspring in adult life. The timing, severity, duration and nature of the maternal nutritional insult may affect the offspring differently. Other factors determining outcome following maternal undernutrition are fetal number and gender. Importantly, effects of maternal undernutrition may be carried over into subsequent generations. This review examines the endocrine pathways disrupted by maternal undernutrition that affect the long-term postnatal health of the offspring. Maternal and childhood undernutrition are highly prevalent in low- and middle-income countries, and, in developed countries, unintentional undernutrition may arise from maternal dieting. It is, therefore, important that we better understand the mechanisms driving the long-term effects of maternal undernutrition, as well as identifying treatments to ameliorate the associated mortality and morbidity.

Does low birth weight predict obesity/overweight and metabolic syndrome in elementary school children?

BACKGROUND

We undertook this study to explore the relationship between birth weight (BW) and childhood overweight and obesity (OW/OB) and metabolic syndrome (MS).

METHODS

This was a cross-sectional assessment performed in 10 elementary public schools in Buenos Aires, Argentina. Participants were 1027 students aged 9.4 +/- 2.1 years. No interventions were done. We measured the association between BW in children and OW/OB and MS at 9 years of age.

RESULTS

Of the total number of children, 164 (16.0%) were OB (BMI >95(th) percentile) and 169 (16.5%) were OW [(body mass index (BMI) > or =85(th), <95(th) percentile); 61% were at Tanner 1. All students came from low socioeconomic families. The prevalence of low (< or =2500 g), normal, and high BW (> or =4000 g) was 7.0% (n = 72), 83.7% (n = 860), and 9.3% (n = 95), respectively. MS prevalence was 5.5%. There was a significant difference in mean BMI sd score (SDS) between low BW (0.07), normal BW (0.54) and high BW (0.99). There was a significant difference in mean BMI, BMI SDS, waist circumference (WC), WC SDS, and systolic blood pressure between low, normal, and high BW groups. In separate logistic regression models, low BW proved to be a protective factor against OW/OB [OR 0.32 (95% CI 0.16-0.63)], whereas high BW was associated with a higher OW/OB risk adjusted for age and sex [OR 2.48 (95% CI 1.62-3.81)]. The risk of MS was high for those with high BW [OR 3.16 (95% CI 1.38-7.24)] and not significant for those with low BW adjusted for age and sex.

CONCLUSIONS

Our data indicate that low BW is not associated with OW/OB or with MS in children, whereas high BW correlates with childhood OW/OB and MS.

Influence of primiparity on size at birth, growth, the somatotrophic axis and fertility in dairy heifers

Epidemiological studies in humans suggest that small size at birth is a predictor of some adult diseases. Nutritional constraint experienced in utero may result in fetal adaptations, which alter subsequent body structure and physiology. Size at birth is influenced by maternal age and parity. Most dairy cows are bred for the first time at about 60% of their mature body weight and therefore carry their first pregnancy whilst still growing. We hypothesized that this might alter the nutritional environment in utero and thus influence the development of the calf. This study compared birth size, growth rates and fertility in consecutively born heifer offspring of 45 primiparous (PP) and 71 multiparous (MP) dairy cows on one farm. Measures of the somatotrophic axis (GH, insulin, IGF-I and glucose) were compared in blood samples collected at the start of the first lactation. Offspring of PP cows were significantly smaller at birth (weight, length, height, girth, P<0.01) than those born to MP dams. The ponderal index (weight/height(3)) was similar, showing that growth restriction was proportional. These differences were no longer apparent at 3 months, indicative of early catch up growth. The PP offspring conceived more rapidly during their first service period as nulliparous heifers (P<0.02). They experienced a greater weight loss postpartum (P<0.002) and had lower concentrations of IGF-I and insulin following their first calving (P<0.05). Fertility in the first lactation was, however, similar between the two groups. We conclude that having a primiparous dam resulted in a smaller size at birth and influenced the somatotrophic axis around calving. Fertility was generally better in offspring of PP than MP dams.

Malnutrition during lactation changes growth hormone mRNA expression in offspring at weaning and in adulthood

Mothers' nutrition during lactation programs growth in their offspring. We studied the contribution of the growth hormone (GH) for this programming, evaluating GH mRNA expression. Lactating dams were grouped as follows: C, control diet with 23% protein; PR, 8% protein-restricted diet; and ER, energy-restricted diet, receiving the control diet in restricted quantities of the PR group's ingestion. Some pups were killed at weaning; the others received the control diet until they were sacrificed as adults. Pituitary GH mRNA was analyzed by Northern blot analysis. At weaning, the ER and PR animals had lower GH mRNA levels (-29% and -18%, respectively) and lower length as well as body weight. Ninety-day-old PR offspring showed a lower body length (-5%), whereas ER offspring showed a higher one (+5%); however, at 180 days, the lengths were not different. Both 90- and 180-day-old animals showed body weight differences against control animals, with PR offspring showing a lower (-10%) and ER offspring showing a higher (+12%) body weight. GH mRNA was higher in ER offspring at 90 and 180 days (+19% and +22%, respectively); it was lower in PR offspring at 90 and 180 days (-19% and -17%, respectively). Thus, we showed a direct relation between GH mRNA expression and length as well as body weight. We suggest that malnutrition during lactation may program GH mRNA expression patterns in adulthood and that these changes could be responsible for differences in growth patterns.

Gender differences in the insulin-like growth factor axis response to a glucose load

AIMS

The insulin-like growth factors (IGFs) are thought to contribute to glucose homeostasis. The aim of our study was to examine the response of the IGFs and their binding proteins to an intravenous load of glucose in a cohort of young men and women with normal glucose tolerance.

METHODS

The intravenous glucose tolerance test (IVGTT) was used to quantify insulin sensitivity and insulin secretion in 160 adults aged 20-21 years in Adelaide, Australia. Serum IGF-I, IGF-II, IGF-binding protein (IGFBP)-1 and IGFBP-3 were measured during the IVGTT.

RESULTS

Women were less insulin sensitive than men with higher fasting insulin (women 55.6 +/- 4.4, men 44.1 +/- 3.6 pmol L(-1), P = 0.001) and first phase insulin secretion (women 3490 +/- 286, men 3038 +/- 271 pmol L(-1) min, P = 0.042). Women showed lower fasting free IGF-I (women 0.29 +/- 0.02, men 0.36 +/- 0.02 mug L(-1), P = 0.004) but higher IGFBP-3 (women 46.3 +/- 0.53, men 43.3 +/- 0.58 mg dL(-1), P = 0.001) and higher IGFBP-1 concentrations (women 37.0 +/- 2.9, men 24.8 +/- 2.3 mug L(-1), P = 0.012). IGFBP-1 fell by 5 min and remained suppressed. IGFBP-3 and total IGF-I fell until 60 min rising again by 2 h. IGF and IGFBP values were all higher in women. IGFBP-1 showed a negative association with fasting and stimulated insulin concentrations in both genders. First phase insulin secretion however showed positive correlations with IGFBP-3 (r = 0.321, P = 0.004) and IGF-I (r = 0.339 P = 0.002) in men but not women.

CONCLUSION

Our data show that IGFBP-1, IGFBP-3 and IGF-I show acute changes following a glucose load and there are marked gender differences in these responses.

Do Birth Variable Data Predict Melatonin Production in 8- to 9-Year-Old Children? Analysis of Excreted 6-Sulfatoxymelatonin

HYPOTHESES

A cross-sectional study on urinary excretion of 6-sulfatoxymelatonin (aMT.6S) in young adults suggests a relation between melatonin production and body size at birth. As individual melatonin production remains stable during childhood and adolescence, this melatonin-birth size relation should also exist in children.

METHODS

Daily urinary output of aMT.6S of 147 healthy white children (78 boys, 69 girls), 8 or 9 years of age, was quantified by ELISA and related to birth variable data.

RESULTS

Contrary to expectation, aMT.6S output was not related to the ponderal index at birth but a moderate positive association with body mass index at the age of 8-9 years was seen.

CONCLUSION

This study in children contradicts previous findings in adults. As no obvious reason can be identified for this discrepancy, further research (particularly a longitudinal study) is recommended to clarify whether birth variable data may predict melatonin production in certain circumstances during or after puberty.

Low birth size and final height predict high sympathetic nerve activity in adulthood

OBJECTIVE

Being born small for gestational age (SGA) is associated with insulin resistance, hypertension and increased cardiovascular morbidity/mortality in adulthood. Sympathetic nerve hyperactivity is a well-known risk factor for cardiovascular disease mortality and is proposed to link insulin resistance with hypertension. The objective of this study was to test the hypothesis that sympathetic nerve activity is altered in individuals born SGA.

DESIGN

A cross-sectional, comparative study of 20 healthy adults (21-25 years old) born SGA (birth weight < -2SD score for healthy newborns) with normal and short stature, and 12 age, gender and body mass index matched individuals, born appropriate for gestational age (AGA) with normal stature.

METHODS

Direct recordings of resting sympathetic nerve activity to the muscle vascular bed (MSA) were obtained from the peroneal nerve posterior to the fibular head. Heart rate, respiration and blood pressure were recorded during the microneurographic session.

RESULTS

MSA was increased in both groups of young adults born SGA as compared to those born AGA (P < 0.05 and P < 0.005, respectively). In the combined study group MSA was inversely correlated to birth weight, length (r = -0.59, P < 0.001 and r = -0.69, P < 0.0005, respectively) and final adult height (r = -0.58; P < 0.001).

CONCLUSIONS

Being born SGA and achieving a short final height is associated with increased sympathetic nerve traffic. We suggest that the increase in sympathetic nerve traffic in young adults born SGA with normal and short stature may be the link between low birth size, hypertension and cardiovascular morbidity later in life.

Serum insulin-like growth factor-I concentrations in late middle age: no association with birthweight in three UK cohorts

BACKGROUND

Small body size at birth and during infancy is associated with an increased risk of adult osteoporosis and cardiovascular disease. Fetal programming of the growth hormone-insulin-like growth factor (GH-IGF) axis may provide a mechanism for these epidemiological findings.

AIMS

To determine whether measurements of GH and IGF-I in late middle age were related to size at birth and in infancy.

METHODS

Overnight urinary GH excretion and fasting serum IGF-I were measured in 309 men and 193 women from Hertfordshire (born 1920-1930) for whom birthweight and weight at 1 year were recorded. Serum IGF-I was measured in men and women from Preston (n=254, born 1935-1943) and Sheffield (n=215, born 1939-1940) whose birthweight and other birth measurements were recorded.

RESULTS

Urinary GH and serum IGF-I were not related to birthweight, other measurements at birth, or weight at 1 year.

CONCLUSION

In contrast to previous studies in children or young adults, these data do not support the hypothesis that IGF-I concentrations are programmed by intra-uterine events, as assessed by birthweight, in late middle age.

An investigation of fetal, postnatal and childhood growth with insulin-like growth factor I and binding protein 3 in adulthood

OBJECTIVE

Weight at birth and adult height are positively associated with cancer risk. These patterns may be mediated by the insulin-like growth factor (IGF) axis. We have examined whether pre- and postnatal growth patterns have a long-term influence on adult IGF-I and IGFBP-3 levels.

DESIGN

A follow-up study of a randomized controlled trial of milk supplementation in pregnancy and childhood.

SUBJECTS

A total of 951 individuals took part in a study of diet and growth in South Wales between 1972 and 1974 followed up from birth until their mid-20s.

MEASUREMENTS

Anthopometric measures at birth, postnatally up to 5 years of age and in adulthood, and serum measures of IGF-I and IGF-I to IGFBP-3 ratio at mean age of 25 years.

RESULTS

A total of 63 subjects (70%) provided blood for analysis. We found no association between birth dimensions and adult IGF-I. Subjects who exhibited 'catch-down growth' had lower IGF-I levels (P-value for trend 0.02). Adult height was positively related to IGF-I, for every one standard deviation increase in adult height, IGF-I increased by 3.75 ng/dl (95% CI 0.46-7.08, P = 0.03). Adiposity was inversely associated with the IGF-I and IGF-I to IGFBP-3 ratio and positively associated with IGFBP-3. The strength of the associations increased with age. Downward centile crossing at any time in childhood was associated with lower IGF-I whilst the highest levels were observed in subjects who were tall throughout their early life course. Adult height remained a significant predictor of IGF-I even after adjustment for earlier growth.

CONCLUSIONS

Our results indicate that IGF-I levels in early adulthood are associated with patterns of childhood growth as well as adult stature and adiposity. These associations suggest the IGFs may contribute to anthropometric associations with cancer risk.

Fetal origins of obesity

The worldwide epidemic of obesity continues unabated. Obesity is notoriously difficult to treat, and, thus, prevention is critical. A new paradigm for prevention, which evolved from the notion that environmental factors in utero may influence lifelong health, has emerged in recent years. A large number of epidemiological studies have demonstrated a direct relationship between birth weight and BMI attained in later life. Although the data are limited by lack of information on potential confounders, these associations seem robust. Possible mechanisms include lasting changes in proportions of fat and lean body mass, central nervous system appetite control, and pancreatic structure and function. Additionally, lower birth weight seems to be associated with later risk for central obesity, which also confers increased cardiovascular risk. This association may be mediated through changes in the hypothalamic pituitary axis, insulin secretion and sensing, and vascular responsiveness. The combination of lower birth weight and higher attained BMI is most strongly associated with later disease risk. We are faced with the seeming paradox of increased adiposity at both ends of the birth weight spectrum-higher BMI with higher birth weight and increased central obesity with lower birth weight. Future research on molecular genetics, intrauterine growth, growth trajectories after birth, and relationships of fat and lean mass will elucidate relationships between early life experiences and later body proportions. Prevention of obesity starting in childhood is critical and can have lifelong, perhaps multigenerational, impact.

Neonatal bone mass: influence of parental birthweight, maternal smoking, body composition, and activity during pregnancy

Evidence is accumulating that intrauterine growth and development may influence an individual's risk of osteoporosis in later adult life. To examine maternal and paternal influences on intrauterine skeletal growth, we used dual-energy X-ray absorptiometry to measure the neonatal bone mineral content (BMC) and bone mineral density (BMD) of 145 infants born at term. Independently of the infant's duration of gestation at birth, the birthweights of both parents and the height of the father were positively correlated with neonatal whole body BMC. Women who smoked during pregnancy had infants with a lower whole body BMC and BMD; overall, there was a 7.1-g (11%) average difference between whole body BMC of infants whose mothers did and did not smoke during pregnancy (p = 0.005). Women with thinner triceps skinfold thicknesses (reflecting lower fat stores) and those who reported a faster walking pace and more frequent vigorous activity in late pregnancy also tended to have infants with a lower BMC and BMD (p values for BMC; 0.02, 0.03, and 0.05, respectively). Maternal thinness and faster walking pace but not maternal smoking or parental birthweight also were associated with lower bone mineral apparent density (BMAD). The influences on skeletal growth and mineralization were independent of placental weight, a marker of the placental capacity to deliver nutrients to the fetus. These observations point to a combination of genetic and intrauterine environmental influences on prenatal skeletal development and suggest that environmental modulation, even at this early stage of life, may reduce the risk of osteoporosis in adulthood.

Programming other hormones that affect insulin

The metabolic syndrome is associated with a marked increase in risk of type 2 diabetes and atherosclerotic vascular disease (AVD). The mechanism responsible for the metabolic syndrome is uncertain, but recent evidence suggests that a combination of low birth weight and adult obesity is associated with a markedly increased prevalence. Insulin resistance is the cardinal feature of the metabolic syndrome. Several hormones, have modes of action that either potentiate or reduce the biological actions of insulin and, therefore, attenuate or induce insulin resistance. Since insulin action may be modified, these hormones potentially contribute to the pathogenesis of the metabolic syndrome. The purpose of this review is to discuss programming of hormones that modulate insulin action. The review focuses on two major endocrine pathways: (i) glucocorticoid hormone action; and (ii) the growth hormone (GH)-insulin-like growth factor (IGF-1) axis, and discusses mechanisms linking abnormal activity of these pathways with reduced early growth, adult obesity and the metabolic syndrome.