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Page L, Younge N, Freemark M. Hormonal Determinants of Growth and Weight Gain in the Human Fetus and Preterm Infant. Nutrients 2023; 15:4041. [PMID: 37764824 PMCID: PMC10537367 DOI: 10.3390/nu15184041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/13/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
The factors controlling linear growth and weight gain in the human fetus and newborn infant are poorly understood. We review here the changes in linear growth, weight gain, lean body mass, and fat mass during mid- and late gestation and the early postnatal period in the context of changes in the secretion and action of maternal, placental, fetal, and neonatal hormones, growth factors, and adipocytokines. We assess the effects of hormonal determinants on placental nutrient delivery and the impact of preterm delivery on hormone expression and postnatal growth and metabolic function. We then discuss the effects of various maternal disorders and nutritional and pharmacologic interventions on fetal and perinatal hormone and growth factor production, growth, and fat deposition and consider important unresolved questions in the field.
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Affiliation(s)
- Laura Page
- Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Noelle Younge
- Neonatology, Duke University Medical Center, Durham, NC 27710, USA;
| | - Michael Freemark
- Division of Pediatric Endocrinology, Duke University Medical Center, Durham, NC 27710, USA;
- The Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC 27710, USA
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Shi Y, Wang CC, Wu L, Zhang Y, Xu A, Wang Y. Pathophysiological Insight into Fatty Acid-Binding Protein-4: Multifaced Roles in Reproduction, Pregnancy, and Offspring Health. Int J Mol Sci 2023; 24:12655. [PMID: 37628833 PMCID: PMC10454382 DOI: 10.3390/ijms241612655] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
Fatty acid-binding protein-4 (FABP4), commonly known as adipocyte-fatty acid-binding protein (A-FABP), is a pleiotropic adipokine that broadly affects immunity and metabolism. It has been increasingly recognized that FABP4 dysfunction is associated with various metabolic syndromes, including obesity, diabetes, cardiovascular diseases, and metabolic inflammation. However, its explicit roles within the context of women's reproduction and pregnancy remain to be investigated. In this review, we collate recent studies probing the influence of FABP4 on female reproduction, pregnancy, and even fetal health. Elevated circulating FABP4 levels have been found to correlate with impaired reproductive function in women, such as polycystic ovary syndrome and endometriosis. Throughout pregnancy, FABP4 affects maternal-fetal interface homeostasis by affecting both glycolipid metabolism and immune tolerance, leading to adverse pregnancy outcomes, including miscarriage, gestational obesity, gestational diabetes, and preeclampsia. Moreover, maternal FABP4 levels exhibit a substantial linkage with the metabolic health of offspring. Herein, we discuss the emerging significance and potential application of FABP4 in reproduction and pregnancy health and delve into its underlying mechanism at molecular levels.
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Affiliation(s)
- Yue Shi
- The Second Clinical Medical School, Beijing University of Chinese Medicine, Beijing 100078, China; (Y.S.); (Y.Z.)
| | - Chi-Chiu Wang
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong;
- Li Ka Shing Institute of Health Sciences, School of Biomedical Sciences, Chinese University of Hong Kong-Sichuan University Joint Laboratory in Reproductive Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Liqun Wu
- Department of Pediatrics, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China;
| | - Yunqing Zhang
- The Second Clinical Medical School, Beijing University of Chinese Medicine, Beijing 100078, China; (Y.S.); (Y.Z.)
| | - Aimin Xu
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong;
- Department of Medicine, The University of Hong Kong, Hong Kong
| | - Yao Wang
- Department of Obstetrics and Gynaecology, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong;
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Liu X, Zheng T, Tao MY, Huang R, Zhang GH, Yang MN, Xu YJ, Wang WJ, He H, Fang F, Dong Y, Fan JG, Zhang J, Ouyang F, Li F, Luo ZC. Cord blood fatty acid binding protein 4 and lipids in infants born small- or large-for-gestational-age. Front Pediatr 2023; 11:1078048. [PMID: 37274820 PMCID: PMC10237290 DOI: 10.3389/fped.2023.1078048] [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: 10/24/2022] [Accepted: 04/28/2023] [Indexed: 06/07/2023] Open
Abstract
Aim Adverse (poor or excessive) fetal growth "programs" an elevated risk of type 2 diabetes. Fatty acid binding protein 4 (FABP4) has been implicated in regulating insulin sensitivity and lipid metabolism relevant to fetal growth. We sought to determine whether FABP4 is associated with poor or excessive fetal growth and fetal lipids. Methods In a nested case-control study in the Shanghai Birth Cohort including 60 trios of small-for-gestational-age (SGA, an indicator of poor fetal growth), large-for-gestational-age (LGA, an indicator of excessive fetal growth) and optimal-for-gestational-age (OGA, control) infants, we measured cord blood concentrations of FABP4 and lipids [high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterols, triglycerides (TG)]. Results Adjusting for maternal and neonatal characteristics, higher cord blood FABP4 concentrations were associated with a lower odds of SGA [OR = 0.29 (0.11-0.77) per log unit increment in FABP4, P = 0.01], but were not associated with LGA (P = 0.46). Cord blood FABP4 was positively correlated with both LDL (r = 0.29, P = 0.025) and HDL (r = 0.33, P = 0.01) in LGA infants only. Conclusion FABP4 was inversely associated with the risk of SGA. The study is the first to demonstrate LGA-specific positive correlations of cord blood FABP4 with HDL and LDL cholesterols, suggesting a role of FABP4 in fetal lipid metabolism in subjects with excessive fetal growth.
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Affiliation(s)
- Xin Liu
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Tao Zheng
- Department of Obstetrics and Gynecology, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Min-Yi Tao
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Rong Huang
- Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Guang-Hui Zhang
- Department of Clinical Assay Laboratory, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Meng-Nan Yang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Ya-Jie Xu
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Wen-Juan Wang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Clinical Skills Center, School of Clinical Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Hua He
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Fang Fang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Yu Dong
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Jian-Gao Fan
- Center for Fatty Liver, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Department of Gastroenterology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Fengxiu Ouyang
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Fei Li
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
| | - Zhong-Cheng Luo
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, Early Life Health Institute, and Department of Pediatrics, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai, China
- Lunenfeld-Tanenbaum Research Institute, Prosserman Centre for Population Health Research, Department of Obstetrics and Gynecology, Mount Sinai Hospital, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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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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Bommarito PA, Welch BM, Keil AP, Baker GP, Cantonwine DE, McElrath TF, Ferguson KK. Prenatal exposure to consumer product chemical mixtures and size for gestational age at delivery. Environ Health 2021; 20:68. [PMID: 34112176 PMCID: PMC8194159 DOI: 10.1186/s12940-021-00724-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 03/19/2021] [Indexed: 05/04/2023]
Abstract
BACKGROUND While fetal growth is a tightly regulated process, it is sensitive to environmental exposures that occur during pregnancy. Many commonly used consumer products contain chemicals that can disturb processes underlying fetal growth. However, mixtures of these chemicals have been minimally examined. We investigated associations between prenatal exposure to 33 consumer product chemicals (nine organophosphate ester flame retardant [OPE] metabolites, 12 phthalate metabolites, and 12 phenols) and the odds of small- or large-for-gestational age (SGA and LGA) births. METHODS This case-control study was comprised of SGA (N = 31), LGA (N = 28), and appropriate for gestational age control (N = 31) births selected from the larger LIFECODES cohort. Biomarkers of exposure to consumer product chemicals were quantified in maternal urine collected from up to three study visits during pregnancy. In a single-pollutant approach, odds ratios (OR) and 95% confidence intervals (CI) of SGA and LGA associated with an interquartile range (IQR)-increase in exposure biomarkers were estimated using multinomial logistic regression. In a multi-pollutant approach, quantile g-computation was used to jointly estimate the OR (95% CI) of SGA and LGA per simultaneous one quartile-change in all biomarkers belonging to each chemical class. RESULTS Among the 33 biomarkers analyzed, 20 were detected in at least 50% of the participants. After adjusting for potential confounders, we observed reduced odds of LGA in association with higher urinary concentrations of several exposure biomarkers. For example, an IQR-increase in the OPE metabolite, diphenyl phosphate, was associated with lower odds of LGA (OR: 0.40 [95% CI: 0.18, 0.87]). Using quantile g-computation, we estimated lower odds of an LGA birth for higher OPE metabolite concentrations (OR: 0.49 [95% CI: 0.27, 0.89]) and phthalate metabolite concentrations (OR: 0.23 [95% CI: 0.07, 0.73]). Associations between consumer product chemicals and SGA were largely null. CONCLUSIONS Joint exposure to OPEs and phthalates was associated with lower odds of delivering LGA. Associations with LGA could indicate a specific impact of these exposures on the high end of the birth weight spectrum. Future work to understand this nuance in the associations between consumer product chemical mixtures and fetal growth is warranted.
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Affiliation(s)
- P. A. Bommarito
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Durham, NC 27709 USA
| | - B. M. Welch
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Durham, NC 27709 USA
| | - A. P. Keil
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Durham, NC 27709 USA
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive, Chapel Hill, NC 27599 USA
| | - G. P. Baker
- NSF International, 789 N. Dixboro Road, Ann Arbor, MI 48105 USA
| | - D. E. Cantonwine
- Division of Maternal-Fetal Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - T. F. McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis Street, Boston, MA 02115 USA
| | - K. K. Ferguson
- Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, 111 T.W. Alexander Drive, Durham, NC 27709 USA
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Vidarsdottir H, Thorkelsson T, Halldorsson TI, Bjarnason R, Geirsson RT, Rinaldo P, Franzson L. Does metabolomic profile differ with regard to birth weight? Pediatr Res 2021; 89:1144-1151. [PMID: 32599610 DOI: 10.1038/s41390-020-1033-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Macrosomia and child obesity are growing health-care issues worldwide. The purpose of the study was to evaluate how extremely high or low birth weight affects metabolic markers evaluated in newborn screening. METHODS The study was register-based and included full-term singletons born in Iceland from 2009 to 2012 with newborn screening samples taken 72-96 h after birth. Three groups based on birth weight were compared: low birth weight (<2500 g), appropriate-for-gestational age, and extreme macrosomia (≥5000 g). The comparison was adjusted for possible confounding factors. RESULTS Compared to appropriate-for-gestational age neonates, both low birth weight and extreme macrosomia were associated with higher levels of glutamic acid. The amino acids alanine and threonine were increased in low birth weight neonates. Free carnitine and some medium- and long-chain acylcarnitines were higher in low birth weight infants. Hydroxybutyrylcarnitine was lower in low birth weight infants, but higher in extremely macrosomic neonates. Acetylcarnitine was higher in low birth weight and extremely macrosomic neonates. Succinylcarnitine was lower and hexadecenoylcarnitine higher in macrosomic newborns. CONCLUSION Low birth weight and extremely macrosomic neonates show distinctive differences in their metabolomic profile compared to appropriate-for-gestational age newborns. The differences are not explained by gestational age. IMPACT The key message of this article is that both low birth weight and extremely macrosomic newborns show dissimilar metabolomic profiles compared to appropriate-for-gestational age neonates. The article contributes to knowledge on what affects evaluation of results in newborn screening. The impact of this article is to provide information on metabolism at both ends of the birth weight range after accounting for confounding factors including gestational age.
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Affiliation(s)
- Harpa Vidarsdottir
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Astrid Lindgren Children´s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Thordur Thorkelsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Children's Medical Center, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Ragnar Bjarnason
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Children's Medical Center, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Reynir Tomas Geirsson
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland.,Women's Clinic, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland
| | - Piero Rinaldo
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Leifur Franzson
- Faculty of Pharmaceutical Sciences, School of Health Science, Univeristy of Iceland, Reykjavik, Iceland. .,Department of Genetics and Molecular Medicine, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.
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Lyons-Reid J, Albert BB, Kenealy T, Cutfield WS. Birth Size and Rapid Infant Weight Gain-Where Does the Obesity Risk Lie? J Pediatr 2021; 230:238-243. [PMID: 33157072 DOI: 10.1016/j.jpeds.2020.10.078] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 10/28/2020] [Accepted: 10/30/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Jaz Lyons-Reid
- Liggins Institute, The University of Aucklan, Auckland, New Zealand
| | | | - Timothy Kenealy
- Liggins Institute, The University of Aucklan, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, The University of Aucklan, Auckland, New Zealand; A Better Start - National Science Challenge, Auckland, New Zealand.
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Satokar VV, Cutfield WS, Derraik JGB, Harwood M, Okasene-Gafa K, Beck K, Cameron-Smith D, O'Sullivan JM, Sundborn G, Pundir S, Mason RP, Albert BB. Double-blind RCT of fish oil supplementation in pregnancy and lactation to improve the metabolic health in children of mothers with overweight or obesity during pregnancy: study protocol. BMJ Open 2020; 10:e041015. [PMID: 33323442 PMCID: PMC7745511 DOI: 10.1136/bmjopen-2020-041015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Maternal obesity during pregnancy is associated with adverse changes in body composition and metabolism in the offspring. We hypothesise that supplementation during pregnancy of overweight and obese women may help prevent the development of greater adiposity and metabolic dysfunction in children. Previous clinical trials investigating fish oil supplementation in pregnancy on metabolic outcomes and body composition of the children have not focused on the pregnancies of overweight or obese women. METHODS AND ANALYSIS A double-blind randomised controlled trial of fish oil (providing 3 g/day of n-3 polyunsaturated fatty acids) versus an equal volume of olive oil (control) taken daily from recruitment until birth, and in breastfeeding mothers, further continued for 3 months post partum. Eligible women will have a singleton pregnancy at 12-20 weeks' gestation and be aged 18-40 years with body mass index ≥25 kg/m2 at baseline. We aim to recruit a minimum of 128 participants to be randomised 1:1. Clinical assessments will be performed at baseline and 30 weeks of pregnancy, including anthropometric measurements, fasting metabolic markers, measures of anxiety, physical activity, quality of life and dietary intake. Subsequent assessments will be performed when the infant is 2 weeks, 3 months and 12 months of age for anthropometry, body composition (dual-energy X-ray absorptiometry (DXA)) and blood sampling. The primary outcome of the study is a between-group difference in infant percentage body fatness, assessed by DXA, at 2 weeks of age. Secondary outcomes will include differences in anthropometric measures at each time point, percentage body fat at 3 and 12 months and homeostatic model assessment of insulin resistance at 3 months. Statistical analysis will be carried out on the principle of intention to treat. ETHICS AND DISSEMINATION This trial was approved by the Northern A Health and Disabilities Ethics Committee, New Zealand Ministry of Health (17/NTA/154). Results will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER ACTRN12617001078347p; Pre-results.
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Affiliation(s)
- Vidit V Satokar
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Endocrinology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Matire Harwood
- National Hauora Coalition, Auckland, New Zealand
- Te Kupenga Hauora Māori Teaching, University of Auckland, Auckland, New Zealand
| | - Karaponi Okasene-Gafa
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
| | - Kathryn Beck
- School of Sport Exercise and Nutrition, Massey University, Auckland, New Zealand
| | - David Cameron-Smith
- Liggins Institute, University of Auckland, Auckland, New Zealand
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore
| | | | - Gerhard Sundborn
- Department of Pacific Health, University of Auckland, Auckland, New Zealand
| | - Shikha Pundir
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - R Preston Mason
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Benjamin B Albert
- Liggins Institute, University of Auckland, Auckland, New Zealand
- A Better Start - National Science Challenge, University of Auckland, Auckland, New Zealand
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Papathanasiou AE, Briana DD, Gavrili S, Georgantzi S, Papathoma E, Marmarinos A, Christou C, Voulgaris K, Gourgiotis D, Malamitsi‐Puchner A. Cord blood fatty acid-binding protein-4 levels are upregulated at both ends of the birthweight spectrum. Acta Paediatr 2019; 108:2083-2088. [PMID: 31025416 DOI: 10.1111/apa.14826] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 04/13/2019] [Accepted: 04/23/2019] [Indexed: 01/17/2023]
Abstract
AIM Fatty acid-binding protein-4 (FABP4) is an adipokine associated with obesity and signs of the metabolic syndrome. We aimed to investigate at birth in term neonates with normal and abnormal intrauterine growth concentrations of FABP4 and associate them with various perinatal parameters. METHODS Serum cord blood FABP4 levels were prospectively determined by ELISA in 80 singleton term appropriate-for-gestational-age (AGA), intrauterine growth-restricted (IUGR) and large-for-gestational-age (LGA) neonates. RESULTS Compared to the AGA group, cord blood FABP4 levels were increased in the IUGR and LGA groups. Additionally, they were higher in early-term than full-term neonates. A significant U-shaped correlation was recorded between serum FABP4 levels and birthweight. A significant negative correlation between cord blood FABP4 and gestational age in the whole study population was noted. CONCLUSION Cord blood FABP4 levels were significantly higher at the extremes of foetal growth at term and negatively correlated with gestational age, being increased in early-term versus full-term neonates. Further longitudinal studies with larger sample sizes are required to elucidate FABP4 implication in foetal growth and its association with future adverse cardiometabolic outcomes in the offspring.
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Affiliation(s)
| | - Despina D. Briana
- Medical School National and Kapodistrian University of Athens Athens Greece
| | - Stavroula Gavrili
- Neonatal Intensive Care Unit ‘Alexandra’ University and State Maternity Hospital Athens Greece
| | - Sophia Georgantzi
- Neonatal Intensive Care Unit ‘Alexandra’ University and State Maternity Hospital Athens Greece
| | - Evangelia Papathoma
- Neonatal Intensive Care Unit ‘Alexandra’ University and State Maternity Hospital Athens Greece
| | - Antonios Marmarinos
- Laboratory of Clinical Biochemistry‐Molecular Diagnostics 2nd Department of Pediatrics National and Kapodistrian University of Athens Athens Greece
| | | | | | - Dimitrios Gourgiotis
- Laboratory of Clinical Biochemistry‐Molecular Diagnostics 2nd Department of Pediatrics National and Kapodistrian University of Athens Athens Greece
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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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11
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Logan KM, Gale C, Hyde MJ, Santhakumaran S, Modi N. Diabetes in pregnancy and infant adiposity: systematic review and meta-analysis. Arch Dis Child Fetal Neonatal Ed 2017; 102:F65-F72. [PMID: 27231266 PMCID: PMC5256410 DOI: 10.1136/archdischild-2015-309750] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 04/01/2016] [Accepted: 04/25/2016] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Maternal glycaemia and anthropometry-derived newborn adiposity are strongly correlated. The children of mothers with diabetes are at greater risk of adverse metabolic health, and increased adiposity is a plausible mediator. We undertook a systematic review and meta-analysis to compare adiposity in infants of diabetic mothers (IDM) and infants of mothers without diabetes (NIDM). DESIGN We identified observational studies reporting adiposity in IDM and NIDM. We searched references, traced forward citations and contacted authors for additional data. We considered all body composition techniques and compared fat mass, fat-free mass, body fat % and skinfold thickness. We used random effects meta-analyses and performed subgroup analyses by maternal diabetes type (type 1, type 2 and gestational) and infant sex. We examined the influence of pre-pregnancy body mass index (BMI) and conducted sensitivity analyses. RESULTS We included data from 35 papers and over 24 000 infants. IDM have greater fat mass than NIDM (mean difference (95% CI)): 83 g (49 to 117). Fat mass is greater in infants of mothers with gestational diabetes: 62 g (29 to 94) and type 1 diabetes: 268 g (139 to 397). Insufficient studies reported data for type 2 diabetes separately. Compared with NIDM, fat mass was greater in IDM boys: 87 g (30 to 145), but not significantly different in IDM girls: 42 g (-33 to 116). There was no attenuation after adjustment for maternal BMI. CONCLUSIONS IDM have significantly greater adiposity in comparison with NIDM. These findings are justification for studies to determine whether measures to reduce infant adiposity will improve later health.
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Affiliation(s)
- Karen M Logan
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK
| | - Chris Gale
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK
| | - Matthew J Hyde
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK
| | - Shalini Santhakumaran
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK
| | - Neena Modi
- Section of Neonatal Medicine, Chelsea and Westminster Hospital Campus, Imperial College London, London, UK
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12
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de Zegher F, Pérez-Cruz M, Sebastiani G, Díaz M, López-Bermejo A, Ibáñez L. Large for Gestational Age Newborns from Mothers Without Diabetes Mellitus Tend to Become Tall and Lean Toddlers. J Pediatr 2016; 178:278-280. [PMID: 27637280 DOI: 10.1016/j.jpeds.2016.08.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2016] [Revised: 07/05/2016] [Accepted: 08/10/2016] [Indexed: 12/27/2022]
Abstract
A longitudinal study with dual x-ray absorptiometry disclosed that infants born large for gestational age from mothers without diabetes mellitus and without excessive gestational weight gain tend to be long with increased adipose tissue as newborns and tall and lean as toddlers.
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Affiliation(s)
- Francis de Zegher
- Department of Development & Regeneration, University of Leuven, Leuven, Belgium
| | - Miriam Pérez-Cruz
- Obstetrics/Gynecology, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain
| | - Giorgia Sebastiani
- Endocrinology, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain
| | - Marta Díaz
- Endocrinology, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain
| | | | - Lourdes Ibáñez
- Endocrinology, Hospital Sant Joan de Déu, University of Barcelona, Esplugues, Barcelona, Spain.
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13
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Chiavaroli V, Derraik JGB, Hofman PL, Cutfield WS. Born Large for Gestational Age: Bigger Is Not Always Better. J Pediatr 2016; 170:307-11. [PMID: 26707580 DOI: 10.1016/j.jpeds.2015.11.043] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 10/27/2015] [Accepted: 11/13/2015] [Indexed: 12/22/2022]
Affiliation(s)
| | - José G B Derraik
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand.
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White V, Jawerbaum A, Mazzucco MB, Gauster M, Desoye G, Hiden U. Diabetes-associated changes in the fetal insulin/insulin-like growth factor system are organ specific in rats. Pediatr Res 2015; 77:48-55. [PMID: 25268143 DOI: 10.1038/pr.2014.139] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2013] [Accepted: 06/23/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Diabetes in pregnancy affects fetal growth and development. The insulin/insulin-like growth factors (IGF) system comprising insulin, IGF, their receptors, and binding proteins, has been implicated in fetal growth regulation. This study tested the hypothesis that maternal diabetes alters the fetal insulin/IGF system in a tissue-specific manner. METHODS Wistar rats were rendered diabetic by neonatal administration of streptozotocin and mated with control rats. At day 21 of gestation, the weights of fetuses, placentas, and fetal organs (heart, lung, liver, stomach, intestine, and pancreas) were determined. Maternal and fetal plasma concentrations of insulin, IGF1, and IGF2 were measured by ELISA, and expression of IGF1, IGF2, IGF1R, IGF2R, IR, IGFBP1, BP2, and BP3 in placenta and fetal organs by qPCR. RESULTS The well-known increase in fetal growth in this model of mild diabetes is accompanied by elevated insulin and IGF1 levels and alterations of the insulin/IGF system in the fetus and the placenta. These alterations were organ and gene specific. The insulin/IGF system was generally upregulated, especially in the fetal heart, while it was downregulated in fetal lung. CONCLUSION In our model of mild diabetes, the effect of maternal diabetes on fetal weight and fetal insulin/IGF system expression is organ specific with highly sensitive organs such as lung and heart, and organs that were less affected, such as stomach.
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Affiliation(s)
- Verónica White
- Laboratory of Reproduction and Metabolism, Center for Pharmacological and Botanical Studies, CEFyBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Alicia Jawerbaum
- Laboratory of Reproduction and Metabolism, Center for Pharmacological and Botanical Studies, CEFyBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - María B Mazzucco
- Laboratory of Reproduction and Metabolism, Center for Pharmacological and Botanical Studies, CEFyBO-CONICET, School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Martin Gauster
- Institute of Cell Biology, Histology and Embryology, Medical University of Graz, Graz, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Ursula Hiden
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
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Chawla R, Badon SE, Rangarajan J, Reisetter AC, Armstrong LL, Lowe LP, Urbanek M, Metzger BE, Hayes MG, Scholtens DM, Lowe WL. Genetic risk score for prediction of newborn adiposity and large-for-gestational-age birth. J Clin Endocrinol Metab 2014; 99:E2377-86. [PMID: 25137420 PMCID: PMC4223445 DOI: 10.1210/jc.2013-4221] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT Macrosomic infants are at increased risk for adverse metabolic outcomes. Improving prediction of large-for-gestational-age (LGA) birth may help prevent these outcomes. OBJECTIVE This study sought to determine whether genes associated with obesity-related traits in adults are associated with newborn size, and whether a genetic risk score (GRS) predicts LGA birth. SETTING AND DESIGN Single nucleotide polymorphisms (SNPs) in 40 regions associated with adult obesity-related traits were tested for association with newborn size. GRS's for birth weight and sum of skinfolds (SSF) specific to ancestry were calculated using the most highly associated SNP for each ancestry in genomic regions with one or more SNPs associated with birth weight and/or SSF in at least one ancestry group or meta-analyses. PARTICIPANTS Newborns from the Hyperglycemia Adverse Pregnancy Outcomes Study were studied (942 Afro-Caribbean, 1294 Northern European, 573 Mexican-American, and 1182 Thai). OUTCOME MEASURES Birth weight >90th percentile (LGA) and newborn SSF >90th percentile were primary outcomes. RESULTS After adjustment for ancestry, sex, gestational age at delivery, parity, maternal genotype, maternal smoking/alcohol intake, age, body mass index, height, blood pressure and glucose, 25 and 23 SNPs were associated (P < .001) with birth weight and newborn SSF, respectively. The GRS was highly associated with both phenotypes as continuous variables across all ancestries (P ≤ 1.6 × 10(-19)) and improved prediction of birth weight and SSF >90th percentile when added to a baseline model incorporating the covariates listed above. CONCLUSIONS A GRS comprised of SNPs associated with adult obesity-related traits may provide an approach for predicting LGA birth and newborn adiposity beyond established risk factors.
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Josefson JL, Zeiss DM, Rademaker AW, Metzger BE. Maternal leptin predicts adiposity of the neonate. Horm Res Paediatr 2014; 81:13-9. [PMID: 24334975 PMCID: PMC4123455 DOI: 10.1159/000355387] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 08/30/2013] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Increased adiposity at birth may identify infants at high risk of developing obesity. Maternal obesity and hyperglycemia in pregnancy are associated with increased neonatal adiposity; however, features of maternal obesity that contribute to increased neonatal adiposity need further study. AIMS To measure adiposity in neonates of obese and normal-weight women without gestational diabetes to test the hypothesis that obese women have neonates with increased adiposity compared to neonates of normal-weight women. METHODS Sixty-one pregnant women, with a normal or obese BMI, and their neonates participated in this cross-sectional study at an academic medical center. Neonatal adiposity, expressed as percent body fat (fat mass/body mass), was measured by air displacement plethysmography and cord blood was assayed for biomarkers. RESULTS Adiposity in neonates of obese and normal-weight mothers did not differ. Stratifying mothers by leptin level showed that neonates born to mothers with higher leptin had significantly higher adiposity (13.2 vs. 11.1%, p = 0.035). In the entire cohort, adiposity positively correlated with cord blood leptin (r = 0.48, p < 0.001) and adiponectin (r = 0.27, p = 0.04) levels. CONCLUSION Obesity in normoglycemic pregnant women was not associated with increased neonatal adiposity. High maternal leptin levels identified neonates with increased adiposity.
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Affiliation(s)
- Jami L. Josefson
- Division of Endocrinology, Ann & Robert H. Lurie Children’s Hospital of Chicago,Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Ill., USA
| | - Dinah M. Zeiss
- Northwestern Comprehensive Center on Obesity, Northwestern University Feinberg School of Medicine, Chicago, Ill., USA
| | - Alfred W. Rademaker
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., USA
| | - Boyd E. Metzger
- Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Ill., USA
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Çetin C, Uçar A, Bas F, Poyrazoğlu Ş, Bundak R, Saka N, Özden T, Darendeliler F. Are metabolic syndrome antecedents in prepubertal children associated with being born idiopathic large for gestational age? Pediatr Diabetes 2013; 14:585-92. [PMID: 23627262 DOI: 10.1111/pedi.12041] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2013] [Revised: 03/07/2013] [Accepted: 03/26/2013] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Being born large for gestational age (LGA) is a risk factor for development of metabolic syndrome (MS) in adolescents and adults. OBJECTIVE To evaluate prepubertal children born idiopathic LGA to non-obese mothers without gestational diabetes or glucosuria with respect to the presence of MS antecedents. PATIENTS AND METHODS We conducted a cross-sectional study to compare 40 (19 F) LGA-born prepubertal children of a mean age of 6.1 ± 2.5 yr and 49 (25 F) appropriate for gestational age (AGA)-born body mass index (BMI)-matched peers of a mean age of 5.4 ± 1.8 yr with respect to their anthropometric data, blood pressure measurements, fasting serum glucose and insulin levels, homeostasis model assessment-insulin resistance (HOMA-IR), and lipids and atherogenic index (AI) [triglyceride (TG)/high-density lipoprotein cholesterol (HDL-C)]. HOMA-IR > 2.5 was used to define IR. HDL-C ≤ 40 mg/dL and TG ≥ 110 mg/dL were used to define dyslipidemia. Both groups were further divided into subgroups as obese and non-obese according to their BMI percentiles and the analyses were repeated. RESULTS Non-obese LGA children had higher waist circumference (WC) standard deviation scores (SDSs) than BMI-matched AGA-born peers (p = 0.024). There were no significant differences between pooled, obese and non-obese subgroups of LGA-born children and their AGA counterparts with respect to dyslipidemia and IR. AI was higher in non-obese LGA children than in AGA counterparts (p = 0.028). CONCLUSIONS Non-obese idiopathic LGA-born children have higher AIs than AGA-born counterparts in the absence of IR. WC seems to be a good clinical screening tool in identifying at risk of non-obese LGA children. Further studies are needed to evaluate MS antecedents in idiopathic LGA-born children.
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Affiliation(s)
- Ceren Çetin
- Paediatric Endocrinology and Diabetes Unit, Istanbul Faculty of Medicine, Istanbul University, İstanbul, Turkey
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18
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Tuersunjiang N, Odhiambo JF, Long NM, Shasa DR, Nathanielsz PW, Ford SP. Diet reduction to requirements in obese/overfed ewes from early gestation prevents glucose/insulin dysregulation and returns fetal adiposity and organ development to control levels. Am J Physiol Endocrinol Metab 2013; 305:E868-78. [PMID: 23921140 PMCID: PMC3798706 DOI: 10.1152/ajpendo.00117.2013] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Obesity at conception and excess gestational weight gain pose significant risks for adverse health consequences in human offspring. This study evaluated the effects of reducing dietary intake of obese/overfed ewes beginning in early gestation on fetal development. Sixty days prior to conception, ewes were assigned to a control diet [CON: 100% of National Research Council (NRC) recommendations], a diet inducing maternal obesity (MO: 150% of NRC recommendations), or a maternal obesity intervention diet (MOI: 150% of NRC recommendations to day 28 of gestation, then 100% NRC) until necropsy at midgestation (day 75) or late (day 135) gestation. Fetal size and weight, as well as fetal organ weights, were greater (P < 0.05) at midgestation in MO ewes than those of CON and MOI ewes. By late gestation, whereas fetal size and weight did not differ among dietary groups, cardiac ventricular weights and wall thicknesses as well as liver and perirenal fat weights remained elevated in fetuses from MO ewes compared with those from CON and MOI ewes. MO ewes and fetuses exhibited elevated (P < 0.05) plasma concentrations of triglycerides, cholesterol, insulin, glucose, and cortisol at midgestation compared with CON and MOI ewes and fetuses. In late gestation, whereas plasma triglycerides and cholesterol, insulin, and cortisol remained elevated in MO vs. CON and MOI ewes and fetuses, glucose concentrations were elevated in both MO and MOI fetuses compared with CON fetuses, which was associated with elevated placental GLUT3 expression in both groups. These data are consistent with the concept that reducing maternal diet of obese/overfed ewes to requirements from early gestation can prevent subsequent alterations in fetal growth, adiposity, and glucose/insulin dynamics.
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Affiliation(s)
- Nuermaimaiti Tuersunjiang
- Center for the Study of Fetal Programming, Department of Animal Science, University of Wyoming, Laramie, Wyoming
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Ford SP, Tuersunjiang N. Maternal obesity: how big an impact does it have on offspring prenatally and during postnatal life? Expert Rev Endocrinol Metab 2013; 8:261-273. [PMID: 30780813 DOI: 10.1586/eem.13.14] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Obesity is increasing at an epidemic rate in women of reproductive age. Not only does obesity during pregnancy lead to increased maternal health concerns, it is also linked to an increase in adiposity and components of the metabolic syndrome in the children and grandchildren of obese women. The potential transgenerational impact of maternal obesity on the health of future generations will undoubtedly result in increasing healthcare costs for society. This review will describe what is known about the specific impacts of maternal obesity on offspring in the human population as well as discuss how controlled animal experiments have shed light on the specific physiological mechanisms involved. Furthermore, preliminary experiments are presented describing potential dietary methods for preventing obesity-induced programming of offspring health concerns in postnatal life.
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Affiliation(s)
- Stephen P Ford
- b Department of Animal Science, Center for the Study of Fetal Programming, University of Wyoming, Laramie, WY 82071, USA.
| | - Nuermaimaiti Tuersunjiang
- a Department of Animal Science, Center for the Study of Fetal Programming, University of Wyoming, Laramie, WY 82071, USA
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20
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Devlin MJ, Grasemann C, Cloutier AM, Louis L, Alm C, Palmert MR, Bouxsein ML. Maternal perinatal diet induces developmental programming of bone architecture. J Endocrinol 2013; 217:69-81. [PMID: 23503967 PMCID: PMC3792707 DOI: 10.1530/joe-12-0403] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Maternal high-fat (HF) diet can alter offspring metabolism via perinatal developmental programming. This study tests the hypothesis that maternal HF diet also induces perinatal programming of offspring bone mass and strength. We compared skeletal acquisition in pups from C57Bl/6J mice fed HF or normal diet from preconception through lactation. Three-week-old male and female pups from HF (HF-N) and normal mothers (N-N) were weaned onto normal diet. Outcomes at 14 and 26 weeks of age included body mass, body composition, whole-body bone mineral content (WBBMC) via peripheral dual-energy X-ray absorptiometry, femoral cortical and trabecular architecture via microcomputed tomography, and glucose tolerance. Female HF-N had normal body mass and glucose tolerance, with lower body fat (%) but higher serum leptin at 14 weeks vs. N-N (P<0.05 for both). WBBMC was 12% lower at 14 weeks and 5% lower at 26 weeks, but trabecular bone volume fraction was 20% higher at 14 weeks in female HF-N vs. N-N (P<0.05 for all). Male HF-N had normal body mass and mildly impaired glucose tolerance, with lower body fat (%) at 14 weeks and lower serum leptin at 26 weeks vs. N-N (P<0.05 for both). Serum insulin was higher at 14 weeks and lower at 26 weeks in HF-N vs. N-N (P<0.05). Trabecular BV/TV was 34% higher and cortical bone area was 6% higher at 14 weeks vs. N-N (P<0.05 for both). These data suggest that maternal HF diet has complex effects on offspring bone, supporting the hypothesis that maternal diet alters postnatal skeletal homeostasis.
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Affiliation(s)
- M J Devlin
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.
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21
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Gill SV, May-Benson TA, Teasdale A, Munsell EG. Birth and developmental correlates of birth weight in a sample of children with potential sensory processing disorder. BMC Pediatr 2013; 13:29. [PMID: 23442948 PMCID: PMC3598529 DOI: 10.1186/1471-2431-13-29] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2012] [Accepted: 01/09/2013] [Indexed: 11/26/2022] Open
Abstract
Background Most research examining birth history (i.e. related birth complications) and developmental milestone achievement follow outcomes for infants at-risk with very specific birth weight categories and gestational age classifications. The purpose of this study was to examine how birth weight relates to infants’ birth histories and developmental milestone achievement when they fall into a variety of birth weight and gestational age categories. Methods In the current study, we examined birth histories and onset ages for developmental milestones by analyzing a convenience sample of anonymous existing data from 663 developmental histories completed by parents at the time of an initial evaluation at a pediatric outpatient occupational therapy clinic. Infants fell into 3 birth weight categories; low birth weight (LBW), normal birth weight (NBW), and high birth weight (HBW) and 3 gestational age classifications considered with birth weight; small for gestational age (SGA), appropriate for gestational age (AGA), and large for gestational age (LGA). Results NBW, AGA, and SGA infants with related birth complications had lower birth weights than infants without birth complications. Larger birth weights were associated with earlier ages for independent sitting for HBW infants, earlier ages for eating solids for NBW infants, and earlier walking onsets for LBW and NBW infants. Higher birth weights were also linked with rolling at a younger age for LGA infants, earlier walking and speaking words for AGA infants, and sooner independent sitting for SGA and AGA infants. Conclusions Our findings suggest that birth weight and gestational age categories provide unique insights into infants’ birth history and developmental milestone achievement.
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Affiliation(s)
- Simone V Gill
- Department of Occupational Therapy, Boston University, College of Health and Rehabilitation Sciences: Sargent College, 635 Commonwealth Avenue, Boston 02215, MA, USA.
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Rugholm S, Baker JL, Olsen LW, Schack-Nielsen L, Bua J, Sørensen TIA. Stability of the Association between Birth Weight and Childhood Overweight during the Development of the Obesity Epidemic. ACTA ACUST UNITED AC 2012; 13:2187-94. [PMID: 16421354 DOI: 10.1038/oby.2005.271] [Citation(s) in RCA: 98] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To assess whether changes in the birth weight distribution or changes in the association of birth weight with the later risk of childhood overweight have contributed to the development of the obesity epidemic. RESEARCH METHODS AND PROCEDURES A Danish population-based cohort study of 124,615 girls and 128,346 boys (ages 6 to 13 years), born between 1936 and 1983, were studied. Birth weight and annual measurements of height and weight were obtained from school health records. Overweight was defined by BMI in relation to internationally accepted criteria. The relative risk of being overweight by birth weight was calculated separately for each age, sex, and time period. RESULTS The birth weight distribution remained relatively stable over time. Compared with children with a birth weight of 3.0 to 3.5 kg, the risk of overweight increased consistently with each increase in birth weight category among girls and boys and at all ages between 6 and 13 years. Furthermore, the association between birth weight and increased risk of overweight in childhood remained stable across a 48-year period. DISCUSSION The increase in the prevalence of overweight could not be explained by time trends in the distribution of birth weight or by changes in the association between birth weight and the later risk of overweight over time. This implies that, unless the prenatal environment influences the later risk of overweight without increasing birth weight, the environmental influences contributing to the obesity epidemic in children of school age operate in the early postnatal period.
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Affiliation(s)
- Susi Rugholm
- Danish Epidemiology Science Centre, Institute of Preventive Medicine, Kommunehospitalet, Copenhagen, Denmark
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Devlin MJ, Bouxsein ML. Influence of pre- and peri-natal nutrition on skeletal acquisition and maintenance. Bone 2012; 50:444-51. [PMID: 21723972 PMCID: PMC3210869 DOI: 10.1016/j.bone.2011.06.019] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2011] [Revised: 05/30/2011] [Accepted: 06/15/2011] [Indexed: 11/29/2022]
Abstract
Early life nutrition has substantial influences on postnatal health, with both under- and overnutrition linked with permanent metabolic changes that alter reproductive and immune function and significantly increase metabolic disease risk in offspring. Since perinatal nutrition depends in part on maternal metabolic condition, maternal diet during gestation and lactation is a risk factor for adult metabolic disease. Such developmental responses may be adaptive, but might also result from constraints on, or pathological changes to, normal physiology. The rising prevalence of both obesity and osteoporosis, and the identification of links among bone, fat, brain, and gut, suggest that obesity and osteoporosis may be related, and moreover that their roots may lie in early life. Here we focus on evidence for how maternal diet during gestation and lactation affects metabolism and skeletal acquisition in humans and in animal models. We consider the effects of overall caloric restriction, and macronutrient imbalances including high fat, high sucrose, and low protein, compared to normal diet. We then discuss potential mechanisms underlying the skeletal responses, including perinatal developmental programming via disruption of the perinatal leptin surge and/or epigenetic changes, to highlight unanswered questions and identify the most critical areas for future research.
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Affiliation(s)
- M J Devlin
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA 02215, USA.
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Kuipers RS, Luxwolda MF, Offringa PJ, Martini IA, Boersma ER, Dijck-Brouwer DAJ, Muskiet FAJ. Gestational age dependent content, composition and intrauterine accretion rates of fatty acids in fetal white adipose tissue. Prostaglandins Leukot Essent Fatty Acids 2012; 86:39-49. [PMID: 22093549 DOI: 10.1016/j.plefa.2011.10.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 10/09/2011] [Accepted: 10/13/2011] [Indexed: 10/15/2022]
Abstract
BACKGROUND Little is known about the gestational age (GA) dependent content, composition and intrauterine accretion rates of fatty acids (FA) in fetal white adipose tissue (WAT). OBJECTIVE & DESIGN To acquire this information, we collected abdominal subcutaneous WAT samples from 40 preterm and term fetuses. Their GA ranged from 22 to 43 weeks. FA were expressed as mg/g wet WAT and g/100g FA (g%). Intrauterine WAT FA accretion rates were estimated for appropriate (AGA) and large (LGA) for gestational age infants. RESULTS From 25 to 40 weeks gestation, saturated-FA (SAFA) increased from 83 to 298 mg/g WAT and monounsaturated-FA (MUFA) from 83 to 226 mg/g WAT, while polyunsaturated-FA (PUFA) increased insignificantly from 18.0 to 23.2 mg/g WAT. As percentages of total FA, SAFA increased from 46 to 55 g%, MUFA decreased from 44 to 41 g%, and PUFA from 10.3 to 4.26 g%. Docosahexaenoic (DHA) and arachidonic acid (AA) accretion rates in WAT during the 3rd trimester for AGA infants were 88 and 193 mg/week, respectively. Contemporaneous DHA and AA accretion rates for 4500 g LGA infants were 184 and 402 mg/week, respectively. Compared to the whole 3rd trimester, increment rates during the last 5 weeks of gestation were about 2-fold higher. CONCLUSION FA accretion rates, notably those of DHA and AA, may be important for designing nutritional regiments for preterm infants. The current WAT-DHA and WAT-AA accretion rates are considerably lower than previously reported in the literature.
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Affiliation(s)
- Remko S Kuipers
- Pathology and Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands.
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Kuipers RS, Luxwolda MF, Offringa PJ, Boersma ER, Dijck-Brouwer DAJ, Muskiet FAJ. Fetal intrauterine whole body linoleic, arachidonic and docosahexaenoic acid contents and accretion rates. Prostaglandins Leukot Essent Fatty Acids 2012; 86:13-20. [PMID: 22115845 DOI: 10.1016/j.plefa.2011.10.012] [Citation(s) in RCA: 95] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2011] [Revised: 10/24/2011] [Accepted: 10/25/2011] [Indexed: 11/29/2022]
Abstract
INTRODUCTION There is no information on the whole body fatty acid (FA) contents of preterm or term infants, although scattered information on the FA-composition of many organs is available. MATERIAL AND METHODS We collected data on the weights, lipid contents and FA-compositions of the quantitatively most important fetal organs of appropriate for gestational age (AGA) Western infants. From these we estimated the total body contents of linoleic (LA), arachidonic (AA) and docosahexaenoic (DHA) acids at 25, 35 and 40 weeks of gestation. RESULTS Western infants accrete FA in the order of LA>AA>DHA at all stages during pregnancy and the highest accretion rates are reached in the last 5 weeks of gestation, i.e. 342 mg LA, 95 mg AA and 42 mg DHA/day. At term, most of the infant's LA, AA and DHA is located in adipose tissue (68, 44 and 50%, respectively), with substantial amounts of LA also located in skeletal muscle (17%) and skin (13%); of AA in skeletal muscle (40%) and brain (11%); and of DHA in brain (23%) and skeletal muscle (21%). The term AGA infant has accreted about 21 g LA, 7.5 g AA and 3 g DHA, which constitutes a gap of 12 g LA, 3.3 g AA and 1.5 g DHA compared to a 35 weeks old AGA infant. CONCLUSION The current fetal LA, AA and DHA pool sizes and accretion rates may especially be useful to estimate the preterm infant's requirements and the maternal LCP needs during pregnancy. Since they derive from populations with typically Western diets they do not necessarily reflect 'optimality' or 'health'.
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Affiliation(s)
- Remko S Kuipers
- Laboratory Medicine, University Medical Center Groningen, Groningen, The Netherlands.
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Bajaj M, Koo W, Hammami M, Hockman EM. Effect of subcutaneous fat on quantitative bone ultrasound in chicken and neonates. Pediatr Res 2010; 68:81-3. [PMID: 20357694 DOI: 10.1203/pdr.0b013e3181df9c8c] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Bone quantitative ultrasound generated speed of sound (SOS) is a marker of bone strength. However, critical evaluation of its validity for use in small bones is extremely limited, and SOS data may not be consistent with data obtained from dual energy x ray absorptiometry, another marker of bone strength. We report the SOS values pre and postinjection of s.c. fat using a chicken bone model; and in large for gestation and appropriate for gestation neonates to determine the influence of s.c. fat. Average SOS were lowered for the chicken bones postfat injection by 36 m/s (CS probe) and 58 m/s (CR probe), and in large for gestation group by 75 m/s (CS probe) and 51 m/s (CR probe) (p = 0.03-0.004 paired t test) although SOS measurements from each probe are significantly correlated within the large (r = 0.78) and appropriate (r = 0.83) for gestation group. Failed SOS measurements occurred significantly more frequently in the postinjection studies regardless of the probe used in the chicken bone model and for the CS probe in large for gestation neonates. The lowered bone quantitative ultrasound measurements in large for gestation neonates is likely a measurement artifact from increased s.c. fat.
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Affiliation(s)
- Monika Bajaj
- Carman and Ann Adams Department of Pediatrics, Wayne State University; and Hutzel Women's Hospital, Detroit, Michigan 48201, USA
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Abstract
Obesity prevalence is generally higher in women than in men, and there is also a sex difference in body fat distribution. Sex differences in obesity can be explained in part by the influence of gonadal steroids on body composition and appetite; however, behavioural, socio-cultural and chromosomal factors may also play a role. This review, which evolved from the 2008 Stock Conference on sex differences in obesity, summarizes current research and recommendations related to hormonal and neuroendocrine influences on energy balance and fat distribution. A number of important gaps in the research are identified, including a need for more studies on chromosomal sex effects on energy balance, the role of socio-cultural (i.e. gender) factors in obesity and the potential deleterious effects of high-fat diets during pregnancy on the foetus. Furthermore, there is a paucity of clinical trials examining sex-specific approaches and outcomes of obesity treatment (lifestyle-based or pharmacological), and research is urgently needed to determine whether current weight loss programmes, largely developed and tested on women, are appropriate for men. Last, it is important that both animal and clinical research on obesity be designed and analysed in such a way that data can be separately examined in both men and women.
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Affiliation(s)
- J C Lovejoy
- Free and Clear Inc., 999 Third Avenue, Seattle, WA 98104, USA.
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Ahlsson FSE, Diderholm B, Ewald U, Gustafsson J. Lipolysis and insulin sensitivity at birth in infants who are large for gestational age. Pediatrics 2007; 120:958-65. [PMID: 17974732 DOI: 10.1542/peds.2007-0165] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE In addition to neonatal hypoglycemia, infants who are born large for gestational age are at risk for developing obesity, cardiovascular disease, and diabetes later in life. The aim of this study was to investigate glucose production, lipolysis, and insulin sensitivity in infants who were born large for gestational age to mothers without diabetes. The effect of glucagon administration on production of energy substrates was also investigated. METHODS Ten healthy term infants who were born large for gestational age to mothers without diabetes were studied 16 +/- 8 hours postnatally after a 3-hour fast. Rates of glucose production and lipolysis were analyzed by gas chromatography-mass spectrometry following constant rate infusion of [6,6-(2)H2]glucose and [2-(13)C]glycerol. Insulin sensitivity was assessed by the Homeostasis Assessment Model. In 8 of the infants, the effect of an intravenous injection of 0.2 mg/kg glucagon was also analyzed. RESULTS Plasma glucose and glycerol averaged 3.8 +/- 0.5 mmol/L and 384 +/- 183 micromol/L, respectively. The glycerol production rate, reflecting lipolysis, was 12.7 +/- 2.9 micromol/kg per min. Mean rate of glucose production was 30.2 +/- 4.6 micromol/kg per min. Homeostasis Assessment Model insulin sensitivity corresponded to 82% +/- 19%, beta-cell function to 221% +/- 73%, and insulin resistance to 1.3 +/- 0.3. After glucagon administration, rate of glucose production increased by 13.3 +/- 8.3 micromol/kg per min and blood glucose by 1.4 +/- 0.5 mmol/L. Glycerol production decreased from 12.8 +/- 3.0 to 10.7 +/- 2.9 micromol/kg per min. Mean insulin concentration increased from 10.9 +/- 3.0 to 30.9 +/- 10.3 mU/L. There was a strong inverse correlation between the decrease in lipolysis and increase in insulin after glucagon administration. CONCLUSIONS Infants who are born large for gestational age show increased lipolysis and a propensity for decreased insulin sensitivity already at birth. The simultaneous increase in plasma insulin correlated strongly with the noted decrease in lipolysis, indicating an antilipolytic effect of insulin in these infants.
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Affiliation(s)
- Fredrik S E Ahlsson
- Department of Women's and Children's Health, Uppsala University, University Children's Hospital, SE-751 85 Uppsala, Sweden.
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Schmelzle HR, Quang DN, Fusch G, Fusch C. Birth weight categorization according to gestational age does not reflect percentage body fat in term and preterm newborns. Eur J Pediatr 2007; 166:161-7. [PMID: 16912899 DOI: 10.1007/s00431-006-0209-x] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2006] [Revised: 05/26/2006] [Accepted: 05/30/2006] [Indexed: 10/24/2022]
Abstract
This study was performed to prove the applicability of the small-for-gestational age (SGA), appropriate-for-gestational age (AGA), and large-for-gestational age (LGA) classification depending on birth weight to predict percentage body fat (%BF) measured by dual-energy X-ray absorptiometry (DXA) in term and preterm infants. The data of 159 healthy term and preterm neonates (87 boys and 72 girls) with a gestational age at delivery of 38.4 weeks from two longitudinal studies were analyzed. Anthropometry and body composition data were assessed within the first 10 days after birth. Correlations between anthropometric parameters and fat mass measured by DXA were calculated. Prevalences of observations with low, middle, and high %BF measured by DXA were compared between SGA, AGA, and LGA groups, according to sex and gestational age. In term infants, 42.9% of the newborns with less than 10% body fat were classified to be AGA; 9.9% of all AGA newborns had less than 10% body fat. For the whole group, among the ratios investigated, the weight-length ratio (r=0.82) showed the best correlation to fat mass measured by DXA. The %BF at the time of study was higher in girls (14.75%) than in boys (11.95%). In conclusion, traditional classification based on birth weight centiles does not reflect %BF in term and preterm newborns.
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Affiliation(s)
- Hansjörg Rudolf Schmelzle
- Department of Neonatology, Ernst-Moritz-Arndt-University, Children's Hospital, Soldmannstrasse 15, 17475 Greifswald, Germany
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Abstract
A better understanding of the nutritional needs of both healthy and sick infants is important. Not only does too much or too little nutrition during early life have long-term effects on health, but periods of rapid growth during the first year of life also have long-term consequences. Knowledge of the changes in body composition in early life can help to better define nutritional needs at these ages. Several methods are available for measuring body composition of neonates and infants. Most focus on an assessment of either body fatness or bone mineralization; only a few can monitor the quality of the non-fat lean tissues. This paper provides an evaluation of the different approaches currently available to monitor infant body composition, identifying both their strengths and limitations.
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Affiliation(s)
- Kenneth J Ellis
- Baylor College of Medicine, USDA/ARS Children's Nutrition Research Center, 1100 Bates St, Houston, TX 77030, USA.
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Rogers IS, Ness AR, Steer CD, Wells JCK, Emmett PM, Reilly JR, Tobias J, Smith GD. Associations of size at birth and dual-energy X-ray absorptiometry measures of lean and fat mass at 9 to 10 y of age. Am J Clin Nutr 2006; 84:739-47. [PMID: 17023699 DOI: 10.1093/ajcn/84.4.739] [Citation(s) in RCA: 94] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Birth weight has been positively associated with risk of overweight in later life. However, little information exists on how weight and length at birth are associated with subsequent lean and total body fat. OBJECTIVE We investigated the association between weight and length at birth and body composition and fat distribution in childhood. DESIGN Body composition was measured by using dual-energy X-ray absorptiometry in 9-10-y-old subjects (n = 3006 boys and 3080 girls). Weight and length at birth were measured or taken from hospital records. RESULTS Birth weight was positively associated with both lean body mass (LBM) and total body fat at 9-10 y of age in both sexes. LBM rose by 320 g per 1-SD increase in birth weight (P < 0.001), and total body fat rose by 2.5% (P = 0.001), but birth weight was unassociated with the fat-to-lean mass ratio (FLR). Ponderal index (PI) at birth (ie, weight/length3) was positively associated with LBM, total body fat, and the FLR in both sexes; the FLR increased by 2.7% in boys (P = 0.021) and by 5.0% in girls per 1-SD increase in PI (P < 0.001). Weight and length at birth did not predict central adiposity; although trunk fat had a strong positive association with PI at birth, this association disappeared after adjustment for total body fat. CONCLUSIONS Higher PI at birth is associated with both higher fat and lean mass in childhood but also with an increase in the FLR. PI at birth is a better predictor of subsequent adiposity than is birth weight.
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Affiliation(s)
- Imogen S Rogers
- Department of Social Medicine, University of Bristol, Bristol, United Kingdom
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Schack-Nielsen L, Mølgaard C, Sørensen TIA, Greisen G, Michaelsen KF. Secular change in size at birth from 1973 to 2003: national data from Denmark. Obesity (Silver Spring) 2006; 14:1257-63. [PMID: 16899807 DOI: 10.1038/oby.2006.143] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To explore whether birth weight (BW) has been increasing in Denmark at the same level as in other countries and whether this increase is paralleled by an increase in birth length (BL) or whether body proportionality, expressed as ponderal index (PI), has changed. RESEARCH METHODS AND PROCEDURES This study used data analysis of information from The Danish Medical Birth Registry including all single live births in Denmark from 1973 to 2003 (n = 1,863,456). BW, BL, gestational age, maternal age, and smoking status (only from 1991 on) were measured. RESULTS Mean BW increased steadily during the period (160 grams; equivalent to approximately 5 g/yr) at a rate higher than that reported from other countries. BL showed only a minor increase (2.4 mm), leading to an increase in PI (0.8 kg/m3) during the period. Controlling for the effect of increasing maternal age and decreasing gestational age and maternal smoking prevalence (only data after 1991), there was still an increase in BW of approximately 4 g/yr. DISCUSSION During the last 30 years, neonates have become bigger, with a larger relative increase in BW than BL, leading to an increase in PI. The increasing BW and PI, which may be caused by increased maternal weight, could further promote the obesity epidemic.
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Affiliation(s)
- Lene Schack-Nielsen
- Department of Human Nutrition and Centre for Advanced Food Studies, The Royal Veterinary and Agricultural University, Frederiksberg C, Denmark.
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Koo WWK, Walters JC, Hockman EM. Body composition in neonates: relationship between measured and derived anthropometry with dual-energy X-ray absorptiometry measurements. Pediatr Res 2004; 56:694-700. [PMID: 15371563 DOI: 10.1203/01.pdr.0000142587.59238.bd] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This study examined the relationship between measured and derived anthropometric measurements with dual-energy X-ray absorptiometry measured lean and fat mass at 3.0 +/- 2.8 (SD) days in 120 neonates with birth weights appropriate (AGA; n=74), large (LGA; n=30); or small (SGA, n=16) for gestational age. Anthropometric measurements, including total body weight and length, and regional measurements, including circumferences of head, chest, abdomen, midarm, and midthigh and dynamic skinfold thickness (15 and 60 s) at tricep, subscapular, suprailiac, and midthigh, were performed. Derived anthropometry included muscle and fat areas, and ratios were calculated from direct measurements. The skinfold thickness measurements between 15 and 60 s were highly correlated (r=0.973-0.996, p <0.001 for all comparisons). Strong correlations existed within the four circumferences of trunk and extremities, the four skinfolds, and the ratios of weight to length and its higher powers. Weight and length accounted for >97% of the variance of lean mass in AGA and SGA infants and 46% of the variance in LGA infants and for 80, 82, and 84% of the variance of fat mass in SGA, AGA, and LGA infants, respectively, whereas midarm:head circumference ratio and arm muscle and fat areas are the most important derived anthropometry in the prediction for body composition. They independently accounted for up to 16.5 and 10.2%, respectively, of the variance in body composition depending on the state of in utero growth. Thus, total body weight and length and some selected regional and derived anthropometry accounted for the vast majority of the variance of body composition.
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Affiliation(s)
- Winston W K Koo
- Department of Pediatrics, University of Tennessee, Memphis, TN 38103, USA.
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Littner Y, Mandel D, Mimouni FB, Dollberg S. Decreased bone ultrasound velocity in large-for-gestational-age infants. J Perinatol 2004; 24:21-3. [PMID: 14726933 DOI: 10.1038/sj.jp.7211013] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Bone speed of sound is a measure of bone breakability. There are few reports on bone mineral content in large for gestational age infants; most of them in infants of diabetic mothers. There are no data on bone speed of sound in large for gestational age infants of nondiabetic mothers. OBJECTIVE To test the hypothesis that large for gestational age infants of nondiabetic mothers have lower bone speed of sound than appropriate for gestational age infants. DESIGN/METHODS Bone speed of sound was measured within the first 96 hours of life at the right tibial midshaft in 25 singleton large for gestational age infants of non diabetic mothers and compared to appropriate for gestational age controls. RESULTS Bone speed of sound measured in large for gestational age infants of nondiabetic mothers was lower than in controls. CONCLUSIONS Large for gestational age infants of nondiabetic mothers have lower bone speed of sound than controls.
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Affiliation(s)
- Yoav Littner
- Department of Neonatology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
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Abstract
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.
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Affiliation(s)
- Emily Oken
- Department of Ambulatory Care and Prevention, Harvard Medical School/Harvard Pilgrim Health Care, Boston, Massachusetts, USA.
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Abstract
OBJECTIVE To measure body composition in newborn twins and to test the hypothesis that differences in body weights between twins are reflected proportionally by their differences in various components of body composition. METHODS 48 pairs of newborn twins delivered at a tertiary teaching hospital had dual energy x-ray absorptiometry (DXA) body composition measurement for bone mineral content (BMC), lean and fat mass (LM, FM). Data analyzed with regression and analysis of variance. RESULTS Body weight, BMC, LM and FM increased with increased gestational age (p < 0.001). The percent difference in BW between each twin pair was significantly correlated with percent difference in BMC, LM, and FM (p < 0.001). However, mean (+/- SD) percent difference in body weight (14.3+/-10.0%) was significantly lower (p < 0.001) than FM (26.0+/-15.0%) but was not significantly different from LM (13.4+/-9.0%) or BMC (15.9+/-11.6%). CONCLUSION In newborn twins, body weight and body composition varies with gestational age. For any twin pair, a difference in body weight was correlated with but not proportional to differences in individual components of body composition.
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Affiliation(s)
- Belinda Koo
- Department of Pediatrics, Obstetrics and Gynecology, University of Tennessee, Memphis, USA
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Lapunzina P, Camelo JSL, Rittler M, Castilla EE. Risks of congenital anomalies in large for gestational age infants. J Pediatr 2002; 140:200-4. [PMID: 11865271 DOI: 10.1067/mpd.2002.121696] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To evaluate the association between large for gestational age (LGA) and demographic and medical risk factors as well as specific types of congenital anomalies. STUDY DESIGN A retrospective, case-control study on 2,149,617 consecutive births was conducted. LGA was defined as 1.64 SD above the mean weight for gestational age, adjusted by sex and altitude. Risk factor frequency distributions were compared between LGA and normal birth weight neonates. Associations between LGA and 41 infants with isolated congenital anomalies were evaluated. RESULTS Of 31,897 neonates with congenital anomalies, 1800 were LGA. Five anomalies were associated with LGA: talipes calcaneovalgus, hydrocephaly, combined angiomatoses, hip subluxation, and non-brown-pigmented nevi. Multiparity, vaginal bleeding, diabetes, and delivery by cesarean section were more frequent in LGA than in appropriate for gestational age infants' mothers. Several maternal but no paternal factors were statistically associated with an increased risk for LGA infants. CONCLUSIONS The clinical observation that nevi are more commonly observed in LGA patients was supported. The higher frequencies of hip subluxation and talipes calcaneovalgus among LGA neonates reinforces their pathogenesis as deformations, whereas those of combined angiomatoses and hydrocephaly could reflect increased fluid or body mass.
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Affiliation(s)
- Pablo Lapunzina
- ECLAMC (Estudio Colaborativo Latino Americano de Malformaciones Congénitas) at Fiocruz, Rio de Janeiro, Brazil
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