Birth weight and lipids in a national birth cohort study

Metabolic and Low-Grade Inflammation Risk in Young Adults with a History of Extrauterine Growth Restriction

Children with a history of extrauterine growth restriction (EUGR), later at prepubertal age, exhibit an increased metabolic risk including risen insulin resistance and low-grade inflammation. However, the progression of such metabolic changes after puberty and the lasting health implications have not yet been investigated. The objective of this study was to ascertain whether young adults with a history of EUGR faced increased vulnerability to metabolic disorders. A study was conducted comparing a group of adults with a history of EUGR with a healthy reference group. A total of 110 young adults (36 from the EUGR group and 74 from the control group) were included. Anthropometric variables, blood pressure (BP), general biochemical parameters, plasma inflammatory biomarkers, and adipokines were assessed. Compared to the reference group, the EUGR group had a shorter height and body weight with higher lean mass and waist circumference, as well as a greater percentage of individuals with high BP. In addition, EUGR patients had higher values of insulin, HOMA-IR, nerve growth factor, and leptin, and lower levels of adiponectin and resistin. The present study suggests that young adults with a history of EUGR present increased metabolic risk factors therefore, clinical follow-up should be considered.

Mediation effect of cord blood cortisol levels between maternal prepregnancy body mass index and birth weight: a hospital-based cross-sectional study

BACKGROUND

Changes in maternal weight affect the maternal and fetal hypothalamic-pituitary-adrenal axis, influencing birth weight and contributing to the fetal origin of adult diseases (Barker's hypothesis). This study primarily focused on cord blood cortisol levels and identified the association between maternal prepregnancy body mass index (pre-BMI) and birth weight. It also assessed cord blood lipid profile changes related to maternal pre-BMI, birth weight, and cord blood cortisol levels.

PURPOSE

To study the mediation effect of cord blood cortisol level between maternal pre-BMI and birth weight and its correlation with cord blood lipid profile.

METHODS

A total of 169 maternal-neonatal pairs were included at 2 tertiary care centers. Mediation analysis was used to estimate the extent of the association between maternal weight changes and birth weight.

RESULTS

For each unit increase in maternal pre-BMI, birth weight increased by 90.5 g; for every kilogram increase in gestational weight, birth weight increased by 128.44 g. No considerable mediation effect of cortisol was found between pre-BMI and gestational weight gain or between rate of weight gain and birth weight. Pre-BMI and birth weight had a significant negative correlation with high-density lipoprotein cholesterol (HDL-C) levels, i.e., HDL-C was decreased by 1.1 mg/dL for every unit increase in BMI (P=0.017) and for every 100-g increase in birth weight, HDL-C decreased by 0.6 mg/dL (P=0.046). A significant positive correlation was found between cord blood lipid profile and cortisol levels, especially HDL-C (P=0.041).

CONCLUSION

Cord blood cortisol levels did not mediate the association between maternal weight change and birth weight. A positive correlation was noted between cord blood cortisol levels and HDL-C level. Cord blood HDL-C level was negatively correlated with maternal pre-BMI and birth weight.

A dietary pattern derived using B-vitamins and its relationship with vascular markers over the life course

Background

Diet may influence vascular function through elevated homocysteine (Hcy) concentrations. However the relationship between dietary patterns (DP), characterised by Hcy and its associated nutrients is unknown.

Objective

To identify a DP characterised by plasma Hcy, dietary folate and dietary vitamin B12, and examine its associations with two markers of vascular function: carotid intima-media thickness (cIMT) and pulse wave velocity (PWV).

Methods

1562 participants of the MRC National Survey of Health and Development (NSHD), a British birth cohort, with dietary data measured at least once between 36 and 60–64 years, and cIMT or PWV measured at 60–64 years were included. DPs were derived using reduced rank regression with three intermediate variables: 1) plasma Hcy (μmol/L) 2) folate intake (μg/1000 kcal) 3) vitamin B12 intake (μg/1000 kcal). Multiple regression models assessed associations between the derived DP z-scores and vascular function adjusting for dietary misreporting, socioeconomic position, BMI, smoking, physical activity and diabetes.

Results

A DP explaining the highest amount of shared variation (4.5%) in plasma Hcy, dietary folate and dietary vitamin B12 highly correlated with folate (r = 0.96), moderately correlated with vitamin B12 (r = 0.27), and weakly correlated with Hcy (r = 0.10). This “high B-vitamin” DP (including folate) was characterised by high intakes of vegetables, fruit and low fibre breakfast cereal, and low intakes of processed meat, white bread, sugar and preserves. No associations were observed between DP z-scores and vascular function at any time point following adjustment for covariates.

Conclusion

This study explored a specific hypothesised pathway linking diet to vascular function. Although we found no consistent evidence for an association between a high B-vitamin DP and vascular function, we did observe an association with CRP and triglycerides in secondary analyses. Further analyses using strongly correlated and biologically relevant intermediate variables are required to refine investigations into diet and CVD in longitudinal cohort data.

Work-Family Life Courses and Metabolic Markers in the MRC National Survey of Health and Development

The aim was to investigate whether the combined work-family life courses of British men and women were associated with differences in metabolic markers-waist circumference, blood pressure, high density lipoprotein cholesterol, triglycerides, and glycated haemoglobin-in mid-life. We used data from the Medical Research Council's National Survey of Health and Development-the 1946 British birth cohort. Multi-channel sequence analysis was used to create a typology of eight work-family life course types combining information on work, partnerships and parenthood between ages 16-51. Linear regression tested associations between work-family types and metabolic outcomes at age 53 on multiply imputed data (20 imputations) of >2,400 participants. Compared with men with strong ties to employment and early transitions to family life, men who made later transitions to parenthood and maintained strong ties to paid work had smaller waist circumferences (-2.16cm, 95% CI: -3.73, -0.59), lower triglycerides (9.78% lower, 95% CI: 0.81, 17.94) and lower blood pressure (systolic: -4.03mmHg, 95% CI: -6.93, -1.13; diastolic: -2.34mmHg, 95% CI: -4.15, -0.53). Married men and women who didn't have children had increased high density lipoprotein cholesterol (7.23% higher, 95% CI: 0.68, 14.21) and lower waist circumferences (-4.67cm, 95% CI: -8.37, -0.97), respectively. For men later transitions to parenthood combined with strong ties to paid work were linked to reduced metabolic risk in mid-life. Fewer differences between work-family types and metabolic markers were seen for women.

Birth weight was longitudinally associated with cardiometabolic risk markers in mid-adulthood

PURPOSE

Birth weight (BW) is associated with risk of cardiovascular (CV) disease. The findings from studies examined the association of BW with metabolic markers of CV risk were inconsistent and controversial. We examined the association of BW with insulin resistance and blood lipids using repeated measures up to mid-adulthood.

METHODS

Data from seven screenings of the Bogalusa Heart Study-a longitudinal study of cardiovascular risk factors in Bogalusa, LA-are analyzed using generalized estimation equations method. Participants with birth data and at least one measurement of study outcomes between 18 and 44 years (n = 2,034) were included.

RESULTS

BW is inversely associated with insulin resistance, triglycerides, and total cholesterol (P < .01 for all). For 1-kg decrease in BW, insulin resistance increased by 2.3 units, 95% confidence interval (CI) = 0.7-3.9; triglycerides by 8.7 mg per dL, 95% CI = 4.9-12.4, and total cholesterol by 5.4 mg per dL, 95% CI = 1.8-9.1. The association of body mass with adult blood lipids levels is weaker in persons with low versus normal BW.

CONCLUSIONS

The study provides strong evidence of an inverse relationship of BW with adulthood cardiometabolic risk profile. Persons born with low BW are maybe less responsive to preventive interventions aiming at weight reduction.

Lifelong patterns of BMI and cardiovascular phenotype in individuals aged 60-64 years in the 1946 British birth cohort study: an epidemiological study

BACKGROUND

Excess body fat is associated with an increase in risk of type 2 diabetes and hypertension in adulthood and these risks can adversely affect progression of arterial disease. We aimed to assess the impact of lifelong patterns of adiposity on cardiovascular risk factors and carotid intima media thickness (cIMT) in later life in participants in the 1946 British birth cohort study.

METHODS

The National Survey of Health and Development Study was a nationally representative sample of 5362 singleton births to married parents in England, Scotland, and Wales, stratified by social class, during 1 week in March 1946. Our present study is based on the 60% of participants still alive and with a known present address in England, Scotland, or Wales who attended a clinic assessment after invitation aged 60-64 years. We included participants with lifetime adiposity measures, cardiovascular risk factors, and cIMT measured at 60-64 years. Participants were classified as normal weight or overweight or obese at each age (36, 43, 53, and 60-64 years) in adulthood, and childhood overweight was defined. Patterns of BMI change were identified and we used BMI to define adiposity status. We used multivariable linear regression to establish the cross-sectional association of BMI category at age 60-64 years with cIMT, adjusted for various confounders.

FINDINGS

We included 1273 (45%) of 2856 participants eligible in 2006-10 (at age 60-64 years) in this study. Compared with normal weight, overweight and obesity were associated with higher cIMT (0·029 mm, 95% CI 0·014-0·043) and systolic blood pressure (7·95 mm Hg, 5·86-10·0). Increased cIMT, systolic blood pressure, leptin, prevalence of diabetes, and reduced adiponectin were all associated with duration of exposure to adult adiposity (p<0·0001 for all). We noted little additional effect of childhood overweight. Individuals who dropped a BMI category in adulthood had lower cIMT (-0·034 mm, -0·056 to -0·013) and leptin concentrations (-0·4 ng/mL, -0·47 to -0·32), even when this change was not maintained, than did those who never lost weight.

INTERPRETATION

Longer exposure to high adiposity in adulthood had a cumulative adverse effect on cardiovascular phenotype in later life. Reductions in BMI category, even if not sustained, were associated with decreases in cIMT and improvements in cardiovascular risk-factor profile, suggesting that weight loss, at any age in adulthood, is worthwhile because it might result in long-term cardiovascular benefit.

FUNDING

Medical Research Council and the British Heart Foundation.

Current growth status and metabolic parameters of Korean adolescents born small for gestational age: results from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2010-2011

BACKGROUND

Currently, little information is available on current growth status and metabolic syndrome (MetS) components according to birthweight at gestational age (BWGA) on Korean adolescents. Herein, the current height and weight and MetS components of Korean adolescents who were born as small for gestational age (SGA) were compared to those of the appropriate for GA (AGA) or large for GA (LGA) groups.

METHODS

Data for 2018 adolescents (aged 10-18 years) recorded in the Fifth Korean National Health and Nutrition Examination Survey 2010-2011 conducted by the Korean Ministry of Health and Welfare were assessed in this cross-sectional study. A total of 1750 subjects were assessed for current growth according to BWGA, and 792 were assessed for MetS components according to BWGA.

RESULTS

From the birth history of 1750 adolescents, the prevalence of SGA, AGA, and LGA was 11.4% (n = 193), 77.7% (n = 1366), and 10.9% (n = 191), respectively. Current height-standard deviation score (SDS) and weight-SDS were significantly positively related to BWGA in all Korean adolescents (P < 0.0001). Of the 792 adolescents, the prevalence of MetS was 1.2% (n = 9). There were no differences in MetS components in Korean adolescents between SGA and AGA or LGA group.

CONCLUSION

BWGA is related to current height and weight in Korean adolescents but is not related to individual components of MetS.

Adult lipids associated with early life growth in traditional Melanesian societies undergoing rapid modernization: a longitudinal study of the mid-20th century

Both poor fetal development and accelerated post-natal growth have been linked to adult dyslipidemias in many studies conducted in developed societies. It is not known, however, whether these relationships only characterize populations with typical Western diets or if they also may develop in groups at the early stages of a dietary transition. Our longitudinal study of traditional rural populations in the Southwest Pacific during a period of extremely rapid modernization in diet and life-styles shows a nascent association between child growth retardation, subsequent growth acceleration, and adult lipid values in spite of a continuing prevalence of very low lipid levels. However, our results do not entirely conform to results from populations with "modern" diets. Outcome (i.e., young adult) cholesterol and triglyceride levels are more consistently related to initial measures of body fat and growth in body fat measures than with stature, while outcome apo A-1 is more consistently related to initial stature or stature growth than to measures of body fat. We suggest this may reflect a pattern characteristic of the initial stages of "modernization" associated with dietary change, with stronger and more pervasive relationships emerging only later as populations complete the dietary transition.

The association of birth weight with cardiovascular risk factors and mental problems among Iranian school-aged children: the CASPIAN-III study

OBJECTIVE

Both high and low birth weights (HBW and LBW) are risk factors for adulthood diseases. The aim of this study was to investigate the association of birth weight with cardiovascular disease (CVD) risk factors and mental problems among Iranian school-aged children.

METHODS

This national multicenter study of school-aged children entitled CASPIAN III was conducted among 5528 students in ranging from ages 10 to 18 y. Biochemical indices and anthropometric measurements were collected. Mental health was assessed by questionnaire. To investigate the association between birth weight categories and CVD risk factors and mental problems, multivariate logistic regression was used.

RESULTS

HBW adolescents were at higher risk for elevated diastolic blood pressure (DBP) (Ptrend < 0.05), low levels of high-density lipoprotein cholesterol (HDL-C) (Ptrend < 0.05), and lower risk for general obesity (Ptrend < 0.05) compared with the LBW category. HBW had no significant association with mental problems (Ptrend > 0.05) compared with LBW adolescents. The results of regression analysis, which considered normal birth weight as the reference group, showed that LBW students had lower risk for overweight and obesity (P < 0.01), as well as higher DBP (P < 0.05) but they were at higher risk for lower levels of HDL-C (P < 0.01). Furthermore, birth-weight categories had a U-shaped relationship with mental problems and sleep disorders (P < 0.05). Risk for confusion was higher among the LBW group (P < 0.05).

CONCLUSION

Findings from this population-based study revealed a positive relation between birth weight categories and CVD risk factors. Compared with students born with normal weight, those born with HBW and LBW were at higher risk for mental problems, sleep disorders, and confusion.

Fetal origins of adult disease

Dr. David Barker first popularized the concept of fetal origins of adult disease (FOAD). Since its inception, FOAD has received considerable attention. The FOAD hypothesis holds that events during early development have a profound impact on one's risk for development of future adult disease. Low birth weight, a surrogate marker of poor fetal growth and nutrition, is linked to coronary artery disease, hypertension, obesity, and insulin resistance. Clues originally arose from large 20th century, European birth registries. Today, large, diverse human cohorts and various animal models have extensively replicated these original observations. This review focuses on the pathogenesis related to FOAD and examines Dr. David Barker's landmark studies, along with additional human and animal model data. Implications of the FOAD extend beyond the low birth weight population and include babies exposed to stress, both nutritional and nonnutritional, during different critical periods of development, which ultimately result in a disease state. By understanding FOAD, health care professionals and policy makers will make this issue a high health care priority and implement preventive measures and treatment for those at higher risk for chronic diseases.

Birth weight, family history of diabetes, and metabolic syndrome in children and adolescents

OBJECTIVE

To evaluate whether a coupled family history of diabetes (FHD) and low birth weight (LBW) or high birth weight (HBW) is associated with metabolic syndrome (MetS) in children and adolescents.

STUDY DESIGN

A total of 1262 children and adolescents age 7-15 years were randomly selected to enroll in this cross-sectional, community-based study.

RESULTS

In the overall population, HBW (odds ratio [OR] = 1.4; 95% confidence interval [CI] = 1.2-10.9), but not LBW (OR = 0.97; 95% CI = 0.6-2.1), was significantly associated with MetS. In the group without FHD, HBW (OR = 1.730; 95% CI = 1.1-2.7), but not LBW (OR = 1.139; 95% CI = 0.7-23), was associated with MetS. In the group with FHD, both LBW (OR = 2.690; 95% CI = 1.4-15.1) and HBW (OR = 3.289; 95% CI = 1.3-30.6) were associated with MetS. Both LBW (OR = 4.710; 95% CI = 1.4-39.7) and HBW (OR = 3.127; 95% CI = 1.3-45.1) were associated with MetS in children and adolescents with FHD in the maternal branch but not in the paternal branch.

CONCLUSIONS

HBW or LBW, in combination with positive FHD in the maternal branch, are determinants of MetS.

Weight gain in childhood and blood lipids in adolescence

Aim:

To assess the effect of weight gain in childhood on blood lipid levels in adolescence.

Methods:

A population-based birth cohort carried out in Pelotas, Southern Brazil. All newborns in the city's hospitals were enrolled in 1982. The subjects have been followed up for several times in childhood. At age 18, 79% of all males were followed, and 2083 blood samples were available. Adjusted analyses controlled for household assets index, family income, parental schooling at birth, maternal smoking during pregnancy and breastfeeding duration.

Results:

Birth weight for gestational age and weight gain in the first 20 months was not associated with blood lipid levels in adolescence. On the other hand, those subjects whose weight gain from 20 to 42 months of age was faster than that predicted from birth weight and weight-for-age z-score at the mean age of 20 months had lower high-density lipoprotein cholesterol (HDL) cholesterol [−0.78 (95% confidence interval: −1.28; −0.29)] and higher very low-density lipoprotein cholesterol (VLDL) and low-density lipoprotein cholesterol (LDL)/HDL ratio in adolescence. After controlling for current body mass index (BMI), the regression coefficient for HDL cholesterol decreased from −0.78 mg/dL to −0.29 mg/dL (95% confidence interval: −1.00 to 0.05).

Conclusion:

Weight gain from 2 to 4 years is related to an atherogenic lipid profile in adolescence and this association is mediated by current BMI.

No difference in the association between birth weight and total cholesterol for males and females. A SHARP (Scottish Heart and Arterial Disease Risk Prevention) study

We carried out a cohort study in a relatively young healthy working population to assess any difference between males and females in the association between birth weight and adult total cholesterol. Perinatal data came from the Walker database of babies born between 1952 and 1966 in Dundee, Scotland. This was record-linked to information from the SHARP (Scottish Heart and Arterial Risk Prevention) cohort who had undergone a cardiovascular risk screening between 1991 and 1993. There were 1158 individuals (56% male, mean age 32.1 years). For both males and females there was no association between birth weight and cholesterol either unadjusted or after adjustment for BMI and other potential confounders: B = -0.11 (95% CI -0.03, 0.04) for males, B = -0.15 (95% CI -0.31, 0.01) for females. All individuals together showed a slight decrease in cholesterol for 1 kg increase in birth weight but only after adjustment for BMI: B = -0.13 (95% CI -0.24, -0.01). These results suggest no difference in the relationship between birth weight and total cholesterol for males and females.

Age at birth of first child and coronary heart disease risk factors at age 53 years in men and women: British birth cohort study

OBJECTIVE

To assess the associations between parental age at birth of first child and coronary heart disease (CHD) risk factors in men and women. To investigate whether the associations are explained by childhood predictors of age at parenthood or adult lifestyle factors related to child rearing.

METHODS

Data from 2540 men and women, with CHD risk factors measured at age 53 years, from a birth cohort study of individuals born in Britain in 1946 (Medical Research Council National Survey of Health and Development) and followed up regularly throughout life, were analysed.

RESULTS

Younger age at birth of first child in both men and women was associated with poorer mean body mass index (BMI), waist-hip ratio, blood pressure (BP), high-density lipoprotein cholesterol, triglyceride and glycated haemoglobin levels. Mean BMI decreased from 28.0 kg/m(2) (95% CI 27.2 to 28.8) in the teenage motherhood group to 26.8 kg/m(2) (25.9 to 27.7) in the oldest motherhood group (> or =30 years). For men, the equivalent mean values were 28.5 kg/m(2) (27.3 to 29.8) and 27.1 kg/m(2) (26.7 to 27.6). Associations with adiposity, lipid measures and glycated haemoglobin were largely explained by childhood antecedents and adult social and lifestyle variables. Associations with BP remained robust to adjustment: systolic blood pressure remained highest in teenage parents (7.5 mmHg (1.0 to 13.9) difference in women and 8.6 mmHg (0.4 to 16.8) difference in men between the youngest and the oldest parenthood groups)

CONCLUSIONS

Lifestyle factors, rather than the biological impact of pregnancy, explain the relationship between age at motherhood and CHD risk factors. Family-based lifestyle interventions targeted at young parents may improve their future CHD risk.

Sex differences in the associations between birthweight and lipid levels in middle-age: findings from the 1958 British birth cohort

OBJECTIVE

To examine sex differences in birthweight-lipid associations.

METHODS AND RESULTS

Using prospectively collected data on birthweight and non-fasting lipid levels at age 44-45 y from the 1958 British birth cohort (3603 men and 3583 women), sex differences in birthweight-lipid associations were examined. There were inverse associations between birthweight and total and low-density-lipoprotein (LDL)-cholesterol among women (a 1 kg increase in birthweight was associated with a 0.13 mmol/L reduction in total cholesterol (p<0.001) and a 0.07 mmol/L reduction in LDL-cholesterol (p=0.02)) but no associations among men (p=0.005 and p=0.01, respectively, for birthweight x sex interactions). There was an inverse association between birthweight and triglycerides of a similar magnitude in both sexes (a 1 kg increase in birthweight was associated with a 7% reduction in triglyceride levels in sex-adjusted models (p<0.001)). There was no association between birthweight and high-density-lipoprotein-cholesterol. Associations were largely unaltered after adjustment for covariates. Of birthweight, current height and BMI, the latter was the strongest predictor of lipid levels.

CONCLUSIONS

The finding of an inverse association between birthweight and triglycerides in both sexes and of inverse associations between birthweight and total and LDL-cholesterol only in women suggests that the mechanisms underlying the associations with birthweight may vary for different lipids.

Number of children and coronary heart disease risk factors in men and women from a British birth cohort

OBJECTIVE

To examine the association between number of children and coronary heart disease (CHD) risk factors in women and men.

DESIGN

Prospective cohort study.

SETTING

Britain.

SAMPLE

A total of 2977 individuals (51% women) from the Medical Research Council National Survey of Health and Development, a birth cohort study of individuals born in Britain in 1946 and followed up regularly throughout life.

MAIN OUTCOME MEASURES

Blood pressure, body mass index (BMI), waist to hip ratio (WHR), total, high-density lipoprotein and low-density lipoprotein cholesterol and triglyceride levels, and glycated haemoglobin (HbA1C) measured at age of 53 years.

RESULTS

Number of children showed no consistent relationship with CHD risk factors at age 53 years in either men or women, and no obvious and consistent sex differences were observed. Mean BMI (95% CI) increased with increasing numbers of children (P = 0.01) in women from 27.4 kg/m2 (26.6-28.2) in those with one child to 28.6 kg/m2 (27.6-29.6) in those with four or more children. WHR and type II diabetes in women and HbA1C in men were the only other risk factors exhibiting a linearly increasing trend with increasing number of children. These associations were largely explained by adjustment for behavioural and lifestyle variables.

CONCLUSION

Our findings suggest that any association between number of children and CHD risk factors is a result of lifestyle and behaviours associated with family life rather than being as result of the biological impact of pregnancy in women.

Life course body size and lipid levels at 53 years in a British birth cohort

OBJECTIVES

To investigate the association between growth in height and change in body mass index (BMI) during the life course on lipid levels at 53 years.

METHODS

2311 men and women from a British cohort study were included in analyses. Non-fasting total, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol levels were measured at 53 years. Height and BMI at 2, 4, 7, 11, 15 and 36 years in relation to the lipid outcomes at 53 years were assessed using multiple regression models. The effects of z scores of height and BMI at 2 years and yearly rates of change (velocities) in height and BMI between 2-7, 7-15 and 15-36 years were also considered.

RESULTS

Total cholesterol level decreased by 0.119 mmol/l (95% CI -0.194 to -0.045) per SD increase in height at 2 years and by 0.073 mmol/l (95% CI -0.145 to -0.001) for every SD increase in height velocity between 15 years and adulthood. Similar, but weaker associations were seen for LDL cholesterol. The relationships between leg length and total and LDL cholesterol were stronger than the relationship with trunk length. Higher BMI at 36 and 53 years and greater BMI increases between 15-36 and 36-53 years were associated with higher total and LDL cholesterol and lower HDL cholesterol levels. The effects of growth could not be explained by birth weight or lifetime socioeconomic status.

CONCLUSIONS

Early life exposures, which restrict height growth in infancy, resulting in shorter adult leg length, may influence lipid levels in adult life.

Birthweight and risk factors for cardiovascular diseases in Japanese schoolchildren

BACKGROUND

Low birthweight (LBW) is associated with an increased risk for atherosclerotic coronary heart disease (ACHD) later in life. However, little information is currently available on the relationship between birthweight (BW) and risk factors for ACHD in children.

METHODS

The relationship between BW and risk factors for ACHD was evaluated in 330 Japanese children (187 boys and 143 girls) aged between 7 and 12 years, who underwent screening for lifestyle-related diseases in Okinawa, Japan. Routine chemical methods were used to determine the serum concentrations of lipids, apolipoproteins, uric acid and glucose. Serum insulin and adiponectin were measured by sandwich enzyme-linked immunosorbent assay.

RESULTS

BW was significantly correlated with serum concentrations of adiponectin (r= 0.163, P= 0.003) and uric acid (r=-0.166. P= 0.003), but not with insulin, lipids or apolipoproteins. These correlations were still significant even after adjusting for age, gender and body mass index (BMI) percentile (BW and adiponectin, r= 0.239, P= 0.000; BW and uric acid, r=-0.247, P= 0.000). In addition, BW was correlated with high-density lipoprotein-cholesterol (HDL-C) only after adjusting for age, gender and BMI percentile (r= 0.117, P= 0.034). In a stepwise multiple regression analysis, BW was a significant predictive variable for adiponectin and uric acid. However, weight velocity (weight gain/year) was a stronger predictive variable than BW for both adiponectin and uric acid. BW was not a significant predictive variable for HDL-C. Adiponectin was the strongest predictive variable for HDL-C.

CONCLUSION

BW is related to serum concentrations of adiponectin and uric acid. However, weight velocity was a stronger determinant of serum adiponectin and uric acid levels than BW in Japanese schoolchildren. Thus, it may be important to control weight gain to prevent the development of ACHD in children, especially in children with LBW.

Glucose and lipid metabolism in small-for-gestational-age infants at 72 hours of age

CONTEXT

Reduced birth weight is associated with increased risk for the insulin resistance syndrome. Part of this risk is hypothesized to originate from intrauterine growth retardation.

OBJECTIVE

The aim of this study is to determine whether or not the components of the insulin resistance syndrome are associated with reduced fetal growth.

DESIGN

This was a case-control study.

SETTING

The study was conducted in Beijing, China.

PARTICIPANTS

Included in this study were 296 singleton neonates (177 males and 119 females), including 76 (37 preterm and 39 full-term newborns) classified as small for gestational age (SGA) and 220 who were appropriate for gestational age (AGA) (84 preterm and 136 full-term newborns).

MAIN OUTCOME MEASURES

The main outcome measures were postabsorptive glucose, insulin, and lipids levels on the third day after birth.

RESULTS

Both full-term and preterm SGA neonates had higher insulin concentrations (mean +/- SEM, 17.11 +/- 1.15 vs.6.80 +/- 0.62 microIU/ml in full-term, P < 0.01; 11.99 +/- 1.18 vs.8.37 +/- 0.78 microIU/ml in preterm, P = 0.03), insulin to glucose ratios (4.48 +/- 0.37 vs. 1.78 +/- 0.20 in full-term, P < 0.01; 3.28 +/- 0.38 vs. 2.30 +/- 0.26 in preterm, P = 0.03), triglycerides (2.29 +/- 0.23 vs.1.57 +/- 0.13 mmol/liter in full-term, P < 0.01; 2.27 +/- 0.16 vs. 1.34 +/- 0.11 mmol/liter in preterm, P < 0.01), total cholesterol (2.35 +/- 0.12 vs. 1.82 +/- 0.22 mmol/liter in full-term, P = 0.04; 2.57 +/- 0.22 vs. 1.95 +/- 0.15 mmol/liter in preterm, P = 0.02), and low-density lipoprotein cholesterol (2.11 +/- 0.58 vs. 1.24 +/- 0.61 mmol/liter in full-term, P = 0.01; 1.87 +/- 0.60 vs. 1.38 +/- 0.59 mmol/liter in preterm, P < 0.01) concentrations than did AGA neonates; however, they had similar glucose levels. Among AGA infants, insulin concentration, insulin to glucose ratios, and lipids levels did not significantly differ between full-term and preterm babies.

CONCLUSIONS

In this study, SGA neonates displayed profiles suggestive of lower insulin sensitivity and less favorable lipid metabolism in the early postnatal period.

Dietary patterns throughout adult life are associated with body mass index, waist circumference, blood pressure, and red cell folate

Dietary patterns are important in the prevention of chronic disease; however, there are few studies that include repeat measures of dietary patterns. The objective of this study was to assess the relations between dietary patterns during adult life (at ages 36, 43, and 53 y) and risk factors for chronic disease at age 53 y. Participants of a longitudinal study of health completed a 5-d food diary at 3 occasions during adult life (n = 1265). Factor analysis was used to identify dietary patterns and a pattern score was calculated from the consumption of the food items in each dietary pattern. Means and 95% CI for dietary pattern scores were calculated for each risk factor category using random effects models adjusted for socio-demographic and health-related behaviors. In women, the fruit, vegetables, and dairy pattern was inversely associated with BMI (P < 0.004), waist circumference (P = 0.0007), blood pressure (P = 0.02), and was positively associated with red cell folate (P < 0.03). The ethnic foods and alcohol pattern was also inversely associated with blood pressure (P = 0.008), whereas the meat, potatoes and sweet foods pattern was positively associated with glycated hemoglobin (P = 0.01). In men, a mixed pattern was inversely associated with waist circumference (P = 0.02) and blood pressure (P = 0.01), whereas there were no significant associations with the ethnic foods and alcohol pattern. Specific dietary patterns throughout adult life were associated with chronic disease risk factors.

Intrauterine, Environmental, and Genetic Influences in the Relationship Between Birth Weight and Lipids in a Female Twin Cohort

Objective— To investigate the association between birth weight and lipid levels in a cohort of UK female twins.

Methods and Results— Birth weights and fasting blood lipid levels were available for 2900 women aged 18 to 80 years. Individual level regressions indicated that a 1-kg increase in birth weight was associated with a 0.08-mmol/L decrease in total cholesterol (95% confidence interval [CI], −0.12, −0.04) and a 0.06-mmol/L decrease in low-density lipoprotein (−0.10, −0.03). Using a regression model that includes both mean twin pair birth weight and individual twin’s difference from the pair mean, we found that these significant relationships were between twin pairs only and not within pairs. We found no significant relationships for high-density lipoprotein. When monozygotic and dizygotic twins were analyzed separately we found similar effect sizes. Restricting the analysis to postmenopausal women we found stronger relationships between birth weight and lipid levels, which was attenuated after adjustment for body mass index (BMI).

Conclusions— These novel results suggest that significant relationships between birth weight and lipids are mediated through shared influences on the maternal environment and do not support the hypothesis that fetal malnutrition is an important determinant of adult lipid levels. Adjustment for BMI also indicates that postnatal growth may be more important than prenatal growth.

Sex differences in the association between birth weight and total cholesterol. A meta-analysis

PURPOSE

Determine whether a sex difference exists in the association between birth weight and total cholesterol later in life.

METHODS

Meta-analysis of within-study differences in regression coefficients of cholesterol on birth weight.

RESULTS

A total of 34 regression coefficients from 30 studies were included in the analyses; these provided data on 33,650 males and 23,129 females. There was evidence that the inverse association between birth weight and total cholesterol was stronger in males compared to females. The pooled within-study difference in age-adjusted regression coefficients was -0.03 mmol/l (-0.06, -0.01), p = 0.02 and the pooled within-study difference in age and body mass index adjusted regression coefficients was -0.04 mmol/l (-0.07, -0.02), p = 0.002. There was no evidence of heterogeneity in these meta-analyses (both p values > 0.6).

CONCLUSIONS

These results provide some evidence for a sex difference in the birth weight-total cholesterol association. This is consistent with studies of fetal growth which suggest that birth size reflects different biological processes for females and males. However, other very large studies are required to confirm this finding.

Supplement use is associated with health status and health-related behaviors in the 1946 British birth cohort

Use of dietary supplements may be one of a number of health-related behaviors that cluster together. The current study investigated the underlying diet, health-related characteristics, and behaviors of users and nonusers of dietary supplements in a longitudinal study of health. Participants (n = 1776) completed a 5-d food diary including information on dietary supplement use (vitamins, minerals, and nutraceuticals) at age 53 y. Sociodemographic information and data on smoking, alcohol, and physical activity were obtained along with anthropometric measurements, blood pressure, and a blood sample (nonfasting subjects). A significantly greater percentage of women reported supplement use compared with men (45.1 vs. 25.2%). Supplement use was associated with lower BMI, lower waist circumference, higher plasma folate and plasma vitamin B-12 concentrations, nonsmoking, participation in physical activity, and nonmanual social class in women and with plasma folate concentrations and participation in physical activity in men. Nonsupplement users tended to be nonconsumers of breakfast cereals, fruit, fruit juice, yogurt, oily fish, and olive oil and had lower dietary intakes of potassium, magnesium, phosphorus, iron, and vitamin C even after adjustment for sociodemographic and behavioral factors. Overall, supplement users tended to differ from nonsupplement users on a range of health-related behaviors and health status indicators, although there were fewer significant associations in men. Similarly, dietary supplements users tended to have underlying diets that, were healthier and those taking supplements may be the least likely to need them. These results support the notion of a clustering of healthy behaviors and cardiovascular risk factors, particularly for women.

Cardiovascular risk at age 53 years in relation to the menopause transition and use of hormone replacement therapy: a prospective British birth cohort study

OBJECTIVES

To investigate cardiovascular risk factors and changes in risk factor levels in relation to menopausal stage, hysterectomy status and hormone replacement therapy use in a cohort of women aged 53 years with prospective data on smoking, lifetime socio-economic circumstances, and blood pressure and obesity at age 43 years.

DESIGN

A prospective study.

SETTING

England, Scotland and Wales.

POPULATION

A cohort of women from the Medical Research Council Survey of Health and Development.

METHODS

A total of 1303 women, aged 53 years, from a UK birth cohort study with measures of cardiovascular risk factors were classified by five menopausal status groups (premenopause, perimenopause, postmenopause, hysterectomy and hormone replacement therapy user). Body mass index, glycosolated haemoglobin, blood pressure, high density lipoprotein, low density lipoprotein and total cholesterol measurements were taken, and analysed within the groups taking confounding variables into account. Changes in body mass index and blood pressure measurement in the same women obtained when 43 years of age were also compared.

MAIN OUTCOME MEASURES

Body mass index, glycosolated haemoglobin, blood pressure, high density lipoprotein, low density lipoprotein and total cholesterol.

RESULTS

At 53 years, body mass index, waist circumference, total and low density lipoprotein cholesterol, and glycosolated haemoglobin (HbA1c) varied by menopausal status group, but blood pressure did not. Levels of total cholesterol and HbA1c increased across the natural menopause transition, before and after adjustment for body mass index, smoking and lifetime socio-economic circumstances. After adjustment for confounders, levels of risk factors for hysterectomised women were similar to those of naturally postmenopausal women. Women on hormone replacement therapy had lower levels of total and low density lipoprotein cholesterol, HbA1c, and were less obese than postmenopausal women. The lower obesity levels were partly due to these women already being less obese at age 43 years.

CONCLUSIONS

This study showed that naturally postmenopausal or hysterectomised women had higher levels of metabolic risk factors compared with premenopausal or perimenopausal women of the same age. The long term stability of these differences and their translation into variations in incidence of cardiovascular disease remain to be seen. The lower levels of metabolic risk factors for women on hormone replacement therapy may protect against future cardiovascular disease or may be overwhelmed by other adverse, and as yet unknown, effects of hormone replacement therapy.

Low birth weight is associated with higher adult total cholesterol concentration in men: findings from an occupational cohort of 25,843 employees

BACKGROUND

The majority of studies investigating the association between birth weight and adult total cholesterol (TC) concentration have been small and underpowered: not surprisingly, the findings have been inconsistent. We aimed to determine whether birth weight predicted adult TC in a large sample population.

METHODS AND RESULTS

Between 1994 and 1996, 132,000 British Telecom employees undertook voluntary occupational health screening. Birth weight and lifestyle factors were self-reported; TC concentration and body size were measured by occupational health nurses. Complete measurements were available for 18,286 men and 7557 women (age range, 17 to 64 years). We found that sex and birth weight significantly interacted to predict adult TC (birth weight/sex interaction term, P=0.002). In men, lower birth weight was associated with higher adult TC levels (a -0.07 reduction in TC for each 1-kg increase in birth weight; 95% CI, -0.09 to -0.04 mmol/L; P<0.001), whereas no association was observed in women. Adjustment for potential confounding factors, including current body size and menopausal status, did not alter the findings. Analysis by SD score showed that in men, a 1-SD decrease in body mass index lowered TC concentration approximately 5-fold more than a 1-SD increase in birth weight.

CONCLUSIONS

This is the largest study to investigate the association between birth weight and TC and suggests that the association may be dependent on sex. The absence of an association in women was not explained by menopausal status. The influence of fetal environment on adult TC is small compared with the influence of adult adiposity.