1
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Alemany M. The Metabolic Syndrome, a Human Disease. Int J Mol Sci 2024; 25:2251. [PMID: 38396928 PMCID: PMC10888680 DOI: 10.3390/ijms25042251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/25/2024] Open
Abstract
This review focuses on the question of metabolic syndrome (MS) being a complex, but essentially monophyletic, galaxy of associated diseases/disorders, or just a syndrome of related but rather independent pathologies. The human nature of MS (its exceptionality in Nature and its close interdependence with human action and evolution) is presented and discussed. The text also describes the close interdependence of its components, with special emphasis on the description of their interrelations (including their syndromic development and recruitment), as well as their consequences upon energy handling and partition. The main theories on MS's origin and development are presented in relation to hepatic steatosis, type 2 diabetes, and obesity, but encompass most of the MS components described so far. The differential effects of sex and its biological consequences are considered under the light of human social needs and evolution, which are also directly related to MS epidemiology, severity, and relations with senescence. The triggering and maintenance factors of MS are discussed, with especial emphasis on inflammation, a complex process affecting different levels of organization and which is a critical element for MS development. Inflammation is also related to the operation of connective tissue (including the adipose organ) and the widely studied and acknowledged influence of diet. The role of diet composition, including the transcendence of the anaplerotic maintenance of the Krebs cycle from dietary amino acid supply (and its timing), is developed in the context of testosterone and β-estradiol control of the insulin-glycaemia hepatic core system of carbohydrate-triacylglycerol energy handling. The high probability of MS acting as a unique complex biological control system (essentially monophyletic) is presented, together with additional perspectives/considerations on the treatment of this 'very' human disease.
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Affiliation(s)
- Marià Alemany
- Faculty of Biology, Universitat de Barcelona, 08028 Barcelona, Catalonia, Spain
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2
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Hokken-Koelega ACS, van der Steen M, Boguszewski MCS, Cianfarani S, Dahlgren J, Horikawa R, Mericq V, Rapaport R, Alherbish A, Braslavsky D, Charmandari E, Chernausek SD, Cutfield WS, Dauber A, Deeb A, Goedegebuure WJ, Hofman PL, Isganatis E, Jorge AA, Kanaka-Gantenbein C, Kashimada K, Khadilkar V, Luo XP, Mathai S, Nakano Y, Yau M. International Consensus Guideline on Small for Gestational Age (SGA): Etiology and Management from Infancy to Early Adulthood. Endocr Rev 2023; 44:539-565. [PMID: 36635911 PMCID: PMC10166266 DOI: 10.1210/endrev/bnad002] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 10/31/2022] [Accepted: 01/10/2023] [Indexed: 01/14/2023]
Abstract
This International Consensus Guideline was developed by experts in the field of SGA of 10 pediatric endocrine societies worldwide. A consensus meeting was held and 1300 articles formed the basis for discussions. All experts voted about the strengths of the recommendations. The guideline gives new and clinically relevant insights into the etiology of short stature after SGA birth, including novel knowledge about (epi)genetic causes. Besides, it presents long-term consequences of SGA birth and new treatment options, including treatment with gonadotropin-releasing hormone agonist (GnRHa) in addition to growth hormone (GH) treatment, and the metabolic and cardiovascular health of young adults born SGA after cessation of childhood-GH-treatment in comparison with appropriate control groups. To diagnose SGA, accurate anthropometry and use of national growth charts are recommended. Follow-up in early life is warranted and neurodevelopment evaluation in those at risk. Excessive postnatal weight gain should be avoided, as this is associated with an unfavorable cardio-metabolic health profile in adulthood. Children born SGA with persistent short stature < -2.5 SDS at age 2 years or < -2 SDS at age of 3-4 years, should be referred for diagnostic work-up. In case of dysmorphic features, major malformations, microcephaly, developmental delay, intellectual disability and/or signs of skeletal dysplasia, genetic testing should be considered. Treatment with 0.033-0.067 mg GH/kg/day is recommended in case of persistent short stature at age of 3-4 years. Adding GnRHa treatment could be considered when short adult height is expected at pubertal onset. All young adults born SGA require counseling to adopt a healthy lifestyle.
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Affiliation(s)
- Anita C S Hokken-Koelega
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Manouk van der Steen
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - Stefano Cianfarani
- Department of Systems Medicine, University of Rome 'Tor Vergata', Children's Hospital, Rome, Italy.,Diabetology and Growth Disorders Unit, IRCCS "Bambino Gesù" Children's Hospital, Rome, Italy.,Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, the Sahlgrenska Academy, the University of Gothenburg and Queen Silvia Children's Hospital, Gothenburg, Sweden
| | - Reiko Horikawa
- Division of Endocrinology and Metabolism, National Center for Child Health and Development, Tokyo, Japan
| | - Veronica Mericq
- Institute of Maternal and Child Research, faculty of Medicine, University of Chile
| | - Robert Rapaport
- Icahn School of Medicine, Division of Pediatric Endocrinology, Mount Sinai Kravis Children's Hospital, New York, NY, USA
| | | | - Debora Braslavsky
- Centro de Investigaciones Endocrinológicas "Dr. Cesar Bergadá" (CEDIE), División de Endocrinología, Hospital de Niños Dr. Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Evangelia Charmandari
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece.,Division of Endocrinology and Metabolism, Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 11527 Athens, Greece
| | - Steven D Chernausek
- Department of Pediatrics, Section of Diabetes and Endocrinology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Wayne S Cutfield
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | - Andrew Dauber
- Division of Endocrinology, Children's National Hospital, Washington, DC 20012, USA
| | - Asma Deeb
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City and College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
| | - Wesley J Goedegebuure
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Paul L Hofman
- Liggins Institute, University of Auckland, Auckland, New Zealand
| | | | - Alexander A Jorge
- Unidade de Endocrinologia Genética (LIM25) do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Brazil
| | - Christina Kanaka-Gantenbein
- Division of Endocrinology, Metabolism and Diabetes, First Department of Pediatrics, National and Kapodistrian University of Athens Medical School, 'Aghia Sophia' Children's Hospital, 11527, Athens, Greece
| | - Kenichi Kashimada
- Department of Pediatrics and Developmental Biology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | | | - Xiao-Ping Luo
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sarah Mathai
- Department of Pediatrics, Christian Medical College, Vellore, India
| | - Yuya Nakano
- Department of Pediatrics, Showa University School of Medicine, Tokyo, Japan
| | - Mabel Yau
- Icahn School of Medicine, Division of Pediatric Endocrinology, Mount Sinai Kravis Children's Hospital, New York, NY, USA
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3
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Steller JG, Gumina D, Driver C, Palmer C, Brown LD, Reeves S, Hobbins JC, Galan HL. 3D Fractional Limb Volume Identifies Reduced Subcutaneous and Lean Mass in Fetal Growth Restriction. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:1623-1632. [PMID: 34580892 DOI: 10.1002/jum.15841] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 07/30/2021] [Accepted: 08/18/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVES Fetal 2D and 3D fractional limb volume (FLV) measurements by ultrasound can detect fetal lean and subcutaneous mass and possibly percent body fat. Our objectives were to 1) compare FLV measurements in fetuses with fetal growth restriction (FGR) versus small for gestational age (SGA) defined by the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG)-supported international Delphi consensus and 2) correlate FLV findings with birth metrics. We hypothesize that FLV measurements will be significantly smaller in FGR versus SGA fetuses and will correlate closer with Ponderal index (PIx) in the neonate than abdominal circumference (AC). METHODS Patients were categorized as FGR or SGA as defined by ISUOG. Total thigh volume (TTV), volumes of lean mass (LMV), and fat mass volume (FMV) were calculated from 3D acquisitions. Measurements were compared between groups and correlated with birthweight (BW) and PIx (BW/crown-heal length). RESULTS The FGR group (n = 37) delivered earlier (37/2 versus 38/0; P = .0847), were lighter (2.2 kg versus 2.6 kg; P = .0003) and had lower PIx (0.023 versus 0.025; P = .0013) than SGAs (n = 22). FGRs had reduced TTV (40.6 versus 48.4 cm3 ; P = .0164), FMV (20.8 versus 25.3 cm3 ; P = .0413), and LMV (19.8 versus 23.1 cm3 ; P = .0387). AC had the highest area under the curve (0.69) for FGR. FMV was more strongly associated with PIx than the AC (P = .0032). CONCLUSIONS The AC and FLV measurements were significantly reduced in FGR fetuses compared to SGAs. While the AC outperformed FLV in predicting FGR, the FLV correlated best with PIx, which holds investigative promise.
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Affiliation(s)
- Jonathan G Steller
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of California, Irvine, Orange, CA, USA
| | - Diane Gumina
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Camille Driver
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Claire Palmer
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Laura D Brown
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Shane Reeves
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - John C Hobbins
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Henry L Galan
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, University of Colorado School of Medicine, Aurora, CO, USA
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4
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Blond K, Jensen BW, Petersen J, Baker JL, Bjerregaard LG. Trajectories of Infant Weight Gain from Birth to 12 Months and Adult-Onset Coronary Heart Disease. J Pediatr 2022; 246:123-130.e4. [PMID: 35398117 DOI: 10.1016/j.jpeds.2022.03.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/25/2022] [Accepted: 03/31/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate associations between infant weight gain trajectories and coronary heart disease (CHD). STUDY DESIGN We followed 3645 Danish individuals born between 1959 and 1961 with information on weight at birth and at age 2 weeks and 1, 2, 3, 4, 6, or 12 months. Sex-specific weight trajectories were generated using latent class modeling. Cases of CHD (n = 279) were identified from national health registers. Hazard ratios (HRs) were estimated by Cox regression with sequential adjustment for sex, socioeconomic status, prepregnancy body mass index, maternal smoking, preterm birth, parity, and birth weight. RESULTS We identified 5 trajectories of weight development in infancy in our cohort: very low-moderate increase (11.5% of the population), low-marked increase (13.9%), low-stable increase (32.4%), average-stable increase (29.8%), and high-moderate increase (12.4%). Compared with the average-stable increasing trajectory, having a very low-moderately increasing weight trajectory in infancy was associated with a higher frequency of adult CHD (HR, 1.56; 95% CI, 1.04-2.33). The higher frequency remained after adjustment for maternal factors but was slightly attenuated after additional adjustment for preterm birth and parity (HR, 1.41; 95% CI, 0.91-2.23) and disappeared after adjustment for birth weight (HR, 0.78; 95% CI, 0.44-1.37). The associations with CHD did not differ between the other trajectories and the average-stable increasing trajectory. CONCLUSIONS Although a pattern of very low-moderate increasing weight during infancy was associated with a higher frequency of adult CHD, the association did not persist after adjustment for birth weight, highlighting the importance of prenatal exposures.
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Affiliation(s)
- Kim Blond
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Britt W Jensen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Janne Petersen
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark; Section of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Jennifer L Baker
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Lise G Bjerregaard
- Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, Copenhagen, Denmark.
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5
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Marcovecchio ML, Gorman S, Watson LPE, Dunger DB, Beardsall K. Catch-Up Growth in Children Born Small for Gestational Age Related to Body Composition and Metabolic Risk at Six Years of Age in the UK. Horm Res Paediatr 2021; 93:119-127. [PMID: 32702692 DOI: 10.1159/000508974] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/15/2020] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES To determine differences in body composition and glucose metabolism according to childhood growth outcomes in a population-based sample of children born small for gestational age (SGA). METHODS A single-centre study of 259 children born SGA identified through hospital records and contacted when aged 4-7 years. Questionnaire data on pre/perinatal history and growth parameters during childhood was collected from the parents, and in a subgroup of 150 children face-to-face assessments were performed, including anthropometric parameters, lean and fat mass, blood pressure, fasting glucose, and C-peptide. RESULTS Based on the questionnaires, few children had formal clinic follow-up of growth, but 7% of the cohort showed a height and weight of <-2SDS during childhood, and only 2 children met the criteria for growth hormone therapy. Out of the 150 children assessed at a mean age of 6.1 ± 0.8 years, 122 (81%) showed a catch-up growth in weight. Compared to those without weight catch-up, these children had a higher fat mass index (3.13 ± 1.36 vs. 2.56 ± 0.91 kg/m2, p = 0.04), trunk-to-limb fat mass ratio (0.63 ± 0.14 vs. 0.56 ± 0.08, p = 0.002), systolic blood pressure SDS (0.09 ± 0.71 vs. -0.32 ± 0.63, p = 0.008), fasting glucose (4.5 ± 0.5 vs. 4.3 ± 0.5 mmol/L, p = 0.03), and C-peptide (306 ± 116 vs. 256 ± 112 pmol/L, p = 0.08). Among children with weight catch-up growth, those with less height gain had a lower limb lean mass index (4.25 ± 0.48 vs. 4.48 ± 0.56 kg/m2, p = 0.02) and fat mass index (1.57 ± 0.59 vs. 1.83 ± 0.77 kg/m2, p = 0.04). CONCLUSIONS Within this population-based sample of SGA children, catch-up growth in weight was associated with higher abdominal fat mass, blood pressure and glycemia; furthermore, in these children, less height gain was associated with reduced limb lean and fat mass.
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Affiliation(s)
| | - Samantha Gorman
- The Weston Centre, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - Laura P E Watson
- National Institute for Health Research (NIHR) Cambridge Clinical Research Facility, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
| | - David B Dunger
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.,Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, United Kingdom
| | - Kathryn Beardsall
- Department of Paediatrics, University of Cambridge, Cambridge, United Kingdom.,Neonatal Unit, Cambridge University Hospitals NHS Trust, Cambridge, United Kingdom
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Impact of size at birth and postnatal growth on metabolic and neurocognitive outcomes in prematurely born school-age children. Sci Rep 2021; 11:6836. [PMID: 33767246 PMCID: PMC7994814 DOI: 10.1038/s41598-021-86292-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Accepted: 03/15/2021] [Indexed: 11/09/2022] Open
Abstract
Prematurity, size at birth, and postnatal growth are important factors that determine cardiometabolic and neurodevelopmental outcomes later in life. In the present study, we aimed to investigate the associations between the size at birth and growth velocity after birth with cardiometabolic and neurodevelopmental outcomes in preterm infants. Fifty-six preterm infants born at < 32 weeks of gestation or having a birth weight of < 1500 g were enrolled and categorized into small for gestational age (SGA) and appropriate for gestational age (AGA) groups. Anthropometric and cardiometabolic parameters were assessed at school-age, and the Korean Wechsler Intelligence Scale for Children, fourth edition (K-WISC-IV) was used for assessing the intellectual abilities. The growth velocity was calculated by changes in the weight z-score at each time period. Multivariate analysis was conducted to investigate the associations of growth velocity at different periods with cardiometabolic and neurodevelopmental outcomes. Forty-two (75%) were classified as AGA and 25% as SGA. At school-age, despite the SGA children showing significantly lower body weight, lean mass index, and body mass index, there were no differences in the cardiometabolic parameters between SGA and AGA groups. After adjusting for gestational age, birth weight z-score, weight z-score change from birth to discharge and sex, change in weight z-score beyond 12 months were associated with a higher systolic blood pressure, waist circumference, and insulin resistance. Full-scale intelligent quotient (β = 0.314, p = 0.036) and perceptional reasoning index (β = 0.456, p = 0.003) of K-WISC-IV were positively correlated with postnatal weight gain in the neonatal intensive care unit. Although cardiometabolic outcomes were comparable in preterm SGA and AGA infants, the growth velocity at different time periods resulted in different cardiometabolic and neurocognitive outcomes. Thus, ensuring an optimal growth velocity at early neonatal period could promote good neurocognitive outcomes, while adequate growth after 1 year could prevent adverse cardiometabolic outcomes in preterm infants.
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de Fluiter KS, van Beijsterveldt IALP, Breij LM, Acton D, Hokken-Koelega ACS. Association Between Fat Mass in Early Life and Later Fat Mass Trajectories. JAMA Pediatr 2020; 174:1141-1148. [PMID: 32804197 PMCID: PMC7432277 DOI: 10.1001/jamapediatrics.2020.2673] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
IMPORTANCE A rapid increase in weight in early life is associated with an increased risk for adiposity and cardiovascular diseases at age 21 years and beyond. However, data on associations of early change in measured fat mass percentage (FM%) with adiposity development are lacking. OBJECTIVE To investigate whether a rapid increase in FM% in the first months of life is associated with higher trajectories of body fat mass during the first 2 years of life. DESIGN, SETTING, AND PARTICIPANTS A birth cohort consisting of 401 healthy, term-born infants of the Sophia Pluto Cohort Study was analyzed. Participants were born between January 7, 2013, and October 13, 2017. Data were analyzed from February 1, 2020, to May 20, 2020. INTERVENTIONS Longitudinal measurements of FM% by air-displacement plethysmography and dual-energy x-ray absorptiometry, and abdominal subcutaneous and visceral fat mass (FM) by ultrasonography in infants at ages 1, 3, 6, 9, 12, 18, and 24 months. A rapid increase in FM% was defined as a change in FM% of greater than 0.67 standard deviation scores (SDS). MAIN OUTCOMES AND MEASURES Associations between change in FM% SDS in the first and second 6-month period of life with body composition at age 2 years and whether a rapid increase in FM% SDS during the first 6 months leads to higher body FM and abdominal FM trajectories during the first 2 years of life. RESULTS Of the 401 participants, 228 infants (57%) were male. Change in FM% SDS from age 1 to 6 months was positively associated with FM% (β, 0.044; 95% CI, 0.017-0.068), FMI (β, 0.061; 95% CI, 0.032-0.091), and abdominal subcutaneous FM (β, 0.064; 95% CI, 0.036-0.092) at age 2 years, but not with visceral FM. In contrast, no associations were found within the 6- to 12-month period. Infants with a rapid increase in FM% of greater than 0.67 SDS in the first 6 months of life had higher trajectories of FM%, FM index, and subcutaneous FM during the first 2 years of life (all P≤.001), but visceral FM index was not significantly different compared with infants without a rapid increase (P = .12). CONCLUSIONS AND RELEVANCE In this study, only the change in FM% in the first 6 months of life was associated with more adiposity at age 2 years. Infants with a rapid increase in FM% had higher trajectories of FM% and FM index during the first 2 years of life. These findings appear to support a critical window for adiposity programming in early life.
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Affiliation(s)
- Kirsten S. de Fluiter
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Inge A. L. P. van Beijsterveldt
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Laura M. Breij
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands
| | - Dennis Acton
- Danone Nutricia Research, Utrecht, the Netherlands
| | - Anita C. S. Hokken-Koelega
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children’s Hospital, Rotterdam, the Netherlands,Dutch Growth Research Foundation, Rotterdam, the Netherlands
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8
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de Fluiter KS, Kerkhof GF, van Beijsterveldt IALP, Breij LM, van de Heijning BJM, Abrahamse-Berkeveld M, Hokken-Koelega ACS. Longitudinal human milk macronutrients, body composition and infant appetite during early life. Clin Nutr 2020; 40:3401-3408. [PMID: 33309161 DOI: 10.1016/j.clnu.2020.11.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 10/15/2020] [Accepted: 11/15/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND & AIMS Breastfeeding is the gold standard infant feeding. Data on macronutrients in relation to longitudinal body composition and appetite are very scarce. The aim of this study was to investigate longitudinal human milk macronutrients at 1 and 3 months in association with body composition and appetite during early life in healthy, term-born infants. We hypothesized that infants receiving higher caloric human milk would have more body fat mass and satiate earlier. METHODS In 133 exclusively breastfed infants (Sophia Pluto Cohort), human milk samples at 1 and 3 months were analyzed for macronutrients (fat, protein, carbohydrate) by MIRIS Human Milk Analyzer, with appetite assessment by Baby Eating Behavior Questionnaires. Fat mass (FM) and fat-free mass (FFM) were measured by PEA POD and DXA, and abdominal FM by ultrasound. RESULTS Milk samples showed large differences in macronutrients, particularly in fat content. Protein and energy content decreased significantly from 1 to 3 months. Fat and carbohydrate content tended to decrease (p = 0.066 and 0.081). Fat (g/100 ml) and energy (kcal/100 ml) content at 3 months were associated with FM% at 6 months (β 0.387 and 0.040, resp.) and gain in FM% from 1 to 6 months (β 0.088 and 0.009, resp.), but not with FM% at 2 years. Carbohydrate content at 3 months tended to associate with visceral FM at 2 years (β 0.290, p = 0.06). Infants receiving higher caloric milk were earlier satiated and finished feeding faster. CONCLUSIONS Our longitudinal data show decreasing milk protein and energy content from age 1 to 3 months, while fat and carbohydrate tended to decrease. Macronutrient composition, particularly fat content, differed considerably between mothers. Milk fat and energy content at 3 months associated with gain in FM% from age 1 to 6 months, indicating that higher fat and energy content associate with higher gain in FM% during the critical window for adiposity programming. As infants receiving higher caloric breastfeeding were earlier satiated, this self-regulatory mechanism might prevent intake of excessive macronutrients. ONLINE TRIAL REGISTRY NTR, NL7833.
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Affiliation(s)
- Kirsten S de Fluiter
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands.
| | - Gerthe F Kerkhof
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Inge A L P van Beijsterveldt
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Laura M Breij
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands
| | | | | | - Anita C S Hokken-Koelega
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center - Sophia Children's Hospital, Rotterdam, the Netherlands; Dutch Growth Research Foundation, Rotterdam, the Netherlands
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9
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Weeks O, Bossé GD, Oderberg IM, Akle S, Houvras Y, Wrighton PJ, LaBella K, Iversen I, Tavakoli S, Adatto I, Schwartz A, Kloosterman D, Tsomides A, Charness ME, Peterson RT, Steinhauser ML, Fazeli PK, Goessling W. Fetal alcohol spectrum disorder predisposes to metabolic abnormalities in adulthood. J Clin Invest 2020; 130:2252-2269. [PMID: 32202514 PMCID: PMC7190939 DOI: 10.1172/jci132139] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 01/17/2020] [Indexed: 12/23/2022] Open
Abstract
Prenatal alcohol exposure (PAE) affects at least 10% of newborns globally and leads to the development of fetal alcohol spectrum disorders (FASDs). Despite its high incidence, there is no consensus on the implications of PAE on metabolic disease risk in adults. Here, we describe a cohort of adults with FASDs that had an increased incidence of metabolic abnormalities, including type 2 diabetes, low HDL, high triglycerides, and female-specific overweight and obesity. Using a zebrafish model for PAE, we performed population studies to elucidate the metabolic disease seen in the clinical cohort. Embryonic alcohol exposure (EAE) in male zebrafish increased the propensity for diet-induced obesity and fasting hyperglycemia in adulthood. We identified several consequences of EAE that may contribute to these phenotypes, including a reduction in adult locomotor activity, alterations in visceral adipose tissue and hepatic development, and persistent diet-responsive transcriptional changes. Taken together, our findings define metabolic vulnerabilities due to EAE and provide evidence that behavioral changes and primary organ dysfunction contribute to resultant metabolic abnormalities.
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Affiliation(s)
- Olivia Weeks
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Gabriel D. Bossé
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Isaac M. Oderberg
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sebastian Akle
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Organismic and Evolutionary Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Yariv Houvras
- Department of Surgery and
- Department of Medicine, Weill Cornell Medical College, New York, New York, USA
| | - Paul J. Wrighton
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kyle LaBella
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Isabelle Iversen
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sahar Tavakoli
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Isaac Adatto
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Arkadi Schwartz
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Daan Kloosterman
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Allison Tsomides
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Michael E. Charness
- Veterans Affairs Boston Healthcare System, West Roxbury, Massachusetts, USA
- Neurology, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Randall T. Peterson
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, Salt Lake City, Utah, USA
| | - Matthew L. Steinhauser
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
- Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA
| | - Pouneh K. Fazeli
- Neuroendocrine Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Wolfram Goessling
- Division of Genetics, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
- Broad Institute, Massachusetts Institute of Technology and Harvard University, Cambridge, Massachusetts, USA
- Harvard Stem Cell Institute, Cambridge, Massachusetts, USA
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts, USA
- Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, USA
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10
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Dunger D, Darendeliler F, Kandemir N, Harris M, Rabbani A, Kappelgaard AM. What is the evidence for beneficial effects of growth hormone treatment beyond height in short children born small for gestational age? A review of published literature. J Pediatr Endocrinol Metab 2020; 33:53-70. [PMID: 31860471 DOI: 10.1515/jpem-2019-0098] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Accepted: 10/17/2019] [Indexed: 12/19/2022]
Abstract
Background An increasing body of evidence supports the view that both an adverse intrauterine milieu and rapid postnatal weight gain in children born small for gestational age (SGA) contribute towards the risk for the development of chronic diseases in adult life. Content The aim of this review was to identify and summarize the published evidence on metabolic and cardiovascular risk, as well as risk of impaired cardiac function, intellectual capacity, quality of life, pubertal development and bone strength among children born SGA. The review will then address whether growth hormone (GH) therapy, commonly prescribed to reduce the height deficit in children born SGA who do not catch up in height, increases or decreases these risks over time. Summary Overall, there are limited data in support of a modest beneficial effect of GH therapy on the adverse metabolic and cardiovascular risk observed in short children born SGA. Evidence to support a positive effect of GH on bone strength and psychosocial outcomes is less convincing. Outlook Further evaluation into the clinical relevance of any potential long-term benefits of GH therapy on metabolic and cardiovascular endpoints is warranted.
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Affiliation(s)
- David Dunger
- Department of Paediatrics, School of Clinical Medicine, University of Cambridge, Box 116, Level 8, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK.,The Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Feyza Darendeliler
- Department of Pediatrics, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Nurgun Kandemir
- İhsan Doğramacı Children's Hospital, Hacettepe University, Ankara, Turkey
| | - Mark Harris
- Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Ali Rabbani
- Growth and Development Research Center, Children's Medical Center of Excellence, Tehran University of Medical Sciences, Tehran, Iran
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11
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Brion LP, Rosenfeld CR, Heyne R, Brown SL, Lair CS, Burchfield PJ, Caraig M. Adjustable feedings plus accurate serial length measurements decrease discharge weight-length disproportion in very preterm infants: quality improvement project. J Perinatol 2019; 39:1131-1139. [PMID: 31263201 DOI: 10.1038/s41372-019-0424-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2019] [Revised: 05/05/2019] [Accepted: 05/26/2019] [Indexed: 11/09/2022]
Abstract
BACKGROUND Preterm very-low-birth-weight (≤1500 g) infants exhibit disproportionate weight-for-length growth in the Neonatal Intensive Care Unit. LOCAL PROBLEM High frequency of body mass index (BMI) > 90th centile at discharge and 1-year postnatal age associated with elevated blood pressure and serum leptin in infancy and adolescence. METHODS Single-institution quality improvement project in appropriately grown infants born at 230/7-286/7 weeks gestational age and discharged home. INTERVENTION Adjustable feeding protocol based on valid serial length measurements (board or caliper). RESULTS The average monthly percentage of weight-for-length disproportion at discharge decreased from 13% in Epoch 1 to 0% in Epoch 2 (P < 0.05). Although the average Z-score for BMI at discharge was lower in Epoch 2 versus Epoch 1 (P < 0.01), this was absent by 1 year follow-up (P = 0.91). CONCLUSIONS Adjustable feedings plus use of accurate serial length measurements decreases weight-for-length disproportion at hospital discharge but not at 1 year.
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Affiliation(s)
- Luc P Brion
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Charles R Rosenfeld
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Roy Heyne
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Cheryl S Lair
- Parkland Hospital and Health System, Dallas, TX, USA
| | - Patti J Burchfield
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Maria Caraig
- Division of Neonatal-Perinatal Medicine, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA
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12
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Darendeliler F. IUGR: Genetic influences, metabolic problems, environmental associations/triggers, current and future management. Best Pract Res Clin Endocrinol Metab 2019; 33:101260. [PMID: 30709755 DOI: 10.1016/j.beem.2019.01.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The children with intrauterine growth restriction (IUGR) especially if they make a catch-up growth in early life have a higher risk for long term problems including short stature and also developing metabolic syndrome, Type 2 diabetes, insulin resistance and cardiovascular diseases. The studies also support that these children may have abnormalities in pubertal timing, adrenarche and reproductive function. The aim of this review was to summarize the published reports mainly on puberty and reproductive functions in children born IUGR at older ages in association with metabolic problems that they encounter. Possible mechanisms explaining these outcomes are discussed. Lastly strategies that may be taken for the prevention of IUGR related morbidities at later life are shortly presented.
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Affiliation(s)
- Feyza Darendeliler
- İstanbul University, Istanbul Faculty of Medicine, Pediatric Endocrinology Unit, İstanbul, Turkey.
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13
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Rønn PF, Jørgensen ME, Smith LS, Bjerregaard P, Dahl-Petersen IK, Larsen CVL, Grarup N, Andersen GS. Associations between birth weight and glucose intolerance in adulthood among Greenlandic Inuit. Diabetes Res Clin Pract 2019; 150:129-137. [PMID: 30851284 DOI: 10.1016/j.diabres.2019.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 02/15/2019] [Accepted: 03/01/2019] [Indexed: 01/09/2023]
Abstract
AIMS To examine the association between birth weight and glucose intolerance in adult Greenlandic Inuit. METHODS We examined 1429 participants aged 18-56 years from two population-based, cross-sectional studies in Greenland with information on birth weight. Oral glucose tolerance tests, anthropometric measures and ultrasound of abdominal tissue were performed. Associations of birth weight with glucose markers were analysed using linear or logistic regressions. Spline analyses were conducted to examine u-shaped associations. Adjustments were done for age, sex, birth place, family history of diabetes, genetic admixture, TBC1D4 p.Arg684Ter carrier status, BMI and visceral adipose tissue. RESULTS The median birthweight was 3300 g and 3.9% had type 2 diabetes, T2DM. Spline analyses indicated overall linear associations. In fully adjusted analyses, an increase in birth weight of 1 kg was associated with a change in fasting plasma glucose of -0.06 mmol/L (95%CI: -0.11, -0.01), 2-h plasma glucose of -0.16 mmol/L (95%CI: -0.35, 0.02), HOMA-IR of -5.45% (95%CI: -10.34, -0.29), insulin sensitivity index of 7.04% (95%CI: 1.88, 12.45) and a trend towards a reduced risk of hyperglycaemia and T2DM, although statistically insignificant. CONCLUSIONS Birth weight was inversely associated with hepatic and peripheral insulin resistance independently of adult adiposity. Thus, the findings support low birth weight as a contributing factor for glucose intolerance in adult Inuit in Greenland.
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Affiliation(s)
| | - Marit Eika Jørgensen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; University of Greenland, Greenland
| | | | - Peter Bjerregaard
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; University of Greenland, Greenland
| | - Inger Katrine Dahl-Petersen
- Steno Diabetes Center Copenhagen, Gentofte, Denmark; National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Christina Viskum Lytken Larsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark; University of Greenland, Greenland
| | - Niels Grarup
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
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14
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Van Hulst A, Paradis G, Benedetti A, Barnett TA, Henderson M. Pathways Linking Birth Weight and Insulin Sensitivity in Early Adolescence: A Double Mediation Analysis. J Clin Endocrinol Metab 2018; 103:4524-4532. [PMID: 30137396 PMCID: PMC6220441 DOI: 10.1210/jc.2018-00525] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 08/15/2018] [Indexed: 01/02/2023]
Abstract
PURPOSE We examined pathways linking birth weight, weight gain from 0 to 2 years, and adiposity during childhood with insulin sensitivity in early adolescence. METHODS Data were from a longitudinal cohort of 630 Quebec white children with a parental history of obesity (Quebec Adipose and Lifestyle Investigation in Youth study). In a subsample of children born at term (n = 395), weight-for-length z score (zWFL) from 0 to 2 years were computed. At 8 to 10 years, the percentage of body fat was assessed using dual energy X-ray absorptiometry. At 10 to 12 years, the Matsuda insulin sensitivity index (ISI) and the homeostasis model assessment for insulin resistance were determined. A linear regression-based approach for mediation analysis was used to estimate the distinct pathways linking zWFL at 0 to 2 years to insulin sensitivity. RESULTS Every additional unit in zWFL at birth was associated with a 10% (95% CI, 5.26% to 14.85%) increase in the Matsuda ISI in early adolescence, independently of the weight at 0 to 2 years and in childhood. An indirect effect of zWFL at birth on the Matsuda ISI was also observed but in the opposite direction (-4.44; 95% CI, -7.91 to -1.05). This relation was mediated by childhood adiposity but not by weight gain from 0 to 2 years. The indirect effect of weight gain from 0 to 2 years, via childhood adiposity, also led to lower insulin sensitivity (-4.83%, 95% CI, -7.34 to -2.53). The findings were similar for the homeostasis model assessment for insulin resistance or when restricted to children with appropriate-for-gestational-age birth weights. CONCLUSIONS A greater birth weight-for-length resulted in improved insulin sensitivity in early adolescence. However, in the presence of excess childhood adiposity, both a greater birth weight and a faster rate of weight gain from 0 to 2 years resulted in lower insulin sensitivity.
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Affiliation(s)
- Andraea Van Hulst
- Ingram School of Nursing, McGill University, Montreal, Quebec, Canada
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Andrea Benedetti
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Quebec, Canada
- Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre, Montreal, Quebec, Canada
| | - Tracie A Barnett
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- INRS-Armand-Frappier Institute, Laval, Quebec, Canada
| | - Mélanie Henderson
- Centre de Recherche du CHU Sainte-Justine, Montreal, Quebec, Canada
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
- Correspondence and Reprint Requests: Mélanie Henderson, MD, PhD, Division of Endocrinology, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin Côte Sainte-Catherine, Montreal, Quebec H3T 1C5, Canada. E-mail:
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15
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Valid serial length measurements in preterm infants permit characterization of growth patterns. J Perinatol 2018; 38:1694-1701. [PMID: 30267002 DOI: 10.1038/s41372-018-0242-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2018] [Revised: 08/15/2018] [Accepted: 08/20/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The lack of a valid and safe method for measuring length in critically ill preterm neonates has led to a primary focus on weight gain. LOCAL PROBLEM Paucity of valid length measurements, precluding the accurate analysis of growth patterns. METHODS Quality improvement project among infants < 29 weeks or small for gestational age < 35 weeks with embedded validation of (1) a caliper (infantometer) for length measurements and (2) length measurements during the first week to estimate birth length. INTERVENTION Implementation of valid methods to measure length. RESULTS We validated infantometer measurements and first week length measurements. The percentage of neonates with valid measurements during the first week rose from 10% to 78%, resulting in increased identification of classifiable growth patterns from < 10% to 89%. CONCLUSIONS By increasing the percentage of neonates with valid length measurements in the first week postnatal, we identified an increased number of neonates with classifiable growth abnormalities.
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16
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Andersen GS, Wibaek R, Kaestel P, Girma T, Admassu B, Abera M, Vistisen D, Jørgensen ME, Michaelsen KF, Friis H, Wells JCK. Body Composition Growth Patterns in Early Infancy: A Latent Class Trajectory Analysis of the Ethiopian iABC Birth Cohort. Obesity (Silver Spring) 2018; 26:1225-1233. [PMID: 29845756 DOI: 10.1002/oby.22197] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Revised: 03/08/2018] [Accepted: 03/22/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The objective of this study was to identify subgroups with distinct fat and fat-free growth patterns in the first 6 months of life and describe predictors of these different patterns. METHODS A total of 510 apparently healthy Ethiopian infants were followed from birth to 6 months of age. Each infant had at least three and up to six repeated measurements of fat and fat-free mass using air-displacement plethysmography. Latent class trajectory analyses were used to categorize infants in groups with distinct body composition patterns. RESULTS Four distinct fat mass and two fat-free mass growth patterns were identified. Of the infants measured, 5% presented a delayed fat growth pattern and 3% presented a catch-up fat growth pattern involving low birth weight but a significant fat growth velocity from 2.5 to 6 months. A large class had a high fat level at birth and an accelerated fat growth pattern in early infancy. Fat-free growth was represented by two distinct classes with less variability. Catch-up growth was primarily seen in fat mass. CONCLUSIONS We identified distinct patterns of delayed, catch-up, and accelerated fat growth in early infancy. This variability is not detected in regular anthropometric assessment and could be a mechanism linking early growth with later obesity and cardiometabolic risk.
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Affiliation(s)
| | - Rasmus Wibaek
- Steno Diabetes Center Copenhagen, Gentofte, Denmark
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Pernille Kaestel
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Tsinuel Girma
- Department of Pediatrics and Child Health, Jimma University Specialized Hospital, Jimma, Ethiopia
| | - Bitiya Admassu
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Department of Population and Family Health, Faculty of Public Health, Jimma University, Jimma, Ethiopia
| | - Mubarek Abera
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
- Department of Psychiatry, Faculty of Medical Sciences, Jimma University, Jimma, Ethiopia
| | | | | | - Kim F Michaelsen
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Henrik Friis
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Frederiksberg, Denmark
| | - Jonathan C K Wells
- Childhood Nutrition Research Centre, University College London Great Ormond Street Institute of Child Health, London, UK
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17
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Breij LM, Abrahamse-Berkeveld M, Acton D, De Lucia Rolfe E, Ong KK, Hokken-Koelega ACS. Impact of Early Infant Growth, Duration of Breastfeeding and Maternal Factors on Total Body Fat Mass and Visceral Fat at 3 and 6 Months of Age. ANNALS OF NUTRITION AND METABOLISM 2017; 71:203-210. [PMID: 29136614 DOI: 10.1159/000481539] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2016] [Accepted: 09/12/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Accelerated gain in fat mass in the first months of life is considered to be a risk factor for adult diseases, given the tracking of infancy fat mass into adulthood. Our objective was to assess the influence of early growth, type of feeding and maternal variables on fat mass in early life. METHODS In 300 healthy term infants, we longitudinally measured fat mass percentage (FM%) by air-displacement-plethysmography at 1, 3, and 6 months and abdominal visceral and subcutaneous fat measured by ultrasound at 3 and 6 months. RESULTS Both gain in FM% and weight-for-length in the first 3 months were positively associated with FM% at 6 months of age and visceral fat at 3 months of age. Gain in FM% and weight-for-length between 3 and 6 months were both positively associated with visceral fat at 6 months. Breastfeeding duration associated positively with subcutaneous fat but not with visceral fat at 3 and 6 months. Maternal characteristics did not associate with FM% or visceral fat at 3 or 6 months. CONCLUSION Higher gain in FM% or in weight-for-length in the first postnatal months leads not only to higher FM% but also more to accumulation of visceral fat. Exclusive breastfeeding appears to promote subcutaneous but not visceral fat in the first 6 months.
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Affiliation(s)
- Laura M Breij
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus MC/Sophia Children's Hospital, Rotterdam, the Netherlands
| | | | | | - Emanuella De Lucia Rolfe
- Medical Research Council Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Ken K Ong
- Medical Research Council Epidemiology Unit, University of Cambridge, Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, United Kingdom
| | - Anita C S Hokken-Koelega
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus MC/Sophia Children's Hospital, Rotterdam, the Netherlands
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18
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Van Hulst A, Barnett TA, Paradis G, Roy-Gagnon MH, Gomez-Lopez L, Henderson M. Birth Weight, Postnatal Weight Gain, and Childhood Adiposity in Relation to Lipid Profile and Blood Pressure During Early Adolescence. J Am Heart Assoc 2017; 6:JAHA.117.006302. [PMID: 28778942 PMCID: PMC5586463 DOI: 10.1161/jaha.117.006302] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background Different pathways likely underlie the association between early weight gain and cardiovascular disease risk. We examined whether birth weight for length relationship and weight gain up to 2 years of age are associated with lipid profiles and blood pressure (BP) in early adolescence and determined whether childhood adiposity mediates these associations. Methods and Results Data from QUALITY (Quebec Adipose and Lifestyle Investigation in Youth), a cohort of white children with parental history of obesity, were analyzed (n=395). Sex‐specific weight for length z scores from birth to 2 years were computed. Rate of postnatal weight gain was estimated using individual slopes of weight for length z‐score measurements. Percentage of body fat was measured at 8 to 10 years. Fasting lipids and BP were measured at 10 to 12 years. Using path analysis, we found indirect effects of postnatal weight gain, through childhood adiposity, on all outcomes: Rate of postnatal weight for length gain was positively associated with childhood adiposity, which in turn was associated with unfavorable lipid and BP levels in early adolescence. In contrast, small beneficial direct effects on diastolic BP z scores, independent of weight at other time points, were found for birth weight for length (β=−0.05, 95% CI, −0.09 to −0.002) and for postnatal weight gain (β=−0.02, 95% CI, −0.03 to −0.002). Conclusions Among children with at least 1 obese parent, faster postnatal weight gain leads to cardiovascular risk factors in early adolescence through its effect on childhood adiposity. Although heavier newborns may have lower BP in early adolescence, this protective direct effect could be offset by a deleterious indirect effect linking birth weight to later adiposity.
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Affiliation(s)
- Andraea Van Hulst
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Canada.,Centre de recherche du CHU Sainte-Justine, Montreal, Canada
| | - Tracie A Barnett
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada.,INRS-Armand-Frappier Institute, Laval, Canada
| | - Gilles Paradis
- Department of Epidemiology Biostatistics and Occupational Health, McGill University, Montreal, Canada
| | | | - Lilianne Gomez-Lopez
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada.,Division of medical genetics, CHU Sainte-Justine, Montreal, Canada
| | - Mélanie Henderson
- Centre de recherche du CHU Sainte-Justine, Montreal, Canada .,Department of Pediatrics, University of Montreal, Canada
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19
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Does prednisone use or disease activity in pregnant women with rheumatoid arthritis influence the body composition of their offspring? Reprod Toxicol 2017; 71:118-123. [DOI: 10.1016/j.reprotox.2017.05.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 04/25/2017] [Accepted: 05/02/2017] [Indexed: 12/22/2022]
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20
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Rom AL, Wu CS, Olsen J, Jawaheer D, Hetland ML, Ottesen B, Mørch LS. Parental Rheumatoid Arthritis, Child Mortality, and Case Fatality: A Nationwide Cohort Study. Arthritis Care Res (Hoboken) 2017; 69:933-937. [PMID: 27390220 DOI: 10.1002/acr.22991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 05/31/2016] [Accepted: 07/05/2016] [Indexed: 11/07/2022]
Abstract
OBJECTIVE We have previously reported increased long-term morbidity in children of parents with rheumatoid arthritis (RA). Here we assess child mortality and case fatality in the same cohort. METHODS All singletons born in Denmark from 1977 to 2008 were identified through linkage of Danish national registries. Cox proportional hazards models were used to calculate hazard ratios (HRs) of death from all causes among children exposed to parental RA, compared to unexposed children. Risk of death after infection or respiratory diseases was also assessed for children below the age of 5 years. RESULTS This study followed 1,917,723 newborns for an average of 16 years. Of these, 13,556 were exposed to maternal RA and 6,330 to paternal RA. Overall mortality rates in children exposed to maternal or paternal RA did not differ from those in unexposed children (HR 0.98 [95% confidence interval (95% CI) 0.84-1.15] and 1.08 [95% CI 0.86-1.36], respectively), nor did the risk of death below the ages of 5 years, 3 years, or 1 year. In the group of children below the age of 5 years, 6,106 children of parents with RA were diagnosed with respiratory diseases and 3,320 with infectious diseases. The case fatality rate in children with these diseases was not significantly higher than in unexposed children (HR 1.11 [95% CI 0.74-1.66] and 0.84 [95% CI 0.52-1.35], respectively). CONCLUSION Children of parents with RA had similar mortality rates as other children, as well as after diagnoses of respiratory or infectious diseases.
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Affiliation(s)
- Ane L Rom
- The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Chun S Wu
- University of Aarhus, Aarhus, Denmark, and Institute of Clinical Research, University of Southern Denmark, and Odense University Hospital, Odense, Denmark
| | - Jørn Olsen
- University of Aarhus, Aarhus, Denmark, and University of California, Los Angeles
| | - Damini Jawaheer
- Children's Hospital Oakland Research Institute, Oakland, California
| | - Merete L Hetland
- Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Rigshospitalet, Glostrup, Denmark, and University of Copenhagen, Copenhagen, Denmark
| | - Bent Ottesen
- The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - Lina S Mørch
- The Juliane Marie Centre, Copenhagen University Hospital Rigshospitalet, and Danish Cancer Society Research Centre, Copenhagen, Denmark
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Lind L, Elmståhl S, Ärnlöv J. Change in Body Weight from Age 20 Years Is a Powerful Determinant of the Metabolic Syndrome. Metab Syndr Relat Disord 2017; 15:112-117. [PMID: 28339342 DOI: 10.1089/met.2016.0121] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Higher body weight is a well-known determinant of the metabolic syndrome (MetS) and its components. It is however less well studied how the change in weight from age 20 years to middle age or old age affects MetS development. METHODS In the community-based EpiHealth (n = 19,000, age range 45 to 75 years, 56% females) and PIVUS (n = 1000, all aged 70 years, 50% females) studies, the participants were asked about their body weight at age 20 years. Data were collected to determine MetS prevalence (NCEP ATP III criteria). RESULTS In EpiHealth, the probability of having MetS increased fairly linearly with increasing weight from age 20 in the obese [odds ratios (OR) 1.04 per kg change in weight, 95% confidence interval (CI) 1.03-1.05, P < 0.0001], as well as in the overweight (OR 1.15, 95% CI 1.14-1.17, P < 0.0001) and normal-weight (OR 1.18, 95% CI 1.14-1.21, P < 0.0001), subjects after adjustment for age, sex, body mass index (BMI) at age 20, alcohol intake, smoking, education, and exercise habits. Also in the PIVUS study, the change in weight over 50 years was related to prevalent MetS (OR 1.08 per kg change in weight, 95% CI 1.06-1.10, P < 0.0001). In both studies, self-reported BMI at age 20 was related to prevalent MetS. CONCLUSION Self-reported weight gain from age 20 was strongly and independently associated with prevalent MetS both in middle age or old age. Interestingly, this relationship was not restricted only to obese subjects. Our data provide additional support for the importance of maintaining a stable weight throughout life.
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Affiliation(s)
- Lars Lind
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden
| | - Sölve Elmståhl
- 2 Department of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö University Hospital , Malmö, Sweden
| | - Johan Ärnlöv
- 1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden .,3 School of Health and Social Studies, Dalarna University , Falun, Sweden
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Smeets CCJ, Codd V, Denniff M, Samani NJ, Hokken-Koelega ACS. Effects of size at birth, childhood growth patterns and growth hormone treatment on leukocyte telomere length. PLoS One 2017; 12:e0171825. [PMID: 28178350 PMCID: PMC5298325 DOI: 10.1371/journal.pone.0171825] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Accepted: 01/26/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Small size at birth and rapid growth in early life are associated with increased risk of cardiovascular disease in later life. Short children born small for gestational age (SGA) are treated with growth hormone (GH), inducing catch-up in length. Leukocyte telomere length (LTL) is a marker of biological age and shorter LTL is associated with increased risk of cardiovascular disease. OBJECTIVES To investigate whether LTL is influenced by birth size, childhood growth and long-term GH treatment. METHODS We analyzed LTL in 545 young adults with differences in birth size and childhood growth patterns. Previously GH-treated young adults born SGA (SGA-GH) were compared to untreated short SGA (SGA-S), SGA with spontaneous catch-up to a normal body size (SGA-CU), and appropriate for gestational age with a normal body size (AGA-NS). LTL was measured using a quantitative PCR assay. RESULTS We found a positive association between birth length and LTL (p = 0.04), and a trend towards a positive association between birth weight and LTL (p = 0.08), after adjustments for gender, age, gestational age and adult body size. Weight gain during infancy and childhood and fat mass percentage were not associated with LTL. Female gender and gestational age were positively associated with LTL, and smoking negatively. After adjustments for gender, age and gestational age, SGA-GH had a similar LTL as SGA-S (p = 0.11), SGA-CU (p = 0.80), and AGA-NS (p = 0.30). CONCLUSIONS Larger size at birth is positively associated with LTL in young adulthood. Growth patterns during infancy and childhood are not associated with LTL. Previously GH-treated young adults born SGA have similar LTL as untreated short SGA, SGA with spontaneous catch-up and AGA born controls, indicating no adverse effects of GH-induced catch-up in height on LTL.
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Affiliation(s)
- Carolina C. J. Smeets
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
- * E-mail:
| | - Veryan Codd
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom
| | - Matthew Denniff
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
| | - Nilesh J. Samani
- Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom
- NIHR Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom
| | - Anita C. S. Hokken-Koelega
- Department of Pediatrics, subdivision of Endocrinology, Erasmus University Medical Center, Rotterdam, The Netherlands
- Dutch Growth Research Foundation, Rotterdam, The Netherlands
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23
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van der Steen M, Smeets CCJ, Kerkhof GF, Hokken-Koelega ACS. Metabolic health of young adults who were born small for gestational age and treated with growth hormone, after cessation of growth hormone treatment: a 5-year longitudinal study. Lancet Diabetes Endocrinol 2017; 5:106-116. [PMID: 28011067 DOI: 10.1016/s2213-8587(16)30422-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Revised: 10/28/2016] [Accepted: 11/02/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Growth hormone treatment reduces fat mass and insulin sensitivity and increases lean body mass. Data are only available for short-term longitudinal changes after cessation of growth hormone treatment in young adults born small for gestational age. We aimed to assess long-term changes over a 5-year period following cessation of growth hormone treatment. METHODS We did a longitudinal study of young adults born small for gestational age and previously treated with growth hormone. Individuals were followed up for 5 years after attainment of adult height, when growth hormone treatment was discontinued: assessments were done at cessation of growth hormone treatment and at 6 months, 2 years, and 5 years thereafter. Data 5 years after cessation of growth hormone were compared with untreated age-matched controls. We used dual-energy x-ray absorptiometry to assess body composition, and did frequently sampled intravenous glucose tolerance tests to assess insulin sensitivity, acute insulin response, and the disposition index (a measure of β-cell function). This study is registered with ISRCTN, numbers ISRCTN96883876 and ISRCTN65230311. FINDINGS Between April, 2004, and April, 2016, we followed up 199 young adults born small for gestational age and previously treated with growth hormone, during the 5 years after cessation of growth hormone treatment. Data at 5 years for these individuals were compared with those for 51 untreated adults born small for gestational age with short stature, 92 untreated adults born small for gestational age with spontaneous catch-up growth, and 142 adults born appropriate for gestational age and unexposed to growth hormone treatment. In young adults born small for gestational age and previously treated with growth hormone, 5 years after cessation of growth hormone treatment, there were increases in fat mass (estimated marginal mean 10·73 kg [95% CI 9·95-11·50] at cessation of treatment vs 16·12 kg [14·77-17·46] at 5 years; p<0·0001), trunk fat (5·34 kg [4·94-5·73] vs 7·86 kg [7·12-8·60]; p<0·0001), and limb fat (4·87 kg [4·49-5·25] vs 7·41 kg [6·78-8·05]; p<0·0001); furthermore, lean body mass had decreased (42·41 kg [95% CI 41·09-43·73] at cessation of treatment vs 41·42 kg [40·17-42·66] at 5 years; p=0·0013). Insulin sensitivity increased within 6 months of cessation and was sustained 5 years after treatment cessation (estimated marginal mean 4·14 mU/L [95% CI 3·79-4·53] at cessation of treatment vs 6·15 mU/L [5·21-7·24] at 5 years; p<0·0001), and acute insulin response was diminished at 6 months, which persisted at 5 year follow-up (597·63 mU/L [539·62-661·86] vs 393·69 mU/L [337·56-459·15]; p<0·0001). The disposition index was increased 6 months after treatment but values at 5 years were similar to those at cessation of treatment (2483·94 [95% CI 2233·43-2762·54] at cessation of treatment vs 2367·83 [2033·43-2757·22] at 5 years; p=0·49). 5 years after cessation of growth hormone treatment, adults born small for gestational age and previously treated with growth hormone had fat mass, insulin sensitivity, and disposition index similar to those of untreated adults born small for gestational age with short stature, but lean body mass (adjusted for sex and height) was lower (46·47 kg [44·95-48·00] in those born small for gestational age with short stature vs 44·32 kg [43·35-45·30] in those born small for gestational age and treated with growth hormone; p=0·007). In adults previously treated with growth hormone born small for gestational age, at 5 years after cessation of growth hormone treatment, compared with adults born small for gestational age with spontaneous catch-up growth and adults born appropriate for gestational age, lean body mass was lower and results from frequently sampled intravenous glucose tolerance tests were similar. INTERPRETATION Significant changes in body composition and insulin sensitivity were recorded 5 years after cessation of growth hormone treatment in adults born small for gestational age, reflecting a loss of pharmacological effects of growth hormone. 5 years after cessation of treatment, fat mass, insulin sensitivity, and β-cell function of previously treated adults were similar to untreated adults born small for gestational age with short stature, indicating that long-term growth hormone treatment in children born small for gestational age has no unfavourable effects on metabolic health in early adulthood. FUNDING Novo Nordisk Farma BV (Netherlands).
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Affiliation(s)
- Manouk van der Steen
- Subdivision of Endocrinology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands.
| | - Carolina C J Smeets
- Subdivision of Endocrinology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Gerthe F Kerkhof
- Subdivision of Endocrinology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Anita C S Hokken-Koelega
- Subdivision of Endocrinology, Department of Pediatrics, Erasmus University Medical Center, Rotterdam, Netherlands
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24
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Singer K, Lumeng CN. The initiation of metabolic inflammation in childhood obesity. J Clin Invest 2017; 127:65-73. [PMID: 28045405 DOI: 10.1172/jci88882] [Citation(s) in RCA: 110] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
An understanding of the events that initiate metabolic inflammation (metainflammation) can support the identification of targets for preventing metabolic disease and its negative effects on health. There is ample evidence demonstrating that the initiating events in obesity-induced inflammation start early in childhood. This has significant implications on our understanding of how early life events in childhood influence adult disease. In this Review we frame the initiating events of metainflammation in the context of child development and discuss what this reveals about the mechanisms by which this unique form of chronic inflammation is initiated and sustained into adulthood.
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25
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Kofler T, Bossard M, Aeschbacher S, Tabord A, Repilado FJR, van der Lely S, Berger S, Risch M, Risch L, Conen D. The interrelationships of birthweight, inflammation and body composition in healthy adults. Eur J Clin Invest 2016; 46:342-8. [PMID: 26880533 DOI: 10.1111/eci.12606] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 02/11/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND Lower birthweight is associated with an increased risk of cardiovascular diseases and diabetes. We hypothesized that inflammation and body fat may be potential mediators for these inverse relationships. MATERIALS AND METHODS Healthy adults aged 25-41 years were enrolled in a prospective population-based cohort study in the Principality of Liechtenstein. Main exclusion criteria were diabetes, overt cardiovascular disease or a body mass index > 35 kg/m(2) . Birthweight was self-reported by the study participants. White blood cell (WBC) count and high-sensitivity C-reactive protein (hs-CRP) levels were assayed from fresh blood samples. Body composition was determined by bioelectrical impedance analysis. Multivariable linear regression models were constructed to assess the relationships between birthweight, inflammation and body composition. RESULTS Our sample consisted of 1774 participants (53·4% females) with a median age of 37 years. Median birthweight was 3355 g. In multivariable models, we found an inverse relationship of birthweight with hs-CRP levels (β -0·010 (95% CI -0·02; -0·002), P = 0·01) and WBC count (β -0·002 (95% CI -0·004; -0·0002), P = 0·03). Additional adjustment for body fat mass attenuated these relationships (β -0·008 (95% CI -0·02; 0·0003), P = 0·06 for hs-CRP levels and (β -0·002 (95% CI -0·004; 0·0006), P = 0·16 for WBC count. Body fat mass itself was strongly associated with birthweight (β -0·06 (95% CI -0·10; -0·03), P < 0·0001). CONCLUSION Birthweight is inversely associated with inflammation in adulthood. This relationship may be mediated by an elevated body fat mass among individuals with lower birthweight.
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Affiliation(s)
- Thomas Kofler
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Matthias Bossard
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland.,Cardiology Division, University Hospital Basel, Basel, Switzerland
| | - Stefanie Aeschbacher
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Alexandra Tabord
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Francisco Javier Ruperti Repilado
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Stéphanie van der Lely
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Sebastian Berger
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
| | - Martin Risch
- Labormedizinisches Zentrum Dr. Risch, Schaan, Liechtenstein.,Division of Laboratory Medicine, Kantonsspital Graubünden, Chur, Switzerland
| | - Lorenz Risch
- Labormedizinisches Zentrum Dr. Risch, Schaan, Liechtenstein.,Division of Clinical Biochemistry, Medical University, Innsbruck, Austria.,Private University, Triesen, Liechtenstein
| | - David Conen
- Department of Medicine, University Hospital Basel, Basel, Switzerland.,Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
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26
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Cho WK, Suh BK. Catch-up growth and catch-up fat in children born small for gestational age. KOREAN JOURNAL OF PEDIATRICS 2016; 59:1-7. [PMID: 26893597 PMCID: PMC4753194 DOI: 10.3345/kjp.2016.59.1.1] [Citation(s) in RCA: 105] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 06/15/2015] [Accepted: 08/20/2015] [Indexed: 12/17/2022]
Abstract
Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects.
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Affiliation(s)
- Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul, Korea
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27
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Faienza MF, Brunetti G, Delvecchio M, Zito A, De Palma F, Cortese F, Nitti A, Massari E, Gesualdo M, Ricci G, Carbonara S, Giordano P, Cavallo L, Scicchitano P, Ciccone MM. Vascular Function and Myocardial Performance Indices in Children Born Small for Gestational Age. Circ J 2016; 80:958-963. [PMID: 26861187 DOI: 10.1253/circj.cj-15-1038] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Maria Felicia Faienza
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Giacomina Brunetti
- Department of Basic and Medical Sciences, Neurosciences and Sense Organs, Section of Human Anatomy and Histology, University “A. Moro”
| | - Maurizio Delvecchio
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Annapaola Zito
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Fabrizia De Palma
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Francesca Cortese
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Adriana Nitti
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Elena Massari
- Department of Pediatric Cardiology, Giovanni XXIII Pediatric Hospital
| | - Michele Gesualdo
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Gabriella Ricci
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Santa Carbonara
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
| | - Paola Giordano
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | - Luciano Cavallo
- Department of Biomedical Sciences and Human Oncology, Section of Pediatrics, University “A. Moro”
| | | | - Marco Matteo Ciccone
- Cardiovascular Diseases Section, Department of Emergency and Organ Transplantation, University “A. Moro”
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28
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Kelishadi R, Haghdoost AA, Jamshidi F, Aliramezany M, Moosazadeh M. Low birthweight or rapid catch-up growth: which is more associated with cardiovascular disease and its risk factors in later life? A systematic review and cryptanalysis. Paediatr Int Child Health 2015; 35:110-23. [PMID: 25034799 DOI: 10.1179/2046905514y.0000000136] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND The effects of birthweight (the Barker hypothesis) and growth trajectory in early life on the incidence of cardiovascular disease (CVD) and its risk factors in later life have been investigated in a number of studies. OBJECTIVE To undertake a systematic review and cryptanalysis of the association of low birthweight (LBW) and the postnatal growth trajectory with CVD and its risk factors. METHODS English-language publications in PubMed, ISI Web of Science and Scopus were searched. Initially, two independent reviewers identified relevant papers in several steps and the quality of papers was then determined by a validated quality-appraisal checklist. RESULTS By applying maximum sensitivity, 7259 paper were identified, 382 of which were duplicates and 1273 were considered to be relevant to the topic. Then, after title and abstract review, 628 irrelevant papers were excluded; 26 papers were added after reference-checking. Then, 250 other papers were deleted after full text review. Finally, 39 relevant papers remained and were entered into the systematic review. Overall, 79·6% of all CVD risk factors reported in primary studies of the rapid catch-up growth hypothesis were statistically significant, whereas the corresponding figure was 58·5% for the effects of LBW (Barker hypothesis). CONCLUSIONS This systematic review highlights the importance of low birthweight in increasing the risk of CVD and its risk factors in later life. The results support rapid postnatal catch-up growth of LBW neonates as a more important factor than LBW alone in CVD and its risk factors.
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Touwslager RNH, Houben AJHM, Tan FES, Gielen M, Zeegers MP, Stehouwer CDA, Gerver WJM, Westerterp KR, Wouters L, Blanco CE, Zimmermann LJ, Mulder ALM. Growth and endothelial function in the first 2 years of life. J Pediatr 2015; 166:666-71.e1. [PMID: 25722270 DOI: 10.1016/j.jpeds.2014.11.059] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 10/14/2014] [Accepted: 11/25/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To test the hypothesis that the inverse association between infant growth and endothelial function at 6 months would persist to 24 months and that accelerated growth would lead to an increased percent body fat, which would, in turn, impact negatively on endothelial function. STUDY DESIGN In a prospective observational study, 104 healthy term newborns underwent anthropometry and measurements of vascular vasodilation at 0, 6, 12, and 24 months. We recorded maximum vasodilation in response to acetylcholine (endothelium-dependent) and nitroprusside (endothelium-independent) by use of laser-Doppler vascular perfusion monitoring of the forearm skin vasculature. Additional anthropometry at 1 and 3 months was collected from child welfare centers. The data were analyzed by multilevel linear regression. RESULTS Weight gain from 0-1 month was associated inversely with maximum perfusion in response to acetylcholine at the age of 2 years (b = -8.28 perfusion units [PU] per Δ z-score, P = .03). Weight gain from 0-1 month was related positively to maximum perfusion in response to nitroprusside (b = 10.12 PU per Δ z-score, P = .04), as was birth weight (b = 8.02 PU per z-score, P = .02). Body fat percentage did not have a significant effect in any of the perfusion models and was not related to maximum perfusion at 2 years. CONCLUSION Infant weight gain from 0-1 month is inversely related to endothelial function in healthy term infants, at least to the age of 2 years. This relationship was not explained by an increased percentage body fat.
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Affiliation(s)
- Robbert N H Touwslager
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands; Maastricht School for Oncology and Developmental Biology (GROW), Maastricht, The Netherlands; Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht, The Netherlands.
| | - Alfons J H M Houben
- Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Maastricht School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | - Frans E S Tan
- Department of Methodology and Statistics, Maastricht University, Maastricht, The Netherlands; School for Public Health and Primary Care (CAPHRI), Maastricht, The Netherlands
| | - Marij Gielen
- Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht, The Netherlands; Section of Complex Genetics, Department of Genetics and Cell Biology, Maastricht University, Maastricht, The Netherlands
| | - Maurice P Zeegers
- Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht, The Netherlands; Section of Complex Genetics, Department of Genetics and Cell Biology, Maastricht University, Maastricht, The Netherlands
| | - Coen D A Stehouwer
- Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht, The Netherlands; Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, The Netherlands; Maastricht School for Cardiovascular Diseases (CARIM), Maastricht, The Netherlands
| | - Willem-Jan M Gerver
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands; Maastricht School for Oncology and Developmental Biology (GROW), Maastricht, The Netherlands
| | - Klaas R Westerterp
- Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht, The Netherlands; Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Loek Wouters
- Nutrition and Toxicology Research Institute Maastricht (NUTRIM), Maastricht, The Netherlands; Department of Human Biology, Maastricht University, Maastricht, The Netherlands
| | - Carlos E Blanco
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands; Maastricht School for Oncology and Developmental Biology (GROW), Maastricht, The Netherlands
| | - Luc J Zimmermann
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands; Maastricht School for Oncology and Developmental Biology (GROW), Maastricht, The Netherlands
| | - Antonius L M Mulder
- Department of Pediatrics, Maastricht University Medical Centre, Maastricht, The Netherlands; Maastricht School for Oncology and Developmental Biology (GROW), Maastricht, The Netherlands
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Milovanovic I, Njuieyon F, Deghmoun S, Chevenne D, Levy-Marchal C, Beltrand J. SGA children with moderate catch-up growth are showing the impaired insulin secretion at the age of 4. PLoS One 2014; 9:e100337. [PMID: 24979613 PMCID: PMC4076235 DOI: 10.1371/journal.pone.0100337] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 05/23/2014] [Indexed: 01/29/2023] Open
Abstract
Background Being born small for gestational age (SGA) is a risk factor for later development of type 2 diabetes. The development of glucose tolerance disorders in adults involves insulin resistance and impaired insulin secretion. Objective To evaluate insulin secretion and insulin sensitivity in a 4-yr old cohort of SGA. Methods 85 children were prospectively followed from mid-gestation to 4 years of age. Fetal growth velocity (FGV) was measured using ultrasound measurements. Body composition and hormonal profile were measured at birth, 1 and 4 years. Results 23 SGA babies had lower birth weight compared to 62 AGA (−1.9±0.3 vs. −0.6±0.8 z-score; p<0.0001) and they were thinner at birth (ponderal index 24.8±1.8 vs. 26.3±3.1 kg/m3; p = 0.01 and fat mass 11±2.6 vs. 12.9±3.1%; p = 0.01). No significant differences in other measured metabolic and hormonal parameters were observed between two groups at birth. SGA infants experienced an early catch-up growth in weight (mean gain of 1.1±0.6 SD) during the first year of life. At 4 years, SGA children remain lighter than AGA, but with weight z-score in the normal range (−0.1±1.3 vs. 0.5±1.3 z-score; p = 0.05). No excess of fat mass was observed (19±4.8 vs. 19.7±4.1%; p = 0.45). 120-min plasma glucose was significantly higher (6.2±1.1 vs. 5.6±0.9 mmol/l; p = 0.006) and insulinogenic index was significantly lower (0.28±0.15 vs. 0.40±2.4; p = 0.02) in the SGA group at 4-yrs of life contrasting with a preserved insulin sensitivity (QUICKI 0.47±0.09 vs. 0.43±0.05; p = 0.06). Conclusion SGA children with compensatory catch-up growth in first year of life show mild disturbances of glucose tolerance associated to a lower insulinogenic index at 4-yrs of age suggesting impairment of β-cell function.
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Affiliation(s)
- Ivana Milovanovic
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
- * E-mail:
| | - Falucar Njuieyon
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Samia Deghmoun
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Didier Chevenne
- Service de biochimie et hormonologie, Hôpital Robert Debré, Paris, France
| | - Claire Levy-Marchal
- INSERM CIE 05 – Unité d'épidémiologie clinique, Hôpital Robert Debré, Paris, France
| | - Jacques Beltrand
- Endocrinologie et diabétologie pédiatrique, Hôpital Necker, Paris, France
- Université Paris 5, René Descartes, Paris, France
- INSERM U845, Imagine Affiliated, Paris, France
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de Steenwinkel FDO, Hokken-Koelega ACS, de Ridder MAJ, Hazes JMW, Dolhain RJEM. Rheumatoid Arthritis During Pregnancy and Postnatal Catch-Up Growth in the Offspring. Arthritis Rheumatol 2014; 66:1705-11. [DOI: 10.1002/art.38519] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2013] [Accepted: 02/18/2014] [Indexed: 11/12/2022]
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Can fetal vascular morphology at 30 weeks of gestation have impact on cardiovascular outcomes in childhood? J Hypertens 2014; 32:1194-6. [PMID: 24781509 DOI: 10.1097/hjh.0000000000000193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Breij LM, Kerkhof GF, Hokken-Koelega ACS. Accelerated infant weight gain and risk for nonalcoholic fatty liver disease in early adulthood. J Clin Endocrinol Metab 2014; 99:1189-95. [PMID: 24423333 DOI: 10.1210/jc.2013-3199] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Nonalcoholic fatty liver disease (NAFLD) is considered the hepatic metabolic syndrome. Some studies demonstrated an association between small size at birth and NAFLD. Rapid catch-up in weight often follows small birth size and has been associated with metabolic syndrome, but its association with NAFLD remained unknown. PATIENTS AND METHODS In 268 adults aged 18-24 years, body mass index, waist circumference, triglyceride, γ-glutamyltransferase, alkaline phosphatase, alanine aminotransferase, and aspartate aminotransferase levels were determined. Fatty liver index (FLI; 0-100) was calculated. Associations of birth weight SD score and first year gain in weight and length SD scores were determined with FLI and other liver markers. Comparisons were performed between subjects with and without rapid catch-up in weight in the first year of life. Furthermore, a FLI score (low, intermediate, high risk for NAFLD) was assigned to each participant to determine clinical relevance, and ordinal regression analyses were performed. RESULTS Gain in weight in the first 3 months of life was associated with FLI as a continuous variable, whereas low birth weight was not. There were no significant associations with γ-glutamyltransferase, alanine aminotransferase, or aspartate aminotransferase. Of the subjects with rapid catch-up in weight for length, 27.8% had an intermediate or high FLI at the age of 21 years, compared with 5.3% of subjects with slow catch-up. Rapid catch-up was also associated with a higher FLI score after adjustments (odds ratio, 11.7; P = .016). CONCLUSION Accelerated gain in weight for length in the first 3 months of life is associated with a higher risk for NAFLD in early adulthood, whereas small size at birth is not.
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Affiliation(s)
- Laura M Breij
- Department of Pediatrics, Subdivision of Endocrinology, Erasmus MC/Sophia Children's Hospital, 3015 GJ Rotterdam, The Netherlands
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Bocca-Tjeertes I, Bos A, Kerstjens J, de Winter A, Reijneveld S. Symmetrical and asymmetrical growth restriction in preterm-born children. Pediatrics 2014; 133:e650-6. [PMID: 24488742 DOI: 10.1542/peds.2013-1739] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To determine how symmetric (proportionate; SGR) and asymmetric (disproportionate; AGR) growth restriction influence growth and development in preterms from birth to 4 years. METHODS This community-based cohort study of 810 children comprised 86 SGR, 61 AGR, and 663 non-growth restricted (NGR) preterms, born in 2002 and 2003. Symmetrical growth restriction was defined as a birth weight below the 16th percentile (-1 SD) compared with full-terms and a head circumference (HC) z score not exceeding the infant's birth weight z score by >1 SD. Asymmetric growth restriction was defined as a HC z score exceeding that for by >1 SD as a proxy of brain sparing. Developmental delay was assessed by the Ages and Stages Questionnaire at 4 years. RESULTS Longitudinal gains in weight and height were similar for SGR and AGR children and less compared with NGR children. At age 4, z scores for weight were -1.1 for SGR and -0.7 for AGR children vs -0.3 for NGR children. z scores for height were -0.8 and -0.5 vs. -0.2. HC gain were 2 cm more in SGR, but at 1 year, they were -0.2 vs. 0.2 (AGR) and 0.1 (NGR). Developmental delay increased with odds ratios of 2.5 (95% confidence interval 1.1-6.0) for SGR and 2.1 (95% confidence interval 0.7-5.9) for AGR. CONCLUSIONS Weight and height gains were similar for AGR and SGR children but poorer compared with NGR children. SGR children caught up on HC. Developmental delay was more likely in growth-restricted preterms independent of HC at birth.
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Sepúlveda C, Urquidi C, Pittaluga E, Iñiguez G, Avila A, Carrasco F, Mericq V. Differences in body composition and resting energy expenditure in childhood in preterm children born with very low birth weight. Horm Res Paediatr 2014; 79:347-55. [PMID: 23774886 DOI: 10.1159/000351466] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Accepted: 04/18/2013] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Rapid early ponderal growth is associated with adverse metabolic risks in young adults born at term. AIM To determine whether there are differences in body composition, resting energy expenditure (REE) and metabolic variables between preterm children born with very low birth weight (VLBW) either appropriate (AGA) or small (SGA) for gestational age and whether these differences are related to an early period of weight gain. METHODS 67 VLBW preterm (40 AGA, 27 SGA). Body composition by DEXA, REE by indirect calorimetry and blood sampling at age 6.7 ± 0.5 years. RESULTS VLBW SGA children were lighter, shorter, had a lower waist and hip circumference, HDL cholesterol and lipid oxidation rates than their AGA counterparts (adjusted for age, sex and BMI). Birth weight correlated negatively with total body and trunk fat mass. In a multivariate linear regression analysis, we found a positive association between weight gain in the first 3 months of life and total and trunk fat at age 6 years and a reciprocal association with REE at age 6 years. In contrast, the weight gain rate at 6-9 months of life was associated with higher REE and lipid oxidation rates at 6 years. A higher weight gain rate at 9-12 months was associated with a higher lean mass at 6 years. CONCLUSION An early fast-pace weight gain in VLBW infants may have detrimental consequences for metabolic health later on.
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Affiliation(s)
- Carolina Sepúlveda
- Institute of Maternal and Child Research, Faculty of Medicine, University of Chile, Santiago, Chile
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36
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Wood-Bradley RJ, Henry SL, Vrselja A, Newman V, Armitage JA. Maternal dietary intake during pregnancy has longstanding consequences for the health of her offspring. Can J Physiol Pharmacol 2013; 91:412-20. [DOI: 10.1139/cjpp-2012-0352] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Over the past 100 years, advances in pharmaceutical and medical technology have reduced the burden of communicable disease, and our appreciation of the mechanisms underlying the development of noncommunicable disease has broadened. During this time, a number of studies, both in humans and animal models, have highlighted the importance of maintaining an optimal diet during pregnancy. In particular, a number of studies support the hypothesis that suboptimal maternal protein and fat intake during pregnancy can have long-term effects on the growing fetus, and increase the likelihood of these offspring developing cardiovascular, renal, or metabolic diseases in adulthood. More recently, it has been shown that dietary intake of a number of micronutrients may offset or reverse the deleterious effects of macronutrient imbalance. Furthermore, maternal fat intake has also been identified as a major contributor to a healthy fetal environment, with a beneficial role for unsaturated fats during development as well as a beneficial impact on cell membrane physiology. Together these studies indicate that attempts to optimise maternal nutrition may prove to be an efficient and cost-effective strategy for preventing the development of cardiovascular, renal, or metabolic diseases.
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Affiliation(s)
- Ryan James Wood-Bradley
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria 3800, Australia
| | - Sarah Louise Henry
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria 3800, Australia
| | - Amanda Vrselja
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria 3800, Australia
| | - Victoria Newman
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria 3800, Australia
| | - James Andrew Armitage
- Department of Anatomy and Developmental Biology, Monash University, Clayton, Victoria 3800, Australia
- School of Medicine (Optometry), Deakin University, Pigdons Road, Waurn Ponds, Victoria 3216, Australia
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Kippler M, Engström K, Mlakar SJ, Bottai M, Ahmed S, Hossain MB, Raqib R, Vahter M, Broberg K. Sex-specific effects of early life cadmium exposure on DNA methylation and implications for birth weight. Epigenetics 2013; 8:494-503. [PMID: 23644563 PMCID: PMC3741219 DOI: 10.4161/epi.24401] [Citation(s) in RCA: 144] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Dietary cadmium exposure was recently found to alter DNA methylation in adults, but data on effects early in life are lacking. Our objective was to evaluate associations between prenatal cadmium exposure, DNA methylation and birth weight. In total 127 mother-child pairs from rural Bangladesh were studied. For comparison, we included 56 children at 4.5 y. Cadmium concentrations in mothers’ blood (gestational week 14) and children’s urine were measured by ICPMS. Global DNA methylation was analyzed by Infinium HumanMethylation450K BeadChip in cord blood and children’s blood. Maternal cadmium exposure was associated with cord blood DNA methylation (p-value < 10–16). The association was markedly sex-specific. In boys, 96% of the top 500 CpG sites showed positive correlations (rS-values > 0.50), whereas most associations in girls were inverse; only 29% were positive (rS > 0.45). In girls we found overrepresentation of methylation changes in genes associated with organ development, morphology and mineralization of bone, whereas changes in boys were found in cell death-related genes. Several individual CpG sites that were positively associated with cadmium were inversely correlated with birth weight, although none statistically significant after correction for multiple comparisons. The associations were, however, fairly robust in multivariable-adjusted linear regression models. We identified CpG sites that were significantly associated with cadmium exposure in both newborns and 4.5-y-old children. In conclusion, cadmium exposure in early life appears to alter DNA methylation differently in girls and boys. This is consistent with previous findings of sex-specific cadmium toxicity. Cadmium-related changes in methylation were also related to lower birth weight.
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Affiliation(s)
- Maria Kippler
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Klenovics KS, Boor P, Somoza V, Celec P, Fogliano V, Sebeková K. Advanced glycation end products in infant formulas do not contribute to insulin resistance associated with their consumption. PLoS One 2013; 8:e53056. [PMID: 23301020 PMCID: PMC3534663 DOI: 10.1371/journal.pone.0053056] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Accepted: 11/27/2012] [Indexed: 01/11/2023] Open
Abstract
INTRODUCTION Infant formula-feeding is associated with reduced insulin sensitivity. In rodents and healthy humans, advanced glycation end product (AGE)-rich diets exert diabetogenic effects. In comparison with human breast-milk, infant formulas contain high amounts of AGEs. We assessed the role of AGEs in infant-formula-consumption-associated insulin resistance. METHODS Total plasma levels of N(ε)-(carboxymethyl)lysine (CML), AGEs-associated fluorescence (λ(ex) = 370 nm/λ(em) = 445 nm), soluble adhesion molecules, markers of micro- binflammation (hsCRP), oxidative stress (malondialdehyde, 8-isoprostanes) and leptinemia were determined, and correlated with insulin sensitivity in a cross-sectional study in 166 healthy term infants aged 3-to-14 months, subdivided according to feeding regimen (breast-milk- vs. infant formula-fed) and age (3-to-6-month-olds, 7-to-10-month-olds, and 11-to-14-month-old infants). Effects of the consumption of low- vs. high-CML-containing formulas were assessed. 36 infants aged 5.8 ± 0.3 months were followed-up 7.5 ± 0.3 months later. RESULTS Cross-sectional study: 3-to-6-month-olds and 7-to-10-month-old formula-fed infants presented higher total plasma CML levels and AGEs-associated fluorescence (p<0.01, both), while only the 3-to-6-month-olds displayed lower insulin sensitivity (p<0.01) than their breast-milk-fed counterparts. 3-to-6-month-olds fed low-CML-containing formulas presented lower total plasma CML levels (p<0.01), but similar insulin sensitivity compared to those on high-CML-containing formulas. Markers of oxidative stress and inflammation, levels of leptin and adhesion molecules did not differ significantly between the groups. Follow-up study: at initial investigation, the breast-milk-consuming infants displayed lower total plasma CML levels (p<0.01) and AGEs-associated fluorescence (p<0.05), but higher insulin sensitivity (p<0.05) than the formulas-consuming infants. At follow-up, the groups did not differ significantly in either determined parameter. CONCLUSIONS In healthy term infants, high dietary load with CML does not play a pathophysiological role in the induction of infant formula-associated insulin resistance. Whether a high load of AGEs in early childhood affects postnatal programming remains to be elucidated.
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Affiliation(s)
- Kristína Simon Klenovics
- Department of Clinical and Experimental Pharmacotherapy, Medical Faculty, Slovak Medical University, Bratislava, Slovakia.
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Ozerlat I. Growth and development: high early postnatal weight gain linked to adult metabolic syndrome. Nat Rev Endocrinol 2012; 8:448. [PMID: 22640995 DOI: 10.1038/nrendo.2012.86] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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