Altered Adiposity after Extremely Preterm Birth

Uthaya, Sabita; Thomas, E. Louise; Hamilton, Gavin; Doré, Caroline J; Bell, Jimmy D.; Modi, Neena

doi:10.1203/01.pdr.0000148284.58934.1c

Cited by 259 publications

(196 citation statements)

References 33 publications

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“…Our study provides support for previous research indicating that preterm infants near or at term-corrected age have a higher percent body fat than infants born term (5)(6)(7)(8). Furthermore, our findings indicate that anthropometry, skinfolds, and ADP are efficient to detect significant differences in body composition between preterm and term infants at hospital discharge.…”

Section: Discussionsupporting

confidence: 90%

“…The American Academy of Pediatrics also recommends that a preterm infant's body composition mimic intrauterine body composition until term age (5). However, current research demonstrate that preterm infants at term-corrected age have higher total body and/or abdominal fat compared with term infants, suggesting that adequate catch-up growth is not achieved postnatally (5)(6)(7)(8). Precise determination of body composition in premature infants may aid health professionals in selecting appropriate interventions to ensure proper postnatal growth and development.…”

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confidence: 99%

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Mid-arm circumference is a reliable method to estimate adiposity in preterm and term infants

et al. 2015

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Background: Premature birth is associated with increased adipose deposition after birth. Standard anthropometry (body weight, length, and head circumference) may not adequately assess fat deposition. Validated methods to assess adiposity are needed to optimize growth quality in preterm infants. The purpose of this study was to identify covariates of infant body fat. Methods: Air displacement plethysmography (ADP), standard anthropometry, and body circumferences were measured at hospital discharge in preterm (n = 28; 31-35 wk postmenstrual age (PMA)) and term (n = 28; 38-41 wks PMA) infants. results: Body weight, length, and head circumference were lower for preterm infants (P < 0.05) at hospital discharge compared with that of term infants. Despite smaller body size and younger PMA, preterm infant percent body fat (%BF) by ADP was 12.33 ± 4.15% vs. 9.64 ± 4.01% in term infants (P = 0.01). Mid-arm circumference (MAC) is a covariate of %BF in both preterm and term infants (adjusted R 2 = 0.49; P < 0.001). In preterm infants alone, MAC accounted for 60.4% of the variability of percent body fat (%BF) by ADP (P < 0.01). conclusions: Preterm infants have increased body fat deposition as they approach term-corrected age, and MAC is a reliable, low-cost measure for monitoring infant body fat deposition in preterm and term infants.

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Section: Discussionsupporting

confidence: 90%

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confidence: 99%

Mid-arm circumference is a reliable method to estimate adiposity in preterm and term infants

et al. 2015

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“…[8][9][10][11] Indeed, the application of whole-body magnetic resonance -which allows adipose tissue imaging and its quantification -has indicated that in infants born extremely preterm (<32 weeks gestational age) and profoundly deficient in adipose tissue, the subsequent accelerated postnatal growth was accompanied by accelerated fat gain such that, at their expected time of delivery several weeks later, these preterm infants reached the same total adiposity as term-born infants despite the fact that they were lighter and shorter. 34 Taken together, these studies further underscore the occurrence of preferential catch-up fat, with lean tissue lagging behind in babies and infants showing catch-up growth, and their predisposition to insulin resistance later in life.…”

Section: The Insulino-resistant 'Catch-up Fat' Phenotypementioning

confidence: 70%

Thrifty energy metabolism in catch-up growth trajectories to insulin and leptin resistance

Dulloo

2008

Best Practice & Research Clinical Endocrinology & Metab

105

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Catch-up growth early in life (after fetal, neonatal or infantile growth retardation) is a major risk factor for later obesity, type-2 diabetes and cardiovascular diseases. These risks are generally interpreted alongside teleological arguments that environmental exposures which hinder growth early in life lead to programming of 'thrifty mechanisms' that are adaptive during the period of limited nutrient supply (or growth constraint), but which increase risks for diseases during improved nutrition and catch-up growth later in life. This paper addresses this notion of 'thrifty mechanisms' in the light of evidence that catch-up growth is characterized by a disproportionately higher rate of fat gain relative to lean tissue gain, and that such preferential catch-up fat is in part driven by energy conservation mechanisms operating via suppressed thermogenesis. It provides a molecular-physiological framework which integrates emerging insights into mechanisms by which this thrifty 'catch-up fat' phenotype cross-links with insulin and leptin resistance.

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“…Thus, LPL may be another important player that regulates rapid postnatal growth, especially in subcutaneous fat accumulation. In a study with extremely preterm infants, born at o32 weeks gestational age, the accelerated postnatal weight gain was also accompanied by increased subcutaneous adiposity (Uthaya et al, 2005). However, their adipose tissue distribution is altered at age term equivalent with increased intraabdominal adiposity.…”

Section: Discussionmentioning

confidence: 97%

Association between serum lipoprotein lipase mass concentration and subcutaneous fat accumulation during neonatal period

et al. 2010

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Background/Objectives: Subcutaneous adipose tissue grows rapidly during the first months of life. Lipoprotein lipase (LPL) has a quantitatively important function in adipose tissue fat accumulation and insulin-like growth factor-I (IGF-I) is a determinant of neonatal growth. Recent studies showed that LPL mass in non-heparinized serum (LPLm) was an index of LPL-mediated lipolysis of plasma triacylglycerol (TG). The objective was to know the influence of serum LPL and IGF-I on neonatal subcutaneous fat growth, especially on catch-up growth in low birth weight infants. Subjects/Methods: We included 47 healthy neonates (30 males, 17 females), including 7 small for gestational age. We measured serum LPLm and IGF-I concentrations at birth and 1 month, and analyzed those associations with subcutaneous fat accumulation. Results: Serum LPLm and IGF-I concentrations increased markedly during the first month, and positively correlated with the sum of skinfold thicknesses both at birth (r ¼ 0.573, P ¼ 0.0001; r ¼ 0.457, P ¼ 0.0035) and at 1 month (r ¼ 0.614, Po0.0001; r ¼ 0.787, Po0.0001, respectively). In addition, serum LPLm concentrations correlated inversely to very low-density lipoprotein (VLDL)-TG levels (r ¼ À0.692, Po0.0001 at birth; r ¼ À0.429, P ¼ 0.0052 at 1 month). Moreover, the birth weight Z-score had an inverse association with the postnatal changes in individual serum LPLm concentrations (r ¼ À0.639, Po0.0001). Conclusions: Both serum LPLm and IGF-I concentrations were the determinants of subcutaneous fat accumulation during the fetal and neonatal periods. During this time, LPL-mediated lipolysis of VLDL-TG may be one of the major mechanisms of rapid growth in subcutaneous fat tissue. Moreover, LPL, as well as IGF-I, may contribute to catch-up growth in smaller neonates.

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Altered Adiposity after Extremely Preterm Birth

Cited by 259 publications

References 33 publications

Mid-arm circumference is a reliable method to estimate adiposity in preterm and term infants

Mid-arm circumference is a reliable method to estimate adiposity in preterm and term infants

Thrifty energy metabolism in catch-up growth trajectories to insulin and leptin resistance

Association between serum lipoprotein lipase mass concentration and subcutaneous fat accumulation during neonatal period

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