Independent effects of weight gain and fetal programming on metabolic complications in adults born small for gestational age

Méas, T.; Deghmoun, S.; Alberti, Corinne; Carreira, Erick M.; Armoogum, Priscilla; Chevenne, Didier; Lévy-Marchal, Claire

doi:10.1007/s00125-009-1650-y

Cited by 71 publications

(57 citation statements)

References 30 publications

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“…30,31 Some studies have found that the effects of birthweight on coronary heart disease are limited to those with high adult BMI 15 or that fetal growth and adult BMI or weight gain interact. 32,33 We also found a relationship between BMI and effects of fetal growth. Many children born small remained small, putting them at lower risk for several metabolic syndrome risk factors.…”

Section: Discussionsupporting

confidence: 55%

Is the Metabolic Syndrome a “Small Baby” Syndrome?: The Bogalusa Heart Study

Harville

Srinivasan

Chen

et al. 2012

Metabolic Syndrome and Related Disorders

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Background: Metabolic syndrome has been called a ''small baby syndrome,'' but other analyses suggest that postnatal growth is more important than birthweight, or that large babies are also at risk. The aim of this analysis was to examine whether there was a relationship between both low and high birthweight and metabolic syndrome, using multiple definitions of metabolic syndrome, and to determine whether this relationship varied by body size across the life course. Methods: Data from the Bogalusa Heart Study, a study of cardiovascular disease in children and young adults, were linked to birth certificate data. Metabolic syndrome was defined by the National Cholesterol Education Program, the International Diabetes Foundation, and the World Health Organization (WHO) definition. Smallfor-gestational-age (SGA) was defined as birthweight < 10 th percentile by sex for gestational age and large-forgestational-age (LGA) as birthweight > 90 th percentile. Birthweight-for-gestational-age was also examined as a continuous predictor. Chi-squared tests and logistic regression were used to examine the relationship between birth size and metabolic syndrome. Results: Higher birthweight-for-gestational-age was associated with a reduced risk of metabolic syndrome, especially by the WHO definition. After adjustment for body mass index (BMI), categorized birthweight was associated with metabolic syndrome, with the protective associations with LGA being stronger than the positive associations with SGA. Among the individual components of metabolic syndrome, higher waist circumference was associated with both SGA and LGA after BMI was controlled for. Effects of SGA and BMI at any age were largely independent rather than interactive. Conclusions: SGA is associated with some, but not all, components of metabolic syndrome. The relationship between SGA and metabolic syndrome is partially confounded by later BMI.

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Section: Discussionsupporting

confidence: 55%

Is the Metabolic Syndrome a “Small Baby” Syndrome?: The Bogalusa Heart Study

Harville

Srinivasan

Chen

et al. 2012

Metabolic Syndrome and Related Disorders

View full text Add to dashboard Cite

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“…Insulin resistance plays a central role in the metabolic syndrome and adults born SGA are more insulin-resistant than controls [2,3]. Insulin sensitivity is already reduced in SGA born children, especially in children with catch-up growth [6,7,9,11,12].…”

Section: Discussionmentioning

confidence: 99%

“…Besides lifestyle and obesity, fetal and early postnatal growth are determinants of the metabolic syndrome. Both term small-for-gestational-age (SGA) infants and preterm born infants have an increased prevalence of several components of the metabolic syndrome in later life, not only in adulthood [1,2,3,4,5], but already in childhood [6,7,8,9,10,11,12,13]. Studies in very-low-birth-weight (VLBW) infants show increased blood pressure and insulin resistance in adulthood [14,15,16,17].…”

Section: Introductionmentioning

confidence: 99%

Components of the Metabolic Syndrome in Early Childhood in Very-Low-Birth-Weight Infants

Jong

Lafeber²,

Cranendonk³

et al. 2013

Horm Res Paediatr

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Background/Aims: Term small-for-gestational-age and preterm born infants have an increased prevalence of metabolic syndrome components already in childhood. Data in very-low-birth-weight (VLBW) children are limited. We investigated the prevalence of metabolic syndrome components in VLBW infants at 2 years of corrected age. Methods: We included 38 children, participating in the Neonatal Insulin Replacement Therapy in Europe (NIRTURE) trial, a randomized controlled trial of early insulin therapy in VLBW infants. Metabolic syndrome components were defined as: body mass index SDS >2; blood pressure (systolic and/or diastolic) ≥90th percentile; triglycerides ≥0.98 mmol/l; high-density lipoprotein (HDL) cholesterol ≤1.03 mmol/l; glucose ≥5.6 mmol/l. Results: Two children (5%) had three metabolic syndrome components, 13 children (34%) had two components, and 11 children (29%) one component. 63% had raised blood pressure (prevalence higher in boys), 32% low HDL, and 30% high triglycerides (prevalence lower in early insulin group). In children with body mass index SDS <0, insulin-treated children had higher HDL than children with standard care. Systolic blood pressure was correlated with growth between term and 2 years of corrected age. Conclusions: VLBW infants already have a high prevalence of metabolic syndrome components at 2 years of corrected age. Early insulin treatment could have long-term benefits for some of these components.

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“…The adaptation of the fetus to conditions of undernutrition in utero involves a gene-environment interaction called fetal programming [1,2] which may modify gene expression permanently. However, the mechanisms underlying this relationship are far from understood, and the relative contributions of intrauterine growth retardation and postnatal growth rates have been controversial.…”

Section: Introductionmentioning

confidence: 99%

Differences in Body Composition and Resting Energy Expenditure in Childhood in Preterm Children Born with Very Low Birth Weight

Sepúlveda¹,

Urquidi

Pittaluga

et al. 2013

Horm Res Paediatr

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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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Independent effects of weight gain and fetal programming on metabolic complications in adults born small for gestational age

Cited by 71 publications

References 30 publications

Is the Metabolic Syndrome a “Small Baby” Syndrome?: The Bogalusa Heart Study

Is the Metabolic Syndrome a “Small Baby” Syndrome?: The Bogalusa Heart Study

Components of the Metabolic Syndrome in Early Childhood in Very-Low-Birth-Weight Infants

Differences in Body Composition and Resting Energy Expenditure in Childhood in Preterm Children Born with Very Low Birth Weight

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