Early and Late Postnatal Accelerated Growth Have Distinct Effects on Metabolic Health in Normal Birth Weight Infants.

Dan-Li Zhang,Pierre Julien,Anissa Djemli,William D Fraser,Qinwen Du,Zhong-Cheng Luo

doi:10.3389/fendo.2017.00340

Abstract

Accelerated growth in postnatal life in low birth weight infants has been associated with insulin resistance and metabolic syndrome-related disorders in later life. Postnatal accelerated growth in also common in normal birth weight infants, but little is known about the impact on metabolic health. In a prospective cohort study of 203 term normal birth weight infants, we evaluated the impacts of accelerated (Δweight Z score > 0.5) or decelerated (Δweight ΔZ < −0.5) growth during early (0–3 months) and late (3–12 months) postnatal life on metabolic health indicators at age 1-year. The primary outcomes were homeostasis model assessment of insulin resistance (HOMA-IR), β-cell function [homeostasis model assessment of β-cell function (HOMA-β)], and fasting plasma lipids. Adjusting for maternal, paternal, and infant characteristics, accelerated growth during the first 3 months of life was associated with a 41.6% (95% confidence interval 8.9–84.2%) increase in HOMA-β, and a 8.3% (0.7–15.4%) decrease in fasting plasma total cholesterols, and was not associated with HOMA-IR in infants at age 1-year. Accelerated growth during 3–12 months was associated with a 30.9% (3.3–66.0%) increase in HOMA-IR and was not associated with HOMA-β. Neither accelerated nor decelerated growth was associated with fasting plasma triglycerides, high-density lipoprotein or low-density lipoprotein cholesterol concentrations in infants at age 1-year. Accelerated growth during early postnatal life may be beneficial for β-cell function, but during late postnatal life harmful for insulin sensitivity in normal birth weight infants.

Highlights

Preterm and/or low birth weight infants often have postnatal catchup or accelerated growth which has been consistently associated with insulin resistance and metabolic syndrome-related disorders in later life [1,2,3,4,5,6,7,8]
Considering the adverse metabolic health impact of postnatal accelerated growth in low birth weight subjects, it is plausible that such accelerated growth may have an adverse metabolic health impact in normal birth weight infants
Accelerated or decelerated postnatal growth is common in normal birth weight infants, yet there is a scarcity of data on the metabolic health impact in these infants

Summary

Introduction

Preterm and/or low birth weight infants often have postnatal catchup or accelerated growth (usually defined as Δweight Z score > 0.5 or 0.67) which has been consistently associated with insulin resistance and metabolic syndrome-related disorders (e.g., type 2 diabetes) in later life [1,2,3,4,5,6,7,8]. Accelerated or decelerated postnatal growth is common in normal birth weight infants, yet there is a scarcity of data on the metabolic health impact in these infants It is unknown whether the metabolic health impact may be different for accelerated growth during early vs late postnatal life in the first year of life, a rapid growth period which may be critical for longterm metabolic health. Studies have been focused on the metabolic health impact of postnatal accelerated growth, and there is a lack of data on postnatal decelerated growth To address these data gaps, we sought to determine whether accelerated or decelerated growth during early (0–3 months) or late (3–12 months) postnatal period is associated with metabolic health indicators in infants at age 1-year

Methods

Results

Conclusion