Peso ao nascer e síndrome metabólica em adultos: meta-análise

Vera Maria Freitas Da Silveira,Bernardo Lessa Horta

doi:10.1590/s0034-89102008000100002

Abstract

To assess published evidences of the effect of birth weight on metabolic syndrome in adults. PubMed and LILACS databases were searched for articles published from 1966 through May 2006. The terms used were: "birth weight", "birthweight", "intra-uterine growth restriction (IUGR)", "fetal growth retardation", "metabolic syndrome", "syndrome X", "Reaven's X syndrome". Two hundred and twenty-four studies reporting estimates of the association between birth weight and metabolic syndrome or its components were considered eligible. Eleven studies provided odds ratios and were included in the meta-analysis. All but two studies reported an inverse relationship between birth weight and metabolic syndrome. A comparison between low birth weight vs. normal birth weight subjects showed the random effects odds ratio for metabolic syndrome was 2.53 (95% CI: 1.57;4.08). The funnel plot graphic suggests a publication bias but, even in the studies with more than 400 subjects, the results remained significant (pooled odds ratio: 2.37 (95% CI: 1.15;4.90). Low birth weight increases the risk of metabolic syndrome in adults.

Highlights

Low birth weight (LBW) is a marker of intra-uterine environment, and a predictor of neonatal and child mortality[57]
A comparison between low birth weight vs. normal birth weight subjects showed the random effects odds ratio for metabolic syndrome was 2.53
The funnel plot graphic suggests a publication bias but, even in the studies with more than 400 subjects, the results remained significant

Summary

Introduction

Low birth weight (LBW) is a marker of intra-uterine environment, and a predictor of neonatal and child mortality[57]. Barker[3] proposed that low birth weight would be associated with adult chronic diseases such as coronary heart disease, hypertension, stroke[21] and type 2 diabetes.[44]. Children with intra-uterine growth retardation are at greater risk to gain adiposity after birth. This can cause obesity in childhood and adolescence and insulin resistance (IR), which are the main suggested mechanisms of metabolic syndrome.[46,58]. Metabolic syndrome is described as a cluster of the following components: central obesity, IR, atherogenic dyslipidemia, hypertension, vascular inflammatory markers, and impaired glucose tolerance, which are associated to greater risk of cardiovascular disease (CVD) and type 2 diabetes.[13].

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