Abstract
BackgroundSubjects born small (SGA) and large (LGA) for gestational age have an increased risk of cardio-metabolic alterations already during prepuberty. Nevertheless, the progression of their cardio-metabolic profile from childhood to adolescence has not been fully explored. Our aim was to assess potential changes in the cardio-metabolic profile from childhood to adolescence in subjects born SGA and LGA compared to those born appropriate (AGA) for gestational age.MethodsThis longitudinal study included 35 AGA, 24 SGA and 31 LGA subjects evaluated during childhood (mean age (±SD) 8.4±1.4 yr) and then re-assessed during adolescence (mean age 13.3±1.8 yr). BMI, blood pressure, insulin resistance (fasting insulin, HOMA-IR) and lipids were assessed. A cardio-metabolic risk z-score was applied and this consisted in calculating the sum of sex-specific z-scores for BMI, blood pressure, HOMA-IR, triglycerides and triglycerides:high-density lipoprotein cholesterol ratio.ResultsFasting insulin and HOMA-IR were higher in SGA and LGA than AGA subjects both during childhood (all P<0.01) and adolescence (all P<0.01). Similarly, the clustered cardio-metabolic risk score was higher in SGA and LGA than AGA children (both P<0.05), and these differences among groups increased during adolescence (both P<0.05). Of note, a progression of the clustered cardio-metabolic risk score was observed from childhood to adolescence within SGA and within LGA subjects (both P<0.05).ConclusionsSGA and LGA subjects showed an adverse cardio-metabolic profile during childhood when compared to AGA peers, with a worsening of this profile during adolescence. These findings indicate an overtime progression of insulin resistance and overall estimated cardiovascular risk from childhood to adolescence in SGA and LGA populations.
Highlights
Birth weight is recognized to have important implications for cardio-metabolic health in adulthood
Birth weight is a marker of intrauterine nutrition, it is likely that the mechanisms mediating the increased metabolic risk of those born SGA are different to those born LGA
The AGA, SGA and LGA groups were similar for gestational weeks, age and sex, whereas a difference was found in birth weight (P,0.01)
Summary
Birth weight is recognized to have important implications for cardio-metabolic health in adulthood. Children born small (SGA) and large (LGA) for gestational age are at greater risk of developing type 2 diabetes and cardiovascular disease as they age [1,2,3,4,5,6]. These groups have been shown to have metabolic alterations in childhood and adolescence, suggesting a phenotype of metabolic dysfunction in early life, leading to the emergence of disease in adulthood [2,6,7,8,9,10]. Our aim was to assess potential changes in the cardio-metabolic profile from childhood to adolescence in subjects born SGA and LGA compared to those born appropriate (AGA) for gestational age
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