Abstract
BackgroundAdults born preterm with very low birth weight (VLBW; <1500g) have higher levels of cardiovascular and metabolic risk factors than their counterparts born at term. Resting energy expenditure (REE) could be one factor contributing to, or protecting from, these risks. We studied the effects of premature birth with VLBW on REE.Methodology/Principal FindingsWe used indirect calorimetry to measure REE and dual x-ray absorptiometry (DXA) to measure lean body mass (LBM) in 116 VLBW and in 118 term-born control individuals (mean age: 22.5 years, SD 2.2) participating in a cohort study. Compared with controls VLBW adults had 6.3% lower REE (95% CI 3.2, 9.3) adjusted for age and sex, but 6.1% higher REE/LBM ratio (95% CI 3.4, 8.6). These differences remained similar when further adjusted for parental education, daily smoking, body fat percentage and self-reported leisure time exercise intensity, duration and frequency.Conclusions/SignificanceAdults born prematurely with very low birth weight have higher resting energy expenditure per unit lean body mass than their peers born at term. This is not explained by differences in childhood socio-economic status, current fat percentage, smoking or leisure time physical activity. Presence of metabolically more active tissue could protect people with very low birth weight from obesity and subsequent risk of chronic disease.
Highlights
0.9 to 1.5% of all live-born infants in high-income countries are born preterm with very low birth weight (VLBW,1500 g) [1,2]
As lean body mass (LBM) is closely related to resting energy expenditure (REE) [16], adults born with VLBW would be expected to have lower Resting energy expenditure (REE)
There was no interaction between the effects of VLBW birth and sex on these outcomes, meaning that the relationship between prematurity and REE was similar in men and women, and we present the results pooled for both sexes
Summary
0.9 to 1.5% of all live-born infants in high-income countries are born preterm with very low birth weight (VLBW, ,1500 g) [1,2]. VLBW infants experience conditions that are highly different from normal growth in utero and could be at increased risk As adults they have substantially increased risk factors for chronic disease, such as impaired glucose regulation and up to 10 mmHg higher systolic blood pressure than their peers born at term [10,11,12,13,14]. One possibility is that VLBW adults have metabolically more active LBM, a phenomenon which has been shown in older adults who were born with a birth weight at the lower end of normal birth weight distribution [16,17] With this background, our primary aim was to study the effects of preterm birth with VLBW on REE in young adults. We studied the effects of premature birth with VLBW on REE
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