The association of low birth weight with serum C reactive protein in 3-year-old children living in Cuba: A population-based prospective study.

Silvia Josefina Venero‐Fernández,Lourdes Batista‐Gutierrez,John Britton,Hermes Fundora‐Hernández,Ileana Del Valle‐Infante,Esperanza De La C Mora‐Faife,Gladys García‐García,Ramón Suárez‐Medina,Liem Gómez‐Marrero,Andrew W Fogarty

doi:10.1002/ajhb.22936

Abstract

ObjectiveLow birthweight is associated with a decreased risk of childhood leukemia and an increased risk of both cardiovascular disease and all‐cause mortality in adult life. Possible biological mediators include systemic innate immunity and inflammation. We tested the hypothesis that birthweight was inversely associated with serum high sensitivity C reactive protein assay (hsCRP), a measure of both innate immunity and systemic inflammation.MethodsData on birthweight and current anthropometric measures along with a range of exposures were collected at 1 and 3 years of age in a population‐based cohort study of young children living in Havana, Cuba. A total of 986 children aged 3‐years‐old provided blood samples that were analyzed for serum hsCRP levels.ResultsNearly 49% of children had detectable hsCRP levels in their serum. Lower birthweight was linearly associated with the natural log of hsCRP levels (beta coefficient −0.70 mg L−1 per kg increase in birthweight, 95% CI: −1.34 to −0.06). This was attenuated but still present after adjustment for the child's sex and municipality (−0.65 mg L−1 per kg birthweight; 95% CI: −1.38 to +0.08). There were no associations between growth from birth or anthropometric measures at 3 years and systemic inflammation.ConclusionsBirthweight was inversely associated with serum hsCRP levels in children aged 3 years living in Cuba. These observations provide a potential mechanism that is present at the age of 3 years to explain the association between low birthweight and both decreased childhood leukemia and increased cardiovascular disease in adults.

Highlights

Exposures from conception onwards are well recognized to impact birthweight and subsequent diseases in adulthood (Gluckman et al, 2008)
Potential biological processes that may be on the casual pathway for these observations include innate immunity whereby immune surveillance prevents the development of aberrant cells into clinical malignancies (Bindea et al, 2010; Chow et al, 2011; Ostrand-Rosenberg, 2008), and systemic inflammation, which is known to be a risk factor for cardiovascular disease (Danesh et al, 2000; Ridker and Cook, 2004; Ridker et al, 1998, 2000)
High sensitivity C reactive protein is a member of the pentraxin protein family, and is a biomarker that contributes to both innate immunity (Du Clos and Mold, 2004; Simons et al, 2014) and systemic inflammation (Black et al, 2004; Mortensen, 2001), and is positively associated with higher all-cause mortality in adults (Zacho et al, 2010)

Summary

Introduction

Exposures from conception onwards are well recognized to impact birthweight and subsequent diseases in adulthood (Gluckman et al, 2008). The associations between lower birthweight and decreased risk of childhood leukemia (Belson et al, 2007; Hjalgrim et al, 2004; Paltiel et al, 2004) and increased cardiovascular disease (Huxley et al, 2007; Mu et al, 2012; Risnes et al, 2011) and all-cause mortality (Risnes et al, 2011) in adults are well recognized the pathogenetic mechanisms are unclear. Prospective studies in children may increase understanding of these associations by determining if birthweight is associated with increased hsCRP levels in later childhood. We have used data from a prospective study in young children to test the primary hypothesis that low birth weight is associated with increased hsCRP levels at the age of 3 years

Results

Discussion

Conclusion