Low BW Research Articles

Association between birth weight and insulin resistance in US adolescents: A retrospective cohort study exploring the role of concurrent body mass index

Background and aimsThis study aimed to investigate the association between birth weight (BW) and abnormal HOMA-IR in US adolescents aged 12–15 years. The role of concurrent body mass index (BMI) in adolescence was also examined. Methods and resultsThis retrospective cohort study included 3429 participants from NHANES with data in 1999–2020. HOMA-IR ≥2.3 was considered abnormal. Participants were classified as low (LBW; <2.5 kg), normal (NBW; 2.5–4.0 kg), or high (HBW; >4.0 kg) BW. Logistic regression was used to explore the association between BW and HOMA-IR. Mediation analysis was used to examine whether BMI z-score in adolescence mediated the association between BW and HOMA-IR. Compared with those in NBW, the odds ratios (95 % CI) of abnormal HOMA-IR in LBW and HBW groups were 1.26 (0.99–1.60), and 0.62 (0.47–0.83) respectively. The association between BW and abnormal HOMA-IR was consistent in all subgroups with no significant interactions. Mediation analysis showed that BW is associated with lower risk of HOMA-IR directly, but with higher risk indirectly via BMI in adolescence. ConclusionThere was a negative linear relationship between BW and the prevalence of abnormal HOMA-IR in adolescents aged 12–15 independent of concurrent BMI. Children who were born with LBW but had high BMI in adolescence were of particularly higher risk of insulin resistance.

Early origins of metabolic and overall health in young adults: An outcome-wide analysis in a general cohort population

IntroductionLong-term consequences of impaired fetal growth are well documented for cardiometabolic outcomes. We propose an outcome-wide analysis of the association between birth weight (BW) and long-term health in a large contemporary adult cohort. MethodsThe study included 73,315 participants under 60 years with a reliable BW from the French nationwide Constances cohort. Low and high BW (LBW/HBW) were defined as BW<10th and >90th of sex-specific percentiles. Associations between BW and outcomes were analyzed with a sex-stratified modified Poisson regression adjusted for the participant's age, maternal health history, geographical origins, and parents' occupation. ResultsMean BW (10th -90th percentile) was 3390 g (2800-4000) for men and 3247g (2680-3820) for women. In men, LBW was associated with (RR [CI95]): fasting glucose impairment (1.33 [1.16;1.52]); hypertriglyceridemia (1.27 [1.17;1.37]); high blood pressure (HBP) (1.15 [1.07;1.24]); non-alcoholic fatty liver disease NAFLD (1.13 [1.02;1.24]); high LDL-cholesterol (1.12 [1.05;1.21]); anxiety (1.12 [1.01;1.24]) and depression (1.09 [1.00;1.18]). HBW was associated with obesity (1.21 [1.08;1.35]). In women, LBW was associated with fasting glucose impairment (1.31 [1.12;1.54]); HBP (1.27 [1.16;1.4]); hypertriglyceridemia (1.20 [1.05;1.36]); anxiety (1.10 [1.03;1.17]); and asthma (1.09 [1;1.19}). HBW was associated with obesity (1.24 [1.13;1.36]) and NAFLD (1.20 [1.06;1.37). LBW and HBW were associated with a lesser likelihood of tertiary education attainment in both sexes. Participants’ education level was a significant partial mediator of the association between LBW and outcomes. ConclusionExtreme BW is associated with long-term health. It should be considered in the personalized prevention of cardiometabolic, respiratory, and mental health conditions in adulthood, especially in socio-economically disadvantaged populations.

Association between birth weight, preterm birth, and nonalcoholic fatty liver disease in a community-based cohort.

The association between birth weight (BW) and metabolic outcomes has been described since the 1980s but NAFLD has been rarely studied. This study aimed to investigate the association between BW and NAFLD occurrence in adult subjects. The study population consisted of participants from the French nationwide Constances cohort from 2012 to 2019. Participants with a history of chronic viral hepatitis or excessive alcohol consumption were excluded. Noninvasive diagnosis of NAFLD and fibrosis was performed using a combination of the Fatty Liver Index (FLI) and the Forns Index. The relationship between BW and NAFLD was analyzed with a sex-stratified logistic regression model adjusted for sociodemographic parameters, lifestyle, and birth term, whereas liver fibrosis was analyzed with a sex-stratified linear regression model. In total, 55,034 individuals with reliable BW were included (43% men, mean age: 38 years). NAFLD (FLI≥60) was present in 5530 individuals (10%). Multivariate logistic regression showed a significant U-shaped relationship between BW and NAFLD, with no significant interaction with sex. A significant and slightly decreasing association was found between BW and Forns Index (β=-0.05; p=0.04). Premature birth (OR, 1.23; 95% CI, 1.03-1.48 for birth between 33 and 37 weeks versus≥37 weeks) was associated with NAFLD, with a significant direct effect of premature birth, and without an indirect effect of low BW in mediation analysis. Forns Index was not significantly higher in participants with preterm birth compared to full-term birth. This large prospective adult-based cohort confirms the relationship between BW and NAFLD occurrence.

Birth weight and renal markers in children aged 5\u201310\u2009years in Cameroon: a cross-sectional study

BackgroundA relationship exists between birth weight (BW) and glomerular filtration rate (GFR) in postnatal kidney. Willing to fill a gap of knowledge in sub-Saharan Africa, we assessed the effect of BW on blood pressure (BP), proteinuria and GFR among Cameroonians children.MethodsThis was a cross-sectional hospital-based study from January to April 2018 at the Yaounde Gynaeco-Obstetric and Paediatric Hospital (YGOPH). We recruited low BW (LBW) [< 2500 g], normal BW (NBW) [2500-3999 g] and high BW (HBW) [> 4000 g] children, aged 5–10 years, born and followed-up at YGOPH. We collected socio-demographic, clinical (weight, height, BP), laboratory (proteinuria, creatinine), maternal and birth data. The estimated GFR was calculated using the Schwartz equation.ResultsWe included 80 children (61.2% boys) with 21 (26.2%) LBW, 45 (56.2%) NBW and 14 (15.5%) HBW; the median (interquartile range) age was 7.3 (6.3–8.1) years and 17 (21.2%) were overweight/obese. Two (2.5%) children, all with a NBW (4.4%), had an elevated BP whereas 2 (2.5%) other children, all with a LBW (9.5%), had hypertension (p = 0.233). Seven (8.7%) children had proteinuria with 19, 2.2 and 14.3% having LBW, NBW and HBW, respectively (p = 0.051). Equivalent figures were 18 (22.5%), 14.3, 24.2 and 28.6% for decreased GFR, respectively (p = 0.818). There was a trend towards an inverse relationship between BW and BP, proteinuria and GFR (p > 0.05).ConclusionProteinuria is more pronounced in childhood with a history of LBW and HBW while LBW children are more prone to develop hypertension. Regular follow-up is needed to implement early nephroprotective measures among children with abnormal BW.

Birth Weight and Risk of Cardiovascular Disease Incidence in Adulthood: a Dose-Response Meta-analysis.

Studies have revealed a relation between birth weight (BW) and later risk of cardiovascular diseases (CVDs). This meta-analysis aimed to report the dose-response relationship between BW and risk of CVDs. The relation of BW to CVD subtypes was found to be U-shaped as BW below ~ 2500g and above ~ 4000g affected positively CVD risk (OR = 1.14 = 95%CI 1.03-1.27 and OR = 1.08; 95%CI 0.99-1.18, respectively). Regarding CVD subtypes, low BW was directly linked to greater risk of CHD (OR = 1.15; 95%CI 1.02-1.29) and stroke (OR = 1.28; 95% CI 1.05-1.55), while high BW was related to increased risk of arterial fibrillation in adulthood. A U-shaped nonlinear relationship was specifically demonstrated between BW and overall CVD and its subtypes. There is a U-shaped association between BW and all CVD subtypes.

Abstract P145: Association Between Birth Weight and Childhood and Maternal Cardiovascular Disease Risk Factors in Full Term Birth Infants

Introduction: Reported associations between birth weight (BTW) and childhood cardiovascular disease (CVD) risk factors have been inconsistent. The relationship between infants’ BTW and later maternal CVD is also a more recent and active area of research. We aimed to examine the association between BTW and subsequent childhood and maternal CVD risk factors 11 years post-partum. Methods: The study used longitudinally linked data from three cross-sectional datasets in West Virginia (N=19,583). The outcome variables included blood pressure for children and lipid levels for both mothers and children. The exposure was BTW of the infants born full-term. The role of the child’s current body mass index (BMI) was assessed as a potential mediator. Results: Unadjusted analyses showed a positive association between BTW and the child’s systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL), and a negative association with triglycerides (TGs). When adjusted for the child’s BMI, the association became non-significant for SBP and DBP but remained significant for HDL [β= 0.14 mg/dL (95% CI: 0.11, 0.18) per1000g increase in BTW] and TGs [β= -0.007 mg/dL (-0.008, -0.005) per 1000g increase in BTW]. Low-density lipoprotein cholesterol (LDL) and non-HDL became significant and negatively associated with BTW in the adjusted analysis [LDL (β = -0.1 mg/dL (-0.19, - 0.16) per 1000 g increase in BTW; non-HDL (b = - 0.18 mg/dL (-0.28, -0.09) per 1000 g increase in BTW]. There was a positive association between infant’s birth weight and maternal total cholesterol (TC) levels, which became non-significant in the adjusted analysis [β = 0.4 (95% CI: -0.01, 0.90) mg/dL per1000g increase in birth weight]. None of the other maternal lipids levels (LDL, HDL, and TG) were significant in the unadjusted or the adjusted analysis. Conclusion: Low BTW was associated with higher LDL, non-HDL, and TGs, and lower HDL levels in fifth grade children independent of the current weight status. As childhood CVD risk factors persist and are often amplified over time, these small effect sizes can have potential unfavorable consequences on lipid levels in later adulthood.

Catch-up growth and catch-up fat in children born small for gestational age.

Infants born small for gestational age (SGA) are at increased risk of perinatal morbidity, persistent short stature, and metabolic alterations in later life. Recent studies have focused on the association between birth weight (BW) and later body composition. Some reports suggest that fetal nutrition, as reflected by BW, may have an inverse programing effect on abdominal adiposity later in life. This inverse association between BW and abdominal adiposity in adults may contribute to insulin resistance. Rapid weight gain during infancy in SGA children seemed to be associated with increased fat mass rather than lean mass. Early catch-up growth after SGA birth rather than SGA itself has been noted as a cardiovascular risk factor in later life. Children who are born SGA also have a predisposition to accumulation of fat mass, particularly intra-abdominal fat. It is not yet clear whether this predisposition is due to low BW itself, rapid postnatal catch-up growth, or a combination of both. In this report, we review the published literature on central fat accumulation and metabolic consequences of being SGA, as well as the currently popular research area of SGA, including growth aspects.

Predictors of depression and anxiety during adolescence: the impact of birth weight.

A complex association has been observed between birth weight (BW) and depression/anxiety symptoms at various stages of life. The purpose of this study was to evaluate whether adolescents with low or insufficient BW were more likely to report depressive/anxiety symptoms. A cross-sectional study was conducted with 102 adolescents (40 boys and 62 girls). Our results demonstrated that the incidence of depressive symptoms was 63% in the first BW quartile and 20% in the fourth quartile. Similarly, we observed that anxiety symptoms were present in 83% of the adolescents in the first BW quartile, followed by 36% in the fourth BW quartile. After adjustment, our study identified potential risk factors that were associated with anxiety symptoms, including female gender (P=0.026) and having a BW in the first quartile (P=0.049). Moreover, the adjusted odds of having depression were 4.5 times higher in adolescents with BW in the lowest quartile (P=0.035). We also found that the incidence of depressive symptoms among females was 61% in the first BW quartile and 30% in the fourth BW quartile and that it was 67% versus 12%, respectively, among males. Finally, a model that used anxiety symptoms as the dependent variable produced similar data. Our findings suggest that a deleterious fetal environment appears to have a significant impact on psychiatric issues.

Effect of low birth weight on inflammation biomarkers and autonomic function in healthy young adults (1074.4)

A number of epidemiological studies have reported an association between birth weight (BW) and hypertension in adulthood. Low‐grade inflammation and deterioration of autonomic regulation play an important role in hypertension. However, the association with BW is unclear, and few relevant studies have been performed in healthy young adults. We examined the association of BW and hypertension risks in a high‐risk Mongolian population. We performed electrocardiography in 20 Mongolian subjects aged 23‐34 years and investigated blood pressure (BP) and heart rate variability at rest and during postural change from a supine to a sitting position. Leukocyte count, platelet count, total cholesterol, HDL‐C, LDL‐C, triglycerides and high‐sensitivity C‐reactive protein (Hs‐CRP) were measured. BW was inversely related to both leukocyte (r = ‐0.49) and platelet counts (r = ‐0.49). BMI was positively related to systolic BP (SBP; r = 0.58), LF/HF (r = 0.47), the atherosclerotic index (r = 0.53) and Hs‐CRP (r = 0.55). Following postural change, the normal BW group (2,500 g 蠄 BW &lt; 4,000 g) showed a significant increase in heart rate, SBP, and LF/HF, whereas the low BW (BW &lt; 2,500 g) and high BW groups (BW 蠅 4,000 g) showed no significant responses. These results suggest that low BW may be an essential predictor of an increase in low‐grade inflammation and deteriorating of autonomic regulation in Mongolian healthy adults.

ADHD and overweight in boys: cross-sectional study with birth weight as a controlled factor

Population studies indicate a strong relationship between birth weight (BW) and body size in later life. However, BW as a variable was never accounted for in studies on the relationship between attention-deficit/hyperactivity disorder (ADHD) and overweight. This study aims to assess the relationship between ADHD and overweight with control of birth weight and other confounding factors. Prevalence of overweight was compared in clinical sample of 219 boys with ADHD and 396 boys without ADHD, aged 6–18 years. The following factors were controlled: BW, parents income and education level, place of residence, ADHD type, selected comorbid disorders and stimulant treatment. Overweight and obesity were diagnosed according to the criteria proposed by the International Obesity Task Force. Logistic regression analysis was used to estimate the association between ADHD and the prevalence of overweight and obesity. Boys with ADHD differed significantly from the control group in distribution of low BW (8.2 vs. 3.0 %, χ 2 = 8.23, p = 0.02). Low BW was associated with a lower prevalence of overweight than normal and high BW (0 vs. 12.14 %, χ 2 = 4.12, p = 0.04). Overweight was observed significantly more often in boys with ADHD (17.3 vs. 8.3 %, χ 2 = 11.23, p < 0.001) even after adjustment for BW and other variables (OR = 2.44, 95 % CI 1.38–4.29, p = 0.002) and after controlling for ADHD type, stimulant treatment and selected comorbid disorders. Independently to applied analysis, obesity was not associated with ADHD. Lower birth weight is over twice more often observed in boys with ADHD than in control group. Although this phenomenon may reduce the rate of overweight in the studied group, ADHD remains strongly associated with increased prevalence of overweight.

Birth weight and subsequent risk of obesity: a systematic review and meta‐analysis

This report describes the association between birth weight (BW) and obesity. Screening of 478 citations from five electronic databases resulted in the inclusion of 33 studies, most of medium quality. The meta-analysis included 20 of these published studies. The 13 remaining articles did not provide sufficient dichotomous data and were systematically reviewed, revealing results consistent with the meta-analysis. Our results revealed that high BW (>4000 g) was associated with increased risk of obesity (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.91-2.24) compared with subjects with BW ≤ 4000 g. Low BW (<2500 g) was associated with decreased risk of obesity (OR, 0.61; 95% CI, 0.46-0.80) compared with subjects with BW ≥ 2500 g. However, when two studies exhibited selection bias were removed, the results indicated no significant association between low BW and obesity (OR, 0.77; 95% CI, 0.58-1.04). Sensitivity analyses showed that differences in the study design, sample size and quality grade of the study had an effect on the low BW/obesity association, which low BW was not associated with the risk of obesity in cohort studies, studies with large sample sizes and studies with high quality grades. Pooled results were similar when normal birth weight (2500-4000 g) was used as the reference category. Subgroup analyses based on different growth and developmental stages (pre-school children, school children and adolescents) also revealed that high BW was associated with increased risk of obesity from childhood to early adulthood. No significant evidence of publication bias was present. These results suggest that high BW is associated with increased risk of obesity and may serve as a mediator between prenatal influences and later disease risk.

Does Low Birth Weight Predict Obesity/Overweight and Metabolic Syndrome in Elementary School Children?

We undertook this study to explore the relationship between birth weight (BW) and childhood overweight and obesity (OW/OB) and metabolic syndrome (MS). This was a cross-sectional assessment performed in 10 elementary public schools in Buenos Aires, Argentina. Participants were 1027 students aged 9.4 +/- 2.1 years. No interventions were done. We measured the association between BW in children and OW/OB and MS at 9 years of age. Of the total number of children, 164 (16.0%) were OB (BMI >95(th) percentile) and 169 (16.5%) were OW [(body mass index (BMI) > or =85(th), <95(th) percentile); 61% were at Tanner 1. All students came from low socioeconomic families. The prevalence of low (< or =2500 g), normal, and high BW (> or =4000 g) was 7.0% (n = 72), 83.7% (n = 860), and 9.3% (n = 95), respectively. MS prevalence was 5.5%. There was a significant difference in mean BMI sd score (SDS) between low BW (0.07), normal BW (0.54) and high BW (0.99). There was a significant difference in mean BMI, BMI SDS, waist circumference (WC), WC SDS, and systolic blood pressure between low, normal, and high BW groups. In separate logistic regression models, low BW proved to be a protective factor against OW/OB [OR 0.32 (95% CI 0.16-0.63)], whereas high BW was associated with a higher OW/OB risk adjusted for age and sex [OR 2.48 (95% CI 1.62-3.81)]. The risk of MS was high for those with high BW [OR 3.16 (95% CI 1.38-7.24)] and not significant for those with low BW adjusted for age and sex. Our data indicate that low BW is not associated with OW/OB or with MS in children, whereas high BW correlates with childhood OW/OB and MS.

Relation of insulin resistance and body size in adolescence to birthweight

P04 A relationship between birthweight (BW) and the insulin resistance syndrome has been reported in adults but has not been defined in adolescents. Data were analyzed in 287 children (124 girls, 163 boys) mean age 15.0 ±1.2 yrs undergoing euglycemic insulin clamp studies (intravenous administration of 1mU/kg/min of insulin balanced by a variable infusion of 20% glucose to maintain blood glucose at 100 mg/dl). Insulin sensitivity (M) was determined by glucose uptake during the final 40 minutes of the 3 hr clamp per kg body weight. BW was reported by parents. BW ranged from 1021-4848g (mean, 3403 ±573), with 5.4% of BW &lt; 2500g. Height increased with BW (r=0.3, p&lt;0.0001). Fat mass and BMI had U-shaped relations with BW after adjustment for ethnicity, age, sex, and blood pressure, but lean body mass was not signficantly different between BW quartiles ( Table). Fasting insulin was positively, and M inversely, related to fat mass (r=0.55,and r=-0.45 respectively p&lt;0.0001). After further adjustment for body weight, fasting insulin was highest (p= 0.009) and M lowest (p=0.17) in the lowest BW quartile. Triglycerides, HDL-C, LDL-C and blood pressure were unrelated to BW. In these data, insulin resistance in adolescence is higher with low BW and increased body fat. In addition, fat mass is increased in both high and low BW in adolescence. Thus both high and low BW are potential risk factors for the development of adult cardiovascular disease and insulin resistance syndrome. Table 1.