Independent effects of prematurity on metabolic and cardiovascular risk factors in short small-for-gestational-age children.
BACKGROUND
Both small-for-gestational-age (SGA) and preterm birth have been associated with an increased incidence of adult cardiovascular disease and diabetes mellitus type 2. However, it is unclear whether preterm birth has an additional effect on cardiovascular risk factors in short children born SGA.


OBJECTIVE
Our objective was to investigate whether prematurity has an independent influence on several cardiovascular risk factors within a population of short SGA children.


METHODS
A cross-sectional observational study was performed.


METHODS
A total of 479 short SGA children (mean age 6.8 yr), divided into preterm (<36 wk) and term (> or =36 wk) children, was included in the study.


METHODS
Insulin sensitivity, beta-cell function, body composition, and lipid levels were studied in subgroups, and blood pressure (BP), anthropometry at birth and during childhood in the total group.


RESULTS
Preterm SGA children were significantly lighter and shorter at birth after correction for gestational age than term SGA children (P < 0.001) but had a comparable head circumference. In preterm SGA children, we found a significantly higher systolic (P = 0.003) and diastolic BP sd score (P = 0.026), lower percent body fat sd score (P = 0.011), and higher insulin secretion (P = 0.033) and disposition index (P = 0.021), independently of the degree of SGA. Insulin sensitivity, serum lipid levels, muscle mass, and body fat distribution were comparable for preterm and term SGA children.


CONCLUSIONS
Within a population of short SGA children, preterm birth has divergent effects on several cardiovascular risk factors. Whereas preterm SGA children had a higher systolic and diastolic BP, they also had a lower percent body fat and a higher insulin secretion and disposition index than term SGA children.
Willemsen
Ruben H
RH
Department of Paediatrics, Division of Endocrinology, Erasmus MC Sophia, 3015 GJ Rotterdam, The Netherlands. r.h.willemsen@erasmusmc.nl
de Kort
Sandra W K
SW
van der Kaay
Danielle C M
DC
Hokken-Koelega
Anita C S
AC
D001053:Apolipoproteins / Q000097:blood; D001724:Birth Weight / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology; D001823:Body Composition / Q000502:physiology*; D001835:Body Weight / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology*; D002648:Child; D003430:Cross-Sectional Studies; D005230:Fatty Acids, Nonesterified / Q000097:blood; D005260:Female; D005951:Glucose Tolerance Test; D006130:Growth Disorders / Q000097:blood / Q000150:complications / Q000209:etiology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000097:blood / Q000502:physiology*; D007236:Infant, Small for Gestational Age / Q000097:blood / Q000502:physiology*; D007328:Insulin / Q000097:blood; D050417:Insulin-Secreting Cells / Q000502:physiology; D016014:Linear Models; D017270:Lipoprotein(a) / Q000097:blood; D008297:Male
D001053:Apolipoproteins; D001786:Blood Glucose; D005230:Fatty Acids, Nonesterified; D007328:Insulin; D017270:Lipoprotein(a)