title: Associations of cord blood metabolites with early childhood obesity risk.
abstract: OBJECTIVE
  Rapid postnatal weight gain is a potentially modifiable risk factor for obesity and metabolic syndrome. To identify markers of rapid infancy weight gain and childhood obesity, we analyzed the metabolome in cord blood from infants differing in their postnatal weight trajectories.
  
  
  METHODS
  We performed a nested case-control study within Project Viva, a longitudinal cohort of mothers and children. We selected cases (n=26) based on top quartile of change in weight-for-age 0-6 months and body mass index (BMI) >85th percentile in mid-childhood (median 7.7 years). Controls (n=26) were age and sex matched, had normal postnatal weight gain (2nd or 3rd quartile of change in weight-for-age 0-6 months) and normal mid-childhood weight (BMI 25th-75th percentile). Cord blood metabolites were measured using untargeted liquid chromatography-mass spectrometry; individual metabolites and pathways differing between cases and controls were compared in categorical analyses. We adjusted metabolites for maternal age, maternal BMI and breastfeeding duration (linear regression), and assessed whether metabolites improved the ability to predict case-control status (logistic regression).
  
  
  RESULTS
  Of 415 detected metabolites, 16 were altered in cases versus controls (t-test, nominal P<0.05). Three metabolites were related to tryptophan: serotonin, tryptophan betaine and tryptophyl leucine (46%, 48% and 26% lower in cases, respectively, P<0.05). Mean levels of two methyl donors, dimethylglycine and N-acetylmethionine, were also lower in cases (18% and 16%, respectively, P=0.01). Moreover, the glutamine:glutamate ratio was reduced by 33% (P<0.05) in cases. Levels of serotonin, tryptophyl leucine and N-acetylmethionine remained significantly different after adjustment for maternal BMI, age and breastfeeding. Adding metabolite levels to logistic regression models including only clinical covariates improved the ability to predict case versus control status.
  
  
  CONCLUSIONS
  Several cord blood metabolites are associated with rapid postnatal weight gain. Whether these patterns are causally linked to childhood obesity is not clear from this cross-sectional analysis, but will require further study.
authors: Research Division, Department of Genetics and Epidemiology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors: E
authors: E
authors: Isganaitis
authors: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
authors: S L
authors: SL
authors: Rifas-Shiman
authors: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
authors: E
authors: E
authors: Oken
authors: 1] Research Division, Department of Genetics and Epidemiology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA [2] Department of Biomedical Engineering, Boston University, Boston, MA, USA.
authors: J M
authors: JM
authors: Dreyfuss
authors: Metabolon, Inc., Durham, NC, USA.
authors: W
authors: W
authors: Gall
authors: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.
authors: M W
authors: MW
authors: Gillman
authors: Research Division, Department of Genetics and Epidemiology, Joslin Diabetes Center, Harvard Medical School, Boston, MA, USA.
authors: M-E
authors: ME
authors: Patti
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood; D001724:Birth Weight; D015992:Body Mass Index; D016022:Case-Control Studies; D005260:Female; D005312:Fetal Blood / Q000737:chemistry*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D024821:Metabolic Syndrome / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D055442:Metabolome; D009035:Mothers; D063766:Pediatric Obesity / Q000097:blood* / Q000209:etiology / Q000517:prevention & control; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000097:blood*; D012307:Risk Factors; D015430:Weight Gain
chemical_list: D015415:Biomarkers