No abstract

For the majority of outcome measures associated with the metabolic syndrome, we found no difference between preterm and term-born adults. Increased plasma low-density lipoprotein in young adults born preterm may represent a greater risk for atherosclerosis and cardiovascular disease in later life. Preterm birth is associated with higher blood pressure in adult life, with women appearing to be at greater risk than men.

Individual compartments of abdominal adiposity and lipid content within the liver and muscle are differentially associated with metabolic risk factors, obesity and insulin resistance. Subjects with greater intra‐abdominal adipose tissue (IAAT) and hepatic fat than predicted by clinical indices of obesity may be at increased risk of metabolic diseases despite their “normal” size. There is a need for accurate quantification of these potentially hazardous depots and identification of novel subphenotypes that recognize individuals at potentially increased metabolic risk. We aimed to calculate a reference range for total and regional adipose tissue (AT) as well as ectopic fat in liver and muscle in healthy subjects. We studied the relationship between age, body‐mass, BMI, waist circumference (WC), and the distribution of AT, using whole‐body magnetic resonance imaging (MRI), in 477 white volunteers (243 male, 234 female). Furthermore, we used proton magnetic resonance spectroscopy (MRS) to determine intrahepatocellular (IHCL) and intramyocellular (IMCL) lipid content. The anthropometric variable which provided the strongest individual correlation for adiposity and ectopic fat stores was WC in men and BMI in women. In addition, we reveal a large variation in IAAT, abdominal subcutaneous AT (ASAT), and IHCL depots not fully predicted by clinically obtained measurements of obesity and the emergence of a previously unidentified subphenotype. Here, we demonstrate gender‐ and age‐specific patterns of regional adiposity in a large UK‐based cohort and identify anthropometric variables that best predict individual adiposity and ectopic fat stores. From these data we propose the thin‐on‐the‐outside fat‐on‐the‐inside (TOFI) as a subphenotype for individuals at increased metabolic risk.

This study provides novel insights into the peripheral mechanism of action of acetate, independent of central action, including 'browning' and enhancement of hepatic mitochondrial function.

Compared with breastfeeding, formula feeding is associated with altered body composition in infancy.

BackgroundMaternal Body Mass Index (BMI) is positively associated with infant obesity risk. Breast milk contains a number of hormones that may influence infant metabolism during the neonatal period; these may have additional downstream effects on infant appetite regulatory pathways, thereby influencing propensity towards obesity in later life.ObjectiveTo conduct a systematic review of studies examining the association between maternal BMI and the concentration of appetite-regulating hormones in breast milk.MethodPubmed was searched for studies reporting the association between maternal BMI and leptin, adiponectin, insulin, ghrelin, resistin, obestatin, Peptide YY and Glucagon-Like Peptide 1 in breast milk.ResultsTwenty six studies were identified and included in the systematic review. There was a high degree of variability between studies with regard to collection, preparation and analysis of breast milk samples. Eleven of fifteen studies reporting breast milk leptin found a positive association between maternal BMI and milk leptin concentration. Two of nine studies investigating adiponectin found an association between maternal BMI and breast milk adiponectin concentration; however significance was lost in one study following adjustment for time post-partum. No association was seen between maternal BMI and milk adiponectin in the other seven studies identified. Evidence for an association between other appetite regulating hormones and maternal BMI was either inconclusive, or lacking.ConclusionsA positive association between maternal BMI and breast milk leptin concentration is consistently found in most studies, despite variable methodology. Evidence for such an association with breast milk adiponectin concentration, however, is lacking with additional research needed for other hormones including insulin, ghrelin, resistin, obestatin, peptide YY and glucagon-like peptide-1. As most current studies have been conducted with small sample sizes, future studies should ensure adequate sample sizes and standardized methodology.

Our investigation addresses the hypothesis that disruption of third trimester development by preterm birth alters multiple biological pathways affecting metabolic health in adult life. We compared healthy adult volunteers aged 18 -27 y born at Յ33 wk gestation or at term. We used whole-body MRI, 1 H magnetic resonance spectroscopy (MRS) of liver and muscle, metabonomic profiling of blood and urine, and anthropometric and blood pressure measurements. Preterm subjects had greater (mean difference (95% CI)) total [2.21 L (0.3, 4.1), p ϭ 0.03] and abdominal adipose tissue [internal 0.51 (0.1, 0.9), p ϭ 0.007]; blood pressure [systolic 6.5 mm Hg (2.2, 10.8), p ϭ 0.004; diastolic 5.9 (1.8, 10.1), p ϭ 0.006]; and ectopic lipid (ratio (95% CI)), intrahepatocellular lipid (IHCL) 3.01 (1.78, 5.28) p Ͻ 0.001, and tibialis-intramyocellular lipid (T-IMCL) [1.31 (1.02, 1.69) p ϭ 0.04]. In preterm, compared with term men, there was greater internal adipose tissue [mean (SD); men: preterm 4.0 (1.6), term 2.7 (1.1) liters; women: preterm 2.6 (0.9); term 2.6 (0.5); gender-gestation interaction p ϭ 0.048] and significant differences in the urinary metabolome (elevated methylamines and acetylglycoproteins, lower hippurate). We have identified multiple premorbid biomarkers in ex-preterm young adults, which are most marked in men and indicative of risks to later wellbeing. These data offer insight into biological trajectories affected by preterm birth and/or neonatal care. A round 2% of births in the developed world are below 33 wk gestation. This rate is rising as is survival and Ͼ90% of these infants will go home. Survival free of major impairment is also rising, bringing with it the expectation of life-long health. Preterm birth may be a risk to adult health (1,2). Several groups describe higher blood pressure (3-7). Insulin resistance (8) and poorer reproductive health (9) have also been reported. The biological mediators are unknown.We have previously shown that by term, preterm infants have an altered body composition with significantly greater abdominal adipose tissue (10) and intrahepatocellular lipid (IHCL) (11). There is a high degree of correlation between hypertension, insulin resistance, and abdominal obesity. Abdominal adipose tissue in particular seems to play a major role in the pathogenesis of the metabolic syndrome (12). Increased "ectopic" lipid in liver and muscle as IHCL and soleus and tibialis intramyocellular lipid (S-IMCL and T-IMCL) are also strongly associated with these conditions (13).In this proof-of-concept study, we postulated that disruption of the normal pattern of third trimester development by preterm birth will affect a range of systems affecting metabolic health. We tested the primary hypothesis that young adults born at or below 33 wk gestation would have increased abdominal adiposity in the absence of overt obesity. We also evaluated IHCL, IMCL, fasting glucose and insulin, insulin resistance, serum lipids and serum, and urine metabolomes. METHODSApproval for the study was obtained fro...

Obesity has become a major global health problem. Recently, attention has focused on the benefits of fermentable carbohydrates on modulating metabolism. Here, we take a system approach to investigate the physiological effects of supplementation with oligofructose‐enriched inulin (In). We hypothesize that supplementation with this fermentable carbohydrate will not only lead to changes in body weight and composition, but also to modulation in neuronal activation in the hypothalamus. Male C57BL/6 mice were maintained on a normal chow diet (control) or a high fat (HF) diet supplemented with either oligofructose‐enriched In or corn starch (Cs) for 9 weeks. Compared to HF+Cs diet, In supplementation led to significant reduction in average daily weight gain (mean ± s.e.m.: 0.19 ± 0.01 g vs. 0.26 ± 0.02 g, P < 0.01), total body adiposity (24.9 ± 1.2% vs. 30.7 ± 1.4%, P < 0.01), and lowered liver fat content (11.7 ± 1.7% vs. 23.8 ± 3.4%, P < 0.01). Significant changes were also observed in fecal bacterial distribution, with increases in both Bifidobacteria and Lactobacillius and a significant increase in short chain fatty acids (SCFA). Using manganese‐enhanced MRI (MEMRI), we observed a significant increase in neuronal activation within the arcuate nucleus (ARC) of animals that received In supplementation compared to those fed HF+Cs diet. In conclusion, we have demonstrated for the first time, in the same animal, a wide range of beneficial metabolic effects following supplementation of a HF diet with oligofructose‐enriched In, as well as significant changes in hypothalamic neuronal activity.