Adaptive Changes in Neonatal Hormonal and Metabolic Profiles Induced by Fetal Growth Restriction

Beltrand, Jacques; Verkauskienė, Rasa; Nicolescu, Ramona; Sibony, O.; Gaucherand, P.; Chevenne, Didier; Claris, Olivier; Lévy-Marchal, Claire

doi:10.1210/jc.2008-0562

Cited by 29 publications

(20 citation statements)

References 31 publications

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“…In this respect, an increase in insulin sensitivity would be a physiological adaptation to fetal growth restriction because insulin is a major regulator of fetal growth. Consistent with this, we and others have reported that smallfor-gestational age (SGA) newborns display increased insulin sensitivity (10)(11)(12). Although RBP4 may play a pivotal role in the development of IR in humans, to date, however, no study has been carried out in low birth weight subjects.…”

Section: Introductionsupporting

confidence: 73%

“…RBP4 levels have been linked to visceral adiposity, visceral fat representing a major source of RBP4 in conditions associated with IR (17). Data from absorptiometry studies show that the amount of fat mass is strikingly reduced in neonates who suffered intrauterine growth retardation, indicating an altered development of adipose tissue (12). Early catch-up growth following fetal growth restriction promotes restoration of body size and fat stores by the 1 st year of post-natal life (20).…”

Section: Discussionmentioning

confidence: 99%

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Retinol-binding protein 4 in neonates born small for gestational age

Giacomozzi

Ghirri

Lapolla

et al. 2010

J Endocrinol Invest

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ABSTRACT. Background: Retinol-binding protein 4 (RBP4) is an adipocyte-derived 'signal' that may contribute to the pathogenesis of insulin resistance and Type 2 diabetes. The relationship of RBP4 with insulin resistance and metabolic risk in human beings has been the subject of several studies. Subjects born small for gestational age (SGA) are at risk of insulin resistance and Type 2 diabetes. Though RBP4 could represent an early marker of insulin resistance, to date, none have determined RBP4 in SGA children. Aim: Our aim was to measure RBP4 concentrations in cord blood of SGA newborns compared with those in children born with a birth weight appropriate for gestational age (AGA) and to determine whether serum RBP4 levels at birth correlate with insulin sensitivity markers. Subjects and methods: Sixty-four newborns, 17 born SGA (mean gestational age: 36.4±2.1 weeks), and 47 born AGA (mean gestational age: 37.0±3.6 weeks) were studied. The main outcome measures included anthropometry, lipid profile, insulin, homeostasis model assessment, quantitative insulin-sensitivity check index, adiponectin, and RBP4. Results: RBP4 concentrations were significantly reduced in SGA newborns (p<0.002). No relationship was found between RBP4 and insulin sensitivity parameters. Stepwise regression analysis revealed that birth weight was the major predictor of RBP4 serum concentrations (p<0.001). Conclusion: RBP4 is reduced in SGA newborns, birth weight representing the major determinant of RBP4 concentrations, and is not related to insulin sensitivity. No significant difference in adiponectin levels and insulin sensitivity markers was found between SGA and AGA neonates. INTRODUCTIONRetinol-binding protein 4 (RBP4) is an adipocyte-derived 'signal' that may contribute to the pathogenesis of insulin resistance (IR) and Type 2 diabetes. RBP4 could play a role in obesity-induced IR, since chronic elevation of RBP4 in mice increases hepatic glucose production, down-regulates insulin signaling in muscle, and causes systemic IR (1). Furthermore, lowering elevated serum RBP4 levels in obese mice with a synthetic retinoid improves insulin sensitivity and normalizes glucose tolerance (1). In humans, the link between RBP4 and IR is less clear. In adulthood, serum RBP4 levels have been shown to correlate with the magnitude of IR in subjects with obesity, impaired glucose tolerance, and Type 2 diabetes (2). Moreover, elevated serum RBP4 was associated with components of the metabolic syndrome, including increased body mass index, waist-tohip ratio, serum triglyceride levels, and systolic blood pressure and decreased HDL cholesterol levels (2). In childhood, a relationship between serum RBP4 and obesity and components of the metabolic syndrome has been described in pre-pubertal and early pubertal children (3).Increased risk of developing IR and Type 2 diabetes in adulthood is associated with low birth weight (4). Although this association is clearly established in adults (5), results in children are still conflicting (6). Some authors have sugg...

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Section: Introductionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Retinol-binding protein 4 in neonates born small for gestational age

Giacomozzi

Ghirri

Lapolla

et al. 2010

J Endocrinol Invest

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“…It has also been suggested that neonates who have a rapid weight gain during infancy seem to have an increased fat mass, greater BMI or an altered fat distribution and body composition during adolescence and adulthood, with an increased risk of cardiovascular disease (18) . One other study documented that fetal growth restriction, and consequential adaptive hormonal and metabolic responses, induce changes in body composition and metabolic parameters at birth irrespective of birth weight itself (19) .…”

Section: Puberty and Growthmentioning

confidence: 99%

Pubertal development and sexuality in female adolescents born preterm: a review of the literature

Paúl¹,

Deans

Viner

et al. 2011

International Journal of Adolescent Medicine and Health

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Introduction : Premature infants, especially very low birth weight infants, and fetal growth restriction are a challenge for healthcare professionals alike owing to the consequences of these conditions. Objective: To provide information for gynecologists, pediatricians and neonatologists to identify correct outcome expectations to help them plan their preventive and therapeutic actions. Searches were made on the MEDLINE database. Results: According to several follow-up studies, there is an increasing evidence for a link between early life exposures (prenatal and postnatal) and long-term outcomes. An adverse in utero environment will induce fetal reprogramming of neuroendocrine axes with permanent alterations of the physiology and metabolism of various body structures and functioning of neuroendocrine axes in later life, leading to a variety of different conditions, such as persistence of neurodevelopmental disability, changes in growth pattern, in body metabolism, in pubertal development, lower educational achievement and even psychological disturbances with possible alterations of sexual behavior in female adolescents and young adults. In addition, short-term transitory consequences can be also present, such as anomalies in genital appearance. Conclusions: Outcome studies on the impact that prematurity, low birth weight and intrauterine growth restriction have on pubertal development, sexuality and fertility are still scarce. Long-term outcomes of small for gestational age or preterm adolescents are complex and multifactorial, with interactions between genetic and environmental infl uences

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“…Several reports demonstrated that customized birth standards are useful in detecting undiagnosed fetal growth restriction (FGR) by a population-based standard and to help to manage FGR [2,8,10,12,26,32] . However, the clinical signifi cance of identifying LGA by a customized standard, in association with adverse intrapartum outcomes, has been rarely investigated.…”

Section: Introductionmentioning

confidence: 99%

Can a customized standard for large for gestational age identify women at risk of operative delivery and shoulder dystocia?

Cha

Kim

Choi

et al. 2012

Journal of Perinatal Medicine

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Adaptive Changes in Neonatal Hormonal and Metabolic Profiles Induced by Fetal Growth Restriction

Abstract: Fetal growth restriction induces changes in body composition and metabolism suggestive of a higher insulin sensitivity independently from BW itself, reflecting adaptive changes to an adverse fetal nutritional environment.

Cited by 29 publications

References 31 publications

Retinol-binding protein 4 in neonates born small for gestational age

Retinol-binding protein 4 in neonates born small for gestational age

Pubertal development and sexuality in female adolescents born preterm: a review of the literature

Can a customized standard for large for gestational age identify women at risk of operative delivery and shoulder dystocia?

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