Cardiometabolic Risk Factors in Young Adults Who Were Born Preterm

Abstract

Adults who were born preterm with a very low birth weight have higher blood pressure and impaired glucose regulation later in life compared with those born at term. We investigated cardiometabolic risk factors in young adults who were born at any degree of prematurity in the Preterm Birth and Early Life Programming of Adult Health and Disease (ESTER) Study, a population-based cohort study of individuals born in 1985–1989 in Northern Finland. In 2009–2011, 3 groups underwent clinical examination: 134 participants born at less than 34 gestational weeks (early preterm), 242 born at 34–36 weeks (late preterm), and 344 born at 37 weeks or later (controls). Compared with controls, adults who were born preterm had higher body fat percentages (after adjustment for sex, age, and cohort (1985–1986 or 1987–1989), for those born early preterm, difference = 6.2%, 95% confidence interval (CI): 0.4, 13.2; for those born late preterm, difference = 8.0%, 95% CI: 2.4, 13.8), waist circumferences, blood pressure (for those born early preterm, difference = 3.0 mm Hg, 95% CI: 0.9, 5.1; for those born late preterm, difference = 1.7, 95% CI: −0.1, 3.4), plasma uric acid levels (for those born early preterm, difference = 20.1%, 95% CI: 7.9, 32.3; for those born late preterm, difference = 20.2%, 95% CI: 10.7, 30.5), alanine aminotransferase levels, and aspartate transaminase levels. They were also more likely to have metabolic syndrome (for those born early preterm, odds ratio = 3.7, 95% CI: 1.6, 8.2; for those born late preterm, odds ratio = 2.5, 95% CI: 1.2, 5.3). Elevated levels of conventional and emerging risk factors suggest a higher risk of cardiometabolic disease later in life. These risk factors are also present in the large group of adults born late preterm.

Physical Fitness in Young Adults Born Preterm

“…In model 2, we further adjusted for the following parental and early-life potential confounders: educational attainment of the more highly educated parent, maternal gestational diabetes and hypertension, and birth weight SD score. In model 3 we additionally adjusted for the following potential adult mediators that may differ between those born preterm and at term: self-reported physical activity, 6,7 diagnosed asthma, 34 height, 6,7 body fat percentage, 5 and smoking. 35 For heart rate after the step test, we also adjusted for whether the participant had received salbutamol in a bronchodilation test.…”

“…4 The adverse consequences of preterm birth have also been suggested to be present in those born LPT and increase with the degree of prematurity. 5 Adolescents and adults born preterm at very (<1500 g) or extremely (<1000 g) low birth weight report undertaking less physical activity than those born at term, [6][7][8] although these associations have not been captured by studies with the use of an objective measurement of physical activity (eg, accelerometry). 9,10 Lower muscular and cardiorespiratory fitness are also features of those born preterm with an extremely low birth weight.…”

Preterm birth: risk factor for early-onset chronic diseases

“…11 Yet, a recent population-based cohort study (n = 711) showed that odds of fulfilling the criteria for metabolic syndrome were 3.7 higher (95% CI 1.6-8.2) in young adults who had been born at less than 34 weeks than in their peers born at term. 23 The link between preterm birth and insulin sensitivity was the subject of a recent systematic review. 24 In early childhood, reduced insulin sensitivity was seen following preterm birth, but as children aged, the strength of this association decreased.…”

Ambulatory Blood Pressure and Its Variability in Adults Born Preterm

“…18 With the subject in a sitting position and after 5-minute rest, a trained study nurse measured BP (mm Hg) from the upper right arm, using an automatic oscillometric BP monitor (Intellisense M10-IT; cuff size, 22-42 cm; Omron Healthcare Co, Ltd, Kyoto, Japan). Three measurements were taken and the mean was calculated.…”