Impact of Birth Weight and Early Infant Weight Gain on Insulin Resistance and Associated Cardiovascular Risk Factors in Adolescence

Abstract

BackgroundLow birth weight followed by accelerated weight gain during early childhood has been associated with adverse metabolic and cardiovascular outcomes later in life. The aim of this study was to examine the impact of early infant weight gain on glucose metabolism and cardiovascular risk factors in adolescence and to study if the effect differed between adolescents born small for gestational age (SGA) vs. appropriate for gestational age (AGA).Methodology/Principal FindingsData from 30 SGA and 57 AGA healthy young Danish adolescents were analysed. They had a mean age of 17.6 years and all were born at term. Data on early infant weight gain from birth to three months as well as from birth to one year were available in the majority of subjects. In adolescence, glucose metabolism was assessed by a simplified intravenous glucose tolerance test and body composition was assessed by dual-energy X-ray absorptiometry. Blood pressures as well as plasma concentrations of triglycerides and cholesterol were measured. Early infant weight gain from birth to three months was positively associated with the fasting insulin concentration, HOMA-IR, basal lipid levels and systolic blood pressure at 17 years. There was a differential effect of postnatal weight gain on HOMA-IR in AGA and SGA participants (P for interaction = 0.03). No significant associations were seen between postnatal weight gain and body composition or parameters of glucose metabolism assessed by the simplified intravenous glucose tolerance test. In subgroup analysis, all associations with early infant weight gain were absent in the AGA group, but the associations with basal insulin and HOMA-IR were still present in the SGA group.ConclusionThis study suggests that accelerated growth during the first three months of life may confer an increased risk of later metabolic disturbances – particularly of glucose metabolism – in individuals born SGA.

Placental and Cord Blood Methylation of Genes Involved in Energy Homeostasis: Association With Fetal Growth and Neonatal Body Composition

“…Growth restraint before birth is thought to confer such risk, particularly when followed by excessive weight gain after birth (3). By the postnatal age of 4 months, SGA infants already have an altered endocrine-metabolic profile with elevated concentrations of circulating IGF-I and high-molecular weight adiponectin (4).…”

Associations of Birth Weight and Postnatal Weight Gain With Cardiometabolic Risk Parameters at 5 Years of Age

“…2 More recent studies have shown that the postnatal growth pattern in infancy is also an important factor in the expression of later disease. [3][4][5][6] Indeed, it is a matter of great interest to know how the interaction between pre-and postnatal growth affects the development of cardiometabolic risk factors.…”

Understanding the Power of Perinatal Events and Metabolic Status in Childhood

“…However, metabolic assessments in these studies were obtained in later childhood 4 or adolescence. 5 Contrary to these reports, Lurbe et al 2 found that weight gain within the first 6 months had no effect on metabolic variations measured at age 5 years in SGA infants. Based on a systematic review of published evidence on the association of birth weight with type 2 diabetes mellitus in adults, Whincup et al 6 reported that in most populations birth weight was inversely related to type 2 diabetes mellitus.…”

“…Subsequent studies to test this idea reported that overnutrition in early infancy was associated with later metabolic abnormalities 4,5 and suggested that overnutrition with accelerated weight gain in the first months of life contributed to adverse metabolic changes. However, metabolic assessments in these studies were obtained in later childhood 4 or adolescence.…”