Serum Lipid Concentrations and Growth Characteristics in 12-year-old Children Born Small for Gestational Age

Abstract

According to Barker's hypothesis, children born small for gestational age (SGA) are at increased risk for cardiovascular diseases in adulthood. The aim of our study was to determine whether retarded fetal growth is associated with dyslipidemia in childhood and, if so, to find predictive factors in the growth characteristics of SGA children. We studied the serum lipid concentrations of 55 SGA children and their 55 appropriate for gestational age control subjects at the age of 12 y. Growth variables were recorded at birth, 5 y, and 12 y of age. The study group consisted of all full-term SGA children born at our university hospital during a 22-mo period in 1984 -1986. Nearly half of the SGA children (47.3%) were in the highest quartile for serum total cholesterol of the appropriate for gestational age children (p ϭ 0.038). In multiple logistic regression analysis, poor catch-up growth in height (odds ratio, 13.8; 95% confidence interval, 2.0 -97.5), female sex (odds ratio, 8.1; 95% confidence interval, 1.3-48.9), and early stage of puberty (odds ratio, 7.5; 95% confidence interval, 1.2-46.5) predicted high cholesterol level in the SGA children. By the age of 5 y, 20 (36.4%) SGA children showed catch-up growth of Ն 2 SD scores in height, and 21 (38.2%) SGA children showed catch-up growth of Ն 2 SD scores in weight from birth. At the age of 12 y, the SGA children were still significantly shorter (p Ͻ 0.001) and lighter (p Ͻ 0.05) than the appropriate for gestational age children, even though their pubertal development was similarly advanced. In conclusion, to be born SGA has long-term consequences for later growth and may already influence the level of serum total cholesterol before the teens. SGA children with poor catch-up growth in height may be at the highest risk for hypercholesterolemia. (Pediatr Res 48: 623-628, 2000) Abbreviations SGA, small for gestational age AGA, appropriate for gestational age TC, total cholesterol PSEH, parent-specific expected height TG, triglycerides Serum lipids and lipoproteins are important determinants for the development of atherosclerosis and coronary heart disease. Previous studies have revealed that antemortem serum lipid values in children and young adults correlate significantly with atherosclerotic changes (1, 2). In addition, follow-up studies of children have shown that concentrations of serum total cholesterol tend to track for several years, and measurements obtained in childhood predict total and LDL cholesterol levels in adults (3-5).Findings by have led to the "fetal origins" hypothesis, which suggests that hypertension, hyperlipidemia, and non-insulin-dependent diabetes are programmed by malnutrition in utero. Low growth rate during fetal life and infancy is associated with increased rates of death caused by cardiovascular diseases in adulthood (10 -12). This association is seen in individuals born SGA rather than in those born prematurely (10). Moreover, Barker et al. (13) have reported a relationship between small abdominal circumference at birth and increased se...

Small for gestational age status is associated with metabolic syndrome in overweight children

“…The association between SGA status and hypertriglyceridemia, hypertension, and impaired glucose metabolism is in concordance with previous studies (7,(26)(27)(28). However, waist circumference and HDL cholesterol levels as major components of the MetS were not related to SGA status in our study of overweight children.…”

Sex differences in the associations between birthweight and lipid levels in middle-age: Findings from the 1958 British birth cohort

“…The sex difference in our study is in the opposite direction to that reported in the 1946 cohort, 12 a British occupational cohort 11 and in a metaanalysis of 30 studies. 3 However, ours is not the first study to find a stronger inverse association among females; several studies [35][36][37][38] in the recent meta-analysis also reported this finding although these differences were small and usually not significant at conventional levels demonstrating the heterogeneity of results and the lack of power which is a limitation of most previous studies.…”

Systematic review indicates postnatal growth in term infants born small‐for‐gestational‐age being associated with later neurocognitive and metabolic outcomes

“…In contrast, a further five studies comprising 364 children reported no association between postnatal growth between the ages of zero and one to eight years and lipid levels in terms of total cholesterol, low‐density lipoprotein, high‐density lipoprotein or triglycerides at the ages of one to eight years 15, 17, 31, 37, 45. Furthermore, three studies comprising 189 children reported that faster height or length gain between birth and five to eight years was negatively associated with total cholesterol, low‐density lipoprotein and high‐density lipoprotein 17, 31, 50. Only one of the seven studies that included an AGA control group reported that the SGA group, particularly those with poor height growth, had significantly higher total cholesterol compared to the AGA group at the age of 12 years 50.…”