Relationship between birthweight and arterial elasticity in childhood

There is a considerable debate about the potential influence of fetal programming on cardiovascular diseases in adulthood. In the present prospective epidemiological cohort study, the relationship between birthweight and arterial elasticity in 472 children between 5 and 8 years of age was assessed. LAEI (large artery elasticity index), SAEI (small artery elasticity index) and BP (blood pressure) were assessed using the HDI/PulseWave CR-2000 CardioVascular Profiling System. Blood concentrations of glucose, total cholesterol and its fractions [LDL (low-density lipoprotein)-cholesterol and HDL (high-density lipoprotein)-cholesterol] and triacylglycerols (triglycerides) were determined by automated enzymatic methods. Insulin was assessed by a chemiluminescent method, insulin resistance by HOMA (homoeostasis model assessment) and CRP (C-reactive protein) by immunonephelometry. Two linear regression models were applied to investigate the relationship between the outcomes, LAEI and SAEI, and the following variables: birthweight, gestational age, glucose, LDL-cholesterol, HDL-cholesterol, triacylglycerols, insulin, CRP, HOMA, age, gender, waist circumference, per capita income, SBP (systolic BP) and DBP (diastolic BP). LAEI was positively associated with birthweight (P=0.036), waist circumference (P<0.001) and age (P<0.001), and negatively associated with CRP (P=0.024) and SBP (P<0.001). SAEI was positively associated with birthweight (P=0.04), waist circumference (P=0.001) and age (P<0.001), and negatively associated with DBP (P<0.001). Arterial elasticity was decreased in apparently healthy children who had lower birthweights, indicating an earlier atherogenetic susceptibility to cardiovascular diseases in adolescence and adult life. Possible explanations for the results include changes in angiogenesis during critical phases of intrauterine life caused by periods of fetal growth inhibition and local haemodynamic anomaliesFAPESP n. 04/04109-

The effect of birth weight and gestational age on the development of obesity, insulin resistance and dyslipidemia in preschool children

Introdução - Estudos recentes relacionam a ocorrência de doenças crônicas. típicas da idade adulta, à desnutrição em fases precoces da vida, como na intra-uterina Este fenômeno é denominado de \"Programação\" ou \"Origem Fetal das Doenças\". Objetivo - Avaliar a relação entre peso ao nascimento (PN) e idade gestacional (IG) e situação nutricional na infância e o risco de desenvolvimento de obesidade, resistência à insulina e dislipidemias em crianças. Metodologia - Estudo epidemiológico de coorte. realizado no município de Jundiaí, São Paulo, considerando-se 890 crianças do estudo de RONDÓ (2003). com idades entre 5 a 8 anos. nascidas em hospitais conveniados ao Sistema Único de Saúde - SUS. A corte incluiu 509 crianças, nas quais, determinou-se níveis de glicose (método glicose hexoquinase automatizado). colesterol total (método colesterol oxidase automatizado). HDL-c (método HDL colesterol direto automatizado). LDL-c (fórmula de FRIEDWALD), triglicérides (método glicerol peroxidase automatizado), insulina (método quimioluminescente- IMMULITE 2000). resistência a insulina (homeostasis model assessment- HOMA) e situação nutricional segundo o escore-z (NCHS) e IMC (CDC/2000). A relação entre as variáveis foi determinada pelo modelo de regressão linear múltipla, considerando-se como variável dependente a insulina e RI-HOMA Resultados - Os níveis médios (95% IC) de glicose, RI- HOMA, CT e LDL-c; foram respectivamente: 92,86 mg/dl (92,27-93,45); 1,0 &mu;mol/Uml (0,93-1,07); 159,13 mg/dl (156,55-161,71); 89,38 mgl/dl (87,13-91,64) e não se relacionaram com o sexo (p=0,352; p=0,337; p=0,861 e p=0,341). A média (95% IC) do HDL-c e TG foram respectivamente: 55,41 mg/dl (54,44-56,39) e 71,69 mg/dl (68,93-74,45) e houve relação com o sexo (p=0,003 e p=0,018). No teste de regressão linear, observou-se relação significativa inversa entre PN e insulina (p<0,001) e PN e RI-HOMA (p<0,001). A prevalência de sobrepeso, considerando o IMC, foi de 8,5%, e não houve relação com o sexo. Conclusão - O baixo peso ao nascer está associado a alterações no metabolismo da insulina e com a elevação da resistência à insulina em crianças de 5 a 8 anos. É importante o acompanhamento do desenvolvimento de crianças com PN inadequado, para se detectar elevações na resistência à insulina e prevenir o surgimento de doenças crônicas na vida adulta.Introduction - Recent studies relate the occurrence of chronic diseases, typical of adult age, to malnutrition in earlier phases of life, as the fetal life. This phenomenon is called \"Programming\" or \"Fetal Origin of diseases\". Objective - To evaluate the relationship between birth weight (BW) and gestational age (GA) with anthropometric measurements, obesity, insulin resistance and dyslipidemia in children. Methodology - Epidemiological cohort study carried out in Jundiaí, involving 890 children from the RONDÓ (2003) study, born in hospitals that belonged to the National Health Service - SUS. Five hundred and nine (509) from 5 to 8 years of age were included in the study. Glucose was determined in blood by the glucose hexoquinase automated method; Total cholesterol (cholesterol oxidase automated method); HDL-c (direct HDL cholesterol automated method); LDL (formula of FRIEDWALC); Triglycerides (glycerol peroxidase automated method); Insulin by chemiluminescent method (IMMULITE 2000) and insulin resistance (homeostasis model assessment -IR HOMA). Evaluation of the nutritional state was assessed according to the NCHS z score and to the CDC (2000) body mass index (BMI) classification. Results - Mean levels (95% IC) of glucose, IR-HOMA, and LDL-c; were respectively: 92,86 mg/dl (92.27-93,45); 1,0 &mu;mol/Uml (0,93-1,07); 159,13 mg/dl (156,55-161,71); 89,38 mg/dl (87,13-91,64) and did not relate with gender (p=0,352; p=0,337; p=0,861 e p=0,341). Mean levels (95% IC) of HDL-c; and TG were respectively: 55,41 mg/dl (54,44-56,39) 71,69 mg/dl (68,93-74,45) and were related with gender (p=0,003 e p=0,018). Linear regression models were used to asses the relationship between the variables. There were significant inverse relationships BW and insulin (p<0,001) and BW and RI-HOMA (p< 0,001). BW did not relate with the CT, HDL-c and TG. GA did not relate with any of the observed variables. The prevalence of overweight according to the BMI measurements was 8,5% and there was no relation between obesity and gender. Conclusions - Low BW causes alterations in insulin metabolism, with an increase in insulin resistance in children from 5 to 8 years of age. It is important to follow the development of children with inadequate BW to detect increases in insulin resistance and to prevent chronic diseases in adult life

The relationship between cortisol concentrations in pregnancy and systemic vascular resistance in childhood

Objective. To assess the relationship between cortisol concentrations in the last trimester of pregnancy and systemic vascular resistance — SVR in childhood. Materials and methods. This study is part of a cohort involving 130 Brazilian pregnant women and their children, ages 5 to 7 years. Maternal cortisol was determined in saliva by an enzyme immunoassay utilizing the mean concentration of 9 samples of saliva (3 in each different day), collected at the same time, early in the morning. SVR was assessed by the HDI/PulseWave CR-2000 Cardiovascular Profiling System®. Socioeconomic and demographic characteristics and life style factors were determined by a questionnaire. The nutritional status of the women and children was assessed by the body mass index — BMI. The association between maternal cortisol and SVR in childhood was calculated by multivariate linear regression analysis. Results.There were statistically significant associations between maternal cortisol and SVR (p = 0.043) and BMI-z score of the children (p = 0.027), controlling for maternal BMI, birth weight, age, and gender of the children. Conclusion. As far as we know this is the first study in the literature assessing the association between cortisol concentrations in pregnancy and SVR in childhood. Overall, the data suggest that exposure to excess glucocorticoid in the prenatal period is associated to vascular complications in childhood, predisposing to cardiovascular diseases in later lifeFAPESP n. 04/04109-

Association between weight at birth and body composition in childhood : a Brazilian cohort study.

Background and aim: Previous studies have shown that the association between birthweight and obesity later in life apparently follows a U-shaped curve. However, due to the continuous increase of mean birth weight in several countries worldwide, it is expected that higher birth weight will play a more important role as a risk factor for further obesity than low birth weight. This study investigated the association between birth weight and body composition of children in order to establish their relationship in an earlier period of life. Study design and subjects: Prospective cohort study carried out from1997 to 2006 in Jundiai city, Brazil, involving 486 children at birth and from 5 to 8 years of age. The following anthropometric measurements were determined: birth weight, weight, height, waist circumference and triceps skinfold thickness. Fat mass percentage, fatmass and fat-free masswere measured by electrical bioimpedance analysis by the 310 Body Composition Analyzer, Biodynamics?. Five multiple linear regression models were developed considering waist circumference, triceps skinfold thickness, fat mass percentage, fat mass and fat-free mass as markers of body composition, and outcomes. Results: Significant positive associations were observed between birth weight and waist circumference (p b 0.001), triceps skinfold thickness (p= 0.006), fat mass (p =0.007) and fat-free mass (p b 0.001). Approximately 10% of the children presented excess body fat assessed by bioimpedance, and 27.6% of them had central adiposity (waist circumference ?95th percentile). Conclusions: Intrauterine growth, assessed byweight at birth,was positively associatedwith body composition of children aged 5?8 years, indicating that thosewith the highest birthweight aremore at risk for obesity, and probably to chronic diseases in adulthood

The relationship between birth weight and insulin resistance in childhood

Chronic diseases that are typical of adulthood may originate in intra-uterine life through inadequate fetal development. The present epidemiological cohort study of 506 healthy children aged 5\20138 years evaluated the relationship between birth weight and insulin resistance in an age group that has been assessed in few similar studies. Insulin concentration was determined by chemiluminescence and insulin resistance by the homeostasis model assessment (HOMA). Blood glucose, total cholesterol and fractions (LDL cholesterol and HDL cholesterol) and TAG concentrations were determined by automated enzymatic methods. Linear regression analysis investigated the relationship between birth weight (assessed as a continuous variable and in three categories: small for gestational age, SGA; adequate for gestational age and large for gestational age) and the HOMA index, using backward stepwise selection and biological models to explain the causal pathway of the relationship. There were negativeassociations between birth weight (P < 0·001), SGA (P = 0·027) and the HOMA index, and a positive association between waist circumference (P < 0·001) and the HOMA index. Considering the significant associations between birth weight and waist circumference (P < 0·001) and waist circumference and insulin resistance (P < 0·001), we can probably suspect that lower birth weight is a common cause of higher waist circumference and insulin resistance. In summary, the results of the present study showed increased insulin resistance in apparently healthy, young children, who had lower weight at birth and higher measurements of waist circumference. There is a need to develop public health policies that adopt preventive measures to promote adequate maternal-fetal and child development and enable early diagnosis of metabolic abnormalitiesFAPESP n. 04/04109-

The influence of birthweight on arterial blood pressure of children

Background & aims.This study examined the relationship between birthweight and blood pressure in childhood. Methods.Prospective cohort study involving 472 Brazilian children ranging in age from 5 to 8 years. Birthweight, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), total cholesterol and fractions (LDL-c, HDL-c), and triglycerides were determined. Total cholesterol, LDL-c, HDL-c, and triglycerides were assessed by automated enzymatic methods. Blood pressure was measured with the HDI/Pulse Wave™ CR-2000 equipment. Multiple regression models were used to investigate the relationship between birthweight and SBP and DBP, controlling for the following variables: gender, age, BMI, total cholesterol, triglycerides, per capita income, and maternal education. Results.When adjusting for gender and BMI, we found a systolic blood pressure increase of 2.9 (95per cent CI = −5.33 to −0.56) mmHg per kilogram birthweight reduction. The unadjusted association was insignificant. Conclusion.Our data suggest that low birthweight is one of the factors contributing to blood pressure elevation at early ages. A way to prevent these diseases is by implementing public policies focused on good nutrition and adequate prenatal care for pregnant womenFAPESP n. 04/04109-