Relationship between serum lipids/adipokines and obesity/hypertension in very-preterm infants during early childhood and preadolescence

Abstract

Background: Childhood overweight/obesity is associated with elevated systolic blood pressure (SBP) and increased cardiovascular risk as adults. Preterm birth (PTB) is a risk factor for childhood overweight/obesity. Few longitudinal studies of childhood obesity following PTB include longitudinal serum adipokine/lipid measurements. Methods: We reenrolled 62/120 children 10–13 years old born ≤32 weeks gestational age (GA) and originally seen at 1–3 years. We measured anthropometric indices, SBP and serum lipids/adipokines and matched them with Term-Born controls (n = 62:124; 2015–2016 NHANES database). Results: PTB are 86% Hispanic, birthweight 1073 ± 251 (SD)gm and GA 28 ± 2 weeks. Follow-up was at 11 ± 1 year. BMIz ≥85th centile occurred in 45% PTB and 48% Term-Controls; however, SBP ≥90th centile was 48% vs. 12% (P < 0.01), respectively. Although weight gain velocity (WtGV) birth to 10–13 years and anthropometric indices were similar, WtGV predicted overweight/obesity and elevated/hypertensive SBP (P ≤ 0.03) in PTB. PTB serum triglyceride and low-density lipoprotein concentrations exceeded Term (P ≤ 0.02); moreover, 44% PTB had triglyceride >130 mg/dL vs. 5% Term. Serum leptin and leptin:adiponectin ratio increased ≥4-fold in PTB at 10–13 years, females » males, and correlated with overweight/obesity and elevated/hypertensive SBP. Conclusions: Early adolescent White Hispanic children born ≤32 weeks GA exhibit elevated serum adipokines, dyslipidemia and central obesity plus hypertension, which are predicted by WtGV, a potential tool for identifying at-risk childhood populations. Impact statement: Key message: Birth ≤32 weeks gestational age (GA) in a predominantly Hispanic population is associated with increased risk for overweight/obesity and hypertension in early adolescence that correlate with excessive weight gain and elevated serum triglyceride/leptin concentrations. Addition to the literature: Prospective assessment of anthropometric measurements and serum adipokines/lipids during early childhood and early adolescence in Hispanics born ≤32 weeks GA. What is the impact: Demonstrates increased risk in Hispanic children born ≤32 weeks GA for obesity and hypertension during childhood and evidence that weight gain velocity from birth to early adolescence may identify those at-risk for adult onset of cardiovascular and metabolic disease.