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Reduced foetal growth and growth hormone secretion in adult life
D E Flanagan1, V M Moore, I F Godsland
1MRC Metabolic Programming Group, University of Southampton, Southampton General Hospital, Southampton, UK.
Insights
Birth size impacts adult growth hormone (GH) secretion. Lower birth weight is linked to reduced GH, potentially explaining increased cardiovascular disease risk in those small at birth.
Area of Science:
- Endocrinology
- Cardiovascular Health
- Developmental Biology
Background:
- Adverse in utero or early infancy conditions can permanently alter growth hormone (GH) secretion.
- GH secretion is a known predictor of cardiovascular risk.
- Reduced fetal growth is associated with increased cardiovascular disease risk.
Purpose of the Study:
- To investigate the relationship between birth size and GH secretion in young adults.
- To determine if birth size influences adult GH levels and potentially cardiovascular risk.
Main Methods:
- Prospective cohort study of 153 healthy men and women aged 20-21 years.
- Measured overnight urinary GH excretion.
- Assessed insulin sensitivity, insulin secretion, blood pressure, and other health factors.
Main Results:
- Low birth weight, placental weight, and body length were strongly associated with reduced GH excretion at age 20.
- These associations remained significant even after accounting for obesity and other factors.
- GH excretion did not differ by gender but was markedly reduced in obese subjects.
Conclusions:
- Birth size is a significant predictor of adult GH excretion.
- Reduced GH secretion in individuals with low birth weight may be a mechanism contributing to their elevated cardiovascular disease risk.
Objectives:
Recent studies suggest that growth restriction or other adverse influences acting in utero or during early infancy lead to permanent alterations in growth hormone (GH) secretion. As GH secretion is known to predict cardiovascular risk, alterations in GH may contribute to the association between reduced foetal growth and cardiovascular disease. We have therefore assessed the relationship between birth size and GH secretion in a prospective study of young adults whose birth size was recorded and who have had their current blood pressure and glucose tolerance measured.
Design:
Prospective cohort study
Patients:
153 healthy men and women, aged 20-21 years.
Measurements:
Subjects carried out a timed overnight urinary collection for analysis of GH excretion. Insulin sensitivity and insulin secretion were measured using the intravenous glucose tolerance test with minimal model analysis. Blood pressure, height, weight, usual level of exercise, smoking habits, alcohol consumption, and socio-economic status were also recorded.
Results:
GH excretion ranged from 0.01 to 41.8 microU per subject. It did not differ according to gender but was markedly reduced in obese subjects (P < 0.0001) Low birthweight was strongly associated with low GH excretion at age 20 years (P = 0.002). Low placental weight and short body length also predicted low GH (P = 0.02 and P = 0.04, respectively). These relationships were independent of other confounding factors including obesity. GH excretion was not independently related to current levels of blood pressure, insulin sensitivity or insulin secretion.
Conclusions:
Body size at birth predicts GH excretion in adult life. Low GH excretion in people who were small at birth may be one mechanism explaining their increased risk of cardiovascular disease.