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Serum lipid concentrations and growth characteristics in 12-year-old children born small for gestational age
S Tenhola1, A Martikainen, E Rahiala
1Department of Pediatrics, Kuopio University Hospital, Kuopio University, FIN-70211 Kuopio, Finland.
Insights
Children born small for gestational age (SGA) face higher risks for high cholesterol. Poor height catch-up growth, female sex, and early puberty predict elevated cholesterol in SGA children.
Area of Science:
- Pediatrics
- Cardiovascular Health
- Growth and Development
Background:
- Barker's hypothesis links small for gestational age (SGA) birth to adult cardiovascular disease.
- Retarded fetal growth may predispose individuals to dyslipidemia later in life.
Purpose of the Study:
- To investigate the association between retarded fetal growth (SGA) and childhood dyslipidemia.
- To identify predictive factors for dyslipidemia in SGA children based on growth characteristics.
Main Methods:
- Serum lipid concentrations were measured in 55 SGA children and 55 appropriate for gestational age controls at age 12.
- Growth variables were recorded at birth, 5 years, and 12 years.
- Multiple logistic regression analysis was used to identify predictive factors for high cholesterol.
Main Results:
- Nearly half of SGA children (47.3%) had total cholesterol in the highest quartile compared to controls (p=0.038).
- Poor catch-up growth in height (OR 13.8), female sex (OR 8.1), and early puberty (OR 7.5) predicted high cholesterol in SGA children.
- At 12 years, SGA children remained significantly shorter and lighter than controls, despite similar pubertal advancement.
Conclusions:
- Being born small for gestational age has lasting effects on growth and can influence serum total cholesterol levels before adolescence.
- SGA children exhibiting poor catch-up growth in height are at the highest risk for developing hypercholesterolemia.
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 = 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 > or =2 SD scores in height, and 21 (38.2%) SGA children showed catch-up growth of > or =2 SD scores in weight from birth. At the age of 12 y, the SGA children were still significantly shorter (p<0.001) and lighter (p< 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.