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Fat mass and lipid profile in young adults born preterm
P E Breukhoven1, G F Kerkhof, R H Willemsen
1Department of Paediatrics, Subdivision of Endocrinology, Erasmus University Medical Centre/Sophia Children's Hospital, Room Sb-2603, Dr. Molewaterplein 60, 3015 GJ Rotterdam, The Netherlands. p.breukhoven@erasmusmc.nl
Insights
Preterm birth is linked to increased body fat mass in young adulthood. However, these individuals also show a more favorable lipid profile, suggesting complex long-term cardiovascular health effects.
Area of Science:
- Cardiovascular Health
- Neonatal Development
- Metabolic Health
Background:
- Associations between small size at birth and later cardiovascular issues are known.
- The distinct effects of small for gestational age versus prematurity on cardiovascular risk factors remain unclear.
- Improved neonatal care increases the number of preterm infants surviving to adulthood, necessitating long-term health assessments.
Purpose of the Study:
- To investigate the long-term impact of gestational age and preterm birth on lipid levels and fat mass in early adulthood.
- To differentiate the effects of prematurity from small size for gestational age on cardiovascular risk markers.
Main Methods:
- A cross-sectional study involving 455 healthy young adults (18-24 years).
- Comparison of 167 preterm-born individuals with 288 full-term born individuals.
- Assessment of total, trunk, and limb fat mass using dual-energy x-ray absorptiometry and measurement of fasting lipid profiles.
Main Results:
- Preterm subjects exhibited significantly higher total, trunk, and limb fat mass percentages compared to term-born subjects.
- Preterm individuals showed significantly lower serum lipoprotein a levels and higher apolipoprotein A-I levels.
- Multiple linear regression analyses confirmed the association between gestational age and fat mass/lipid levels.
Conclusions:
- Preterm birth in this cohort was associated with increased body fat mass (total, trunk, and limb).
- Despite increased adiposity, preterm birth was linked to a relatively favorable lipid profile in early adulthood.
- These findings highlight the complex, long-term metabolic and cardiovascular implications of preterm birth.
Context:
Associations between small size at birth and abnormal cardiovascular parameters in later life have been reported. It is, however, unknown whether the effect of a small size at birth on cardiovascular risk factors in later life is due to a small size for gestational age or due to prematurity. Due to advances in neonatal care, survival of preterm infants has significantly improved, and nowadays an increasing number of these children reach adulthood. It is, therefore, of increasing importance to assess the long-term effect of prematurity on determinants for cardiovascular disease.
Objective:
The aim of the study was to assess the long-term effects of gestational age and particularly preterm birth on lipid levels and fat mass in early adulthood.
Design And Patients:
A cross-sectional study was conducted with 455 healthy subjects, aged 18 to 24 yr; 167 preterm subjects were compared with 288 full-term subjects.
Outcome Measure:
Total fat mass, trunk fat mass, and limb fat mass were determined by dual-energy x-ray absorptiometry. Furthermore, fasting lipid levels (total cholesterol, low-density lipoprotein, triglyceride, apolipoprotein B, lipoprotein a, high-density lipoprotein, and apolipoprotein A-I) were measured.
Results:
Preterm subjects had a significantly higher percentage of total fat mass, trunk fat mass, and limb fat mass than subjects born term. Furthermore, preterm subjects had significantly lower serum lipoprotein a levels and higher apolipoprotein A-I levels than term subjects. Multiple linear regression analyses to assess the association between gestational age and fat mass and lipid levels showed similar results.
Conclusion:
In our cohort of 455 young adults, preterm birth was associated with more total fat mass, trunk fat, and limb fat mass but a relatively favorable lipid profile.
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