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Different levels of cardiometabolic indicators in multiple vs. singleton children
Maria João Fonseca1, Ana Cristina Santos2,3, Henrique Barros2,3
1ISPUP-EPIUnit, Universidade do Porto, Rua das Taipas n° 135, 4050-600, Porto, Portugal. mjoao.fonseca@ispup.up.pt.
Insights
Children born as multiples had better cardiometabolic health at age 7, linked to lower birth weight. This effect was mediated by birth weight for most indicators, except blood pressure.
Area of Science:
- Pediatric Health
- Cardiovascular Health
- Metabolic Health
Background:
- Cardiovascular and metabolic health are crucial in childhood.
- Birth status (singleton vs. multiple) may influence long-term health outcomes.
- Understanding these differences can inform early health interventions.
Purpose of the Study:
- To compare cardiometabolic indicators in singletons and multiples at age 7.
- To investigate the mediating role of birth weight in these comparisons.
Main Methods:
- Analysis of data from the Generation XXI birth cohort (5431 singletons, 103 multiples).
- Collection of anthropometric measurements, body composition, and fasting blood samples.
- Calculation of z-scores and use of path analysis to determine effects.
Main Results:
- Multiples exhibited lower z-scores for weight, height, BMI, fat mass index, waist circumference, and waist-to-height ratio.
- These differences were mediated by birth weight, with no significant direct effects observed for most indicators.
- Indirect effects were noted for fat-free mass index, glucose, insulin, and blood pressure, but total effects were not significant.
Conclusions:
- At age 7, multiples showed improved cardiometabolic indicators compared to singletons.
- Lower birth weight significantly mediated these positive outcomes for most indicators.
- Lower blood pressure in multiples was an exception, independent of birth weight mediation.
Background:
We aimed to compare cardiometabolic indicators in singletons and multiples at age 7 and explore the birthweight mediation effect.
Methods:
We studied 5431 singletons and 103 sets of multiples from Generation XXI birth cohort. Anthropometric measurements, body composition, and fasting blood samples were obtained. Age- and sex-specific z-scores were calculated (additionally height-specific for blood pressure). Adjusted regression coefficients and respective 95% confidence intervals [β (95%CI)] were computed using path analysis.
Results:
Multiples had lower weight [- 0.419 (- 0.616;-0.223)], height [- 0.404 (- 0.594;-0.213)], BMI [- 0.470 (- 0.705;-0.234)], fat mass index [- 0.359 (- 0.565;-0.152)], waist circumference [- 0.342 (- 0.537;-0.147)], and waist-to-height ratio [- 0.165 (- 0.326;-0.003)] z-scores. These results were explained by the indirect effect via birthweight, which was also negative and significant for all the aforementioned cardiometabolic indicators, while no direct effect was present. There were also significant indirect effects regarding fat-free mass index, glucose, insulin, and blood pressure, though the total effects were not significant, due to the balance between direct and indirect effects. The only significant direct effect was regarding diastolic blood pressure [- 0.165 (- 0.302;-0.028)].
Conclusions:
At age 7, multiples presented better cardiometabolic indicators explained by lower weight at birth, except for the lower blood pressure which was independent of an effect via birthweight.
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