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Metabolic outcomes in adults born preterm with very low birthweight or small for gestational age at term: A cohort study

Journal of Clinical Endocrinology & Metabolism Nov 18, 2018

Balasuriya CND, et al. - In this follow-up cohort study, researchers evaluated metabolic outcomes, including relation with skeletal parameters, in adults born preterm with very low birthweight (VLBW) or term-born small for gestational age (tb-SGA). The LBW groups and, in the VLBW group, the females showed a less favorable metabolic profile than the controls. The inverse association of metabolic syndrome (MetS) and bone quality suggests an increased risk of future fractures.

Methods
  • Study participants were 189 individuals (females 51%), between the ages of 25 and 28; 55 were preterm VLBW (≤1500 g), 59 were tb-SGA (<10th percentile), and 75 were controls (≥10th percentile).
  • The results were indices of MetS: blood pressure (BP), waist circumference, fasting glucose, lipid profile, and relationship between calculated MetS score and bone mineral density (BMD) and trabecular bone score (TBS), a measure of bone quality.

Results
  • Individuals with VLBW showed higher systolic [mean (SD), 126 (13.3) vs 119 (12.3) mm Hg; 95% CI, 1.27 to 11.48 mm Hg] and diastolic [71.9 (7.6) vs 68.6 (7.1) mm Hg; 95% CI, 0.3 to 6.2 mm Hg] BP, higher glycated hemoglobin, higher C-peptide, increased insulin resistance (Homeostatic Model Assessment 2), and lower high-density lipoprotein cholesterol [1.34 (0.3) vs 1.50 (0.4); 95% CI, 0.32 to 0.01] compared with controls.
  • There were substantial differences between control females and females with VLBW.
  • Tb-SGA adults had a higher waist circumference and a higher total and low density lipoprotein cholesterol compared to controls.
  • The MetS score in males was positively related to BMD and vice versa to TBS.
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