Increased Oxidative Stress in Prepubertal Children Born Small for Gestational Age

Abstract Context: Low birth weight is associated with an increased risk of metabolic and cardiovascular diseases in adulthood. The development of insulin resistance (IR) seems to play a pivotal role; no data on the oxidant-antioxidant status are available in this risk group. Objective: This study is an assessment of oxidant-antioxidant status in prepubertal children born small for gestational age (SGA) in comparison to healthy controls and the relationship to IR. Design: This cross-sectional study compares indexes of IR and oxidant-antioxidant status in three different groups (SGA+, SGA−, controls), with analysis by post hoc and Pearson correlation. Setting: The study was conducted in the Academic Department of Pediatrics. Participants: A total of 19 SGA+ and 16 SGA− children were compared with 13 controls. Intervention: No intervention was used. Main Outcome Measures: Indexes of IR (glucose to insulin ratio, homeostasis model assessment of IR) were evaluated, and markers of oxidative stress (lag phase, malonildialdehyde, vitamin E) were measured. Results: Homeostasis model assessment of IR was significantly higher in SGA+ than SGA− children (1.32 ± 0.9 vs. 0.69 ± 0.47; P = 0.03) and controls (0.71 ± 0.37; P = 0.04). Glucose to insulin ratio was significantly lower in SGA+ than SGA− children (12.41 ± 5.01 vs. 26.54 ± 17.18; P = 0.02) and controls (26.96 ± 20.70; P = 0.04). Lag phase was significantly shorter in SGA+ than SGA− children (24.3 ± 4.38 vs. 35.59 ± 11.29 min; P = 0.003) and controls (45.28 ± 7.69 min; P = 0.0001) and in SGA− than controls (P = 0.01). Malonildialdehyde was significantly higher in SGA+ than SGA− children (0.79 ± 0.3 vs. 0.6 ± 0.1 nmol/mg; P = 0.03) and controls (0.36 ± 0.04 nmol/mg; P = 0.0001) and in SGA− children than controls (P = 0.02). Vitamin E was significantly reduced in SGA+ children than controls (27.54 ± 7.9 vs. 43.23 ± 11.32 μmol/liter; P = 0.002). Conclusion: Oxidative stress is present in both SGA+ and SGA− children, with a continuous alteration in relation to IR. Therefore, catch-up growth might exert the greatest influence in the development of future diseases.

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Biomarkers of Oxidative Stress and Antioxidant Status in Children Born Small for Gestational Age: Evidence of Lipid Peroxidation

Pediatric Research ◽

10.1203/pdr.0b013e3180986d04 ◽

2007 ◽

Vol 62 (2) ◽

pp. 204-208 ◽

Cited By ~ 49

Author(s):

Maria C P Franco ◽

Elisa M Kawamoto ◽

Renata Gorjão ◽

Viviani M F Rastelli ◽

Rui Curi ◽

...

Keyword(s):

Oxidative Stress ◽

Lipid Peroxidation ◽

Gestational Age ◽

Small For Gestational Age ◽

Antioxidant Status ◽

Biomarkers Of Oxidative Stress

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Ghrelin levels are decreased in non-obese prepubertal children born large for gestational age

Acta Endocrinologica ◽

10.1530/eje-08-0924 ◽

2009 ◽

Vol 160 (6) ◽

pp. 951-956 ◽

Cited By ~ 6

Author(s):

Feyza Darendeliler ◽

Sukran Poyrazoglu ◽

Firdevs Bas ◽

Ozlem Sancakli ◽

Gulbin Gokcay

Keyword(s):

Insulin Resistance ◽

Birth Weight ◽

Gestational Age ◽

Energy Homeostasis ◽

Standard Deviation Score ◽

Postnatal Growth ◽

Large For Gestational Age ◽

Model Assessment ◽

Prepubertal Children ◽

Increased Risk

BackgroundGhrelin is the natural ligand of GH secretagogue receptor. It has several metabolic functions including regulation of food intake, energy homeostasis, and body weight. An inverse relationship between fasting plasma ghrelin and insulin concentrations has been shown. Being born large for gestational age (LGA) has an increased risk of developing insulin resistance.ObjectiveThe aim of this study was to evaluate ghrelin levels in LGA born children who have no obesity at prepubertal ages and the effect of intrauterine and postnatal growth on ghrelin levels.Patients and methodsThirty-two (17F, 15M) LGA born non-obese children (mean (±s.e.m.) age 4.4±0.3 years) were evaluated with respect to glucose, insulin, and ghrelin levels. Their data were compared with that of non-obese 45 (19F, 26M) appropriate for gestational age (AGA) children (mean (±s.e.m.) age 4.0±0.1 years).ResultsLGA children, who had similar age and body mass index (BMI) standard deviation score (SDS) as AGA children, had significantly higher insulin (P=0.044) and at a borderline significance higher homeostasis model assessment-insulin resistance levels (P=0.054) than AGA children. Ghrelin level was significantly lower in LGA born than AGA born children (P=0.001) even after controlling for age, sex, and BMI (P=0.006). There were no differences between genders in insulin and ghrelin levels. Multivariate analysis revealed that birth weight was the only significant parameter influencing ghrelin levels (R2=0.13, B=−0.007, P=0.002).ConclusionsLGA born non-obese prepubertal children have lower ghrelin levels when compared with age and BMI matched AGA children. Birth weight seems to have the only significant effect on the reduced ghrelin levels.

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Associations of Size at Birth and Metabolic Syndrome Antecedents With Serum Spexin Levels in Prepubertal Children

Journal of the Endocrine Society ◽

10.1210/jendso/bvab048.1445 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. A709-A710

Author(s):

Fatma Duygu Ozturk Onsal ◽

Ahmet Ucar ◽

Ali Bulbul ◽

Zeynep Yildiz Yildirmak ◽

Gizem Kara Elitok

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Gestational Age ◽

Small For Gestational Age ◽

Model Assessment ◽

Prepubertal Children ◽

Excess Adiposity ◽

Significant Difference ◽

Idefics Study ◽

Size At Birth

Abstract Background: Spexin is a novel peptide implicated in food intake and obesity. The primary aim of this study was to analyze whether serum spexin levels, along with total leptin and active ghrelin levels were different in prepubertal children born small for gestational age(SGA) and appropriate for gestational(AGA). Secondary aims were to analyze whether serum spexin, leptin and active ghrelin levels correlated with metabolic syndrome(MS)antecedents according to the Dietary and lifestyle-induced health effects in children and infants (IDEFICS)study. Subjects and Methods: We conducted a cross-sectional study on prepubertal37SGA- (median:5.6yr)and50prepubertalAGA-born children(median:5.9yr). Anthropometric data, homeostasis model assessment of insulin resistance(HOMAIR),plasma lipids, serum spexin, total leptin and active ghrelin levels were analyzed. Associations of serum spexin levels with MS antecedents according to the IDEFICS study were investigated. Results: Children bornSGA had higher body mass index and waist circumference than AGA-born peers(p <0.05). Serum total leptin levels were higher in SGA-born children than in AGA-born peers (p<0.05). Plasma active ghrelin and spexin levels were not different between the subgroups(p>0.05). Children bornSGA had higher MS risk scores than AGA-born peers(p <0.05). Small for gestational age- born children had higher plasma glucose,insulin and HOMA-IR than AGA-born peers(p<0.05). In children born SGA, the number of subjects with excess adiposity (NSGA=18(43.9%)andNAGA=7(14%),p=0.016)and insulin resistance(NSGA=14(34%) andNAGA=6(12%),p=0.035)was higher than in AGA-born peers. There was no significant difference in frequency of dyslipidemia between the subgroups(p=0.19). The frequency of children with more than one MS antecedent was higher in SGA-born children than in AGA-born peers(Chi-Square p <0.01). Metabolic syndrome risk score according to IDEFICS was higher in SGA born children than in AGA-born peers(2.2±1.8vs1.1±1.8;p=0.008). Serum spexin levels were lower in children with MS antecedents than those without MS antecedents in both AGA -and SGA-born children[Serum spexin levels in AGA-born children with and without MS antecedents: 48,5pg/mL(25-75%IQR:19.8-93.8pg/mL)and143pg/mL(25-75%IQR:104-211pg/mL),p<0.001;respectively, serum spexin levels inSGAborn children with and without MS antecedents: 31,0pg/mL(25-75%IQR:16.5-47.0 pg/mL) and79.5pg/mL(25-75% IQR:49.5-274.8pg/mL),p=0,0016;respectively]. In the whole study group, the most important factor associated with excess adiposity was history of being born SGA(OddsRatio=91.3[95%CI:2.2-374;p=0.017] Conclusions: Serum spexin levels were not different inSGA- and AGA-born children. Serum spexin levels were reduced in children with MS antecedents independent of size at birth.

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Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience

Nutrients ◽

10.3390/nu13061941 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1941

Author(s):

Rachele De Giuseppe ◽

Manuela Bocchi ◽

Silvia Maffoni ◽

Elsa Del Bo ◽

Federica Manzoni ◽

...

Keyword(s):

Gestational Diabetes ◽

Mediterranean Diet ◽

Gestational Age ◽

Small For Gestational Age ◽

Small Sample Size ◽

Demographic Data ◽

Small Sample ◽

Activity Level ◽

Lifestyle Habits ◽

Increased Risk

Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. Methods. One hundred women (16–44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. Results. Women were divided into “SGA group” vs. “non-SGA group”. The MD was adopted by 71% of women and its adherence was higher in the “non-SGA group” (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the “SGA group” (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. Conclusions. MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation.

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Prevalence of small for gestational age infants in 21 cities in China, 2014–2019

Scientific Reports ◽

10.1038/s41598-021-87127-9 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Hui He ◽

Huazhang Miao ◽

Zhijiang Liang ◽

Ye Zhang ◽

Wei Jiang ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Health Information System ◽

Guangdong Province ◽

Significant Negative Correlation ◽

Term Infants ◽

Per Capita Gdp ◽

Increased Risk ◽

Per Capita ◽

Epidemiological Characteristics

AbstractInfants who are small for gestational age (SGA) are at increased risk of neonatal and infant death, non-communicable diseases and growth retardation. However, the epidemiological characteristics of SGA remain unclear. We aim to explore the prevalence of SGA and to examine its socioeconomic associations by using data from 21 cities. 10,515,494 single live birth records between 2014 and 2019 from the Guangdong Women and Children Health Information System were included in the study. Descriptive statistical methods were used to analyze the prevalence trend of SGA and its distribution. We also analyze the associations between the prevalence of SGA and per-capita GDP. The prevalence of SGA in Guangdong Province from the years 2014–2019 was 13.17%, 12.96%, 11.96%, 12.72%, 11.45%, 11.30% respectively, and the overall prevalence was 12.28%. The prevalence of term SGA infants in Guangdong Province was 12.50%, which was much higher than that of preterm SGA (7.71%). There was a significant negative correlation between the SGA prevalence and per-capita GDP in 21 cities of Guangdong Province. The level of economic development may affect the prevalence of SGA. The prevalence of SGA in full term infants is significantly higher than in premature infants, suggesting that most SGA infants may be born at a later gestational age.

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512: Are appropriately sized fetuses who “fall off the curve” at increased risk for small-for-gestational age at birth?

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2017.11.038 ◽

2018 ◽

Vol 218 (1) ◽

pp. S306-S307

Author(s):

Nathan R. Blue ◽

Mariam Savabi ◽

Meghan E. Beddow ◽

Vivek R. Katukuri ◽

Cody M. Fritts ◽

...

Keyword(s):

Gestational Age ◽

Small For Gestational Age ◽

Increased Risk ◽

Gestational Age At Birth ◽

Age At Birth

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Circulating Irisin in Relation to Insulin Resistance and the Metabolic Syndrome

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2013-2373 ◽

2013 ◽

Vol 98 (12) ◽

pp. 4899-4907 ◽

Cited By ~ 235

Author(s):

Kyung Hee Park ◽

Lesya Zaichenko ◽

Mary Brinkoetter ◽

Bindiya Thakkar ◽

Ayse Sahin-Efe ◽

...

Keyword(s):

Insulin Resistance ◽

Metabolic Syndrome ◽

Body Mass Index ◽

Body Mass ◽

Model Assessment ◽

Homeostasis Model Assessment ◽

Cvd Risk ◽

Baseline Serum ◽

The Metabolic Syndrome ◽

Increased Risk

Context: Irisin, a recently identified hormone, has been proposed to regulate energy homeostasis and obesity in mice. Whether irisin levels are associated with risk of the metabolic syndrome (MetS), cardiometabolic variables, and cardiovascular disease (CVD) risk in humans remains unknown. Objective: Our objective was to assess the associations between baseline serum irisin levels and MetS, cardiometabolic variables, and CVD risk. Design, Setting, and Subjects: We conducted a comparative cross-sectional evaluation of baseline circulating levels of the novel hormone irisin and the established adipokine adiponectin with MetS, cardiometabolic variables, and CVD risk in a sample of 151 subjects. Results: Baseline irisin levels were significantly higher in subjects with MetS than in subjects without MetS. Irisin was associated negatively with adiponectin (r = −0.4, P < .001) and positively with body mass index (r = 0.22, P = .008), systolic (r = 0.17, P = .04) and diastolic (r = 0.27, P = .001) blood pressure, fasting glucose (r = 0.25, P = .002), triglycerides (r = 0.25, P = .003), and homeostasis model assessment for insulin resistance (r = 0.33, P < .001). After adjustment for potential confounders, including body mass index, subjects in the highest tertile of irisin levels were more likely to have MetS (odds ratio [OR] = 9.44, 95% confidence interval [CI] = 2.66–33.44), elevated fasting blood glucose (OR = 5.80, 95% CI = 1.72–19.60), high triglycerides (OR = 3.89, 95% CI = 1.16–13.03), and low high-density lipoprotein cholesterol (OR = 3.30, 95% CI = 1.18–9.20). Irisin was independently associated with homeostasis model assessment for insulin resistance and general Framingham risk profile in multiple linear regression analyses after adjustment for confounders. Adiponectin demonstrated the expected associations with outcomes. Conclusions: Irisin is associated with increased risk of MetS, cardiometabolic variables, and CVD in humans, indicating either increased secretion by adipose/muscle tissue and/or a compensatory increase of irisin to overcome an underlying irisin resistance in these subjects.

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Perinatal Outcomes of Small for Gestational Age in Twin Pregnancies: Twin vs. Singleton Charts

Journal of Clinical Medicine ◽

10.3390/jcm10040643 ◽

2021 ◽

Vol 10 (4) ◽

pp. 643

Author(s):

Veronica Giorgione ◽

Corey Briffa ◽

Carolina Di Fabrizio ◽

Rohan Bhate ◽

Asma Khalil

Keyword(s):

Birth Weight ◽

Preterm Birth ◽

Gestational Age ◽

Small For Gestational Age ◽

Perinatal Death ◽

Perinatal Outcomes ◽

Adverse Outcomes ◽

Chi Square ◽

Increased Risk ◽

Twin Pregnancies

Twin pregnancies are commonly assessed using singleton growth and birth weight reference charts. This practice has led to a significant number of twins labelled as small for gestational age (SGA), causing unnecessary interventions and increased risk of iatrogenic preterm birth. However, the use of twin-specific charts remains controversial. This study aims to assess whether twin-specific estimated fetal weight (EFW) and birth weight (BW) charts are more predictive of adverse outcomes compared to singleton charts. Centiles of EFW and BW were calculated using previously published singleton and twin charts. Categorical data were compared using Chi-square or McNemar tests. The study included 1740 twin pregnancies, with the following perinatal adverse outcomes recorded: perinatal death, preterm birth <34 weeks, hypertensive disorders of pregnancy (HDP) and admissions to the neonatal unit (NNU). Twin-specific charts identified prenatally and postnatally a smaller proportion of infants as SGA compared to singleton charts. However, twin charts showed a higher percentage of adverse neonatal outcomes in SGA infants than singleton charts. For example, perinatal death (SGA 7.2% vs. appropriate for gestational age (AGA) 2%, p < 0.0001), preterm birth <34 weeks (SGA 42.1% vs. AGA 16.4%, p < 0.0001), HDP (SGA 21.2% vs. AGA 13.5%, p = 0.015) and NNU admissions (SGA 69% vs. AGA 24%, p < 0.0001), when compared to singleton charts (perinatal death: SGA 2% vs. AGA 1%, p = 0.029), preterm birth <34 weeks: (SGA 20.6% vs. AGA 17.4%, p = 0.020), NNU admission: (SGA 34.5% vs. AGA 23.9%, p < 0.000). There was no significant association between HDP and SGA using the singleton charts (p = 0.696). In SGA infants, according to the twin charts, the incidence of abnormal umbilical artery Doppler was significantly more common than in SGA using the singleton chart (27.0% vs. 8.1%, p < 0.001). In conclusion, singleton charts misclassify a large number of twins as at risk of fetal growth restriction. The evidence suggests that the following twin-specific charts could reduce unnecessary medical interventions prenatally and postnatally.

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