Physical activity attenuates the negative effect of low birth weight on leptin levels in European adolescents; The HELENA study

We examined whether physical activity (PA) influences the association between birth weight and serum leptin in adolescents. The study comprised a total of 538 adolescents (315 girls), aged 12.5–17.49 years, born at term (≥37 weeks of gestation). We measured serum leptin levels and time engaged in moderate-vigorous PA (MVPA) by accelerometry. There was an interaction effect between birth weight and meeting the PA recommendations (60 min/day MVPA) on leptin levels in girls (P = 0.023) but not in boys (P = 0.809). Birth weight was negatively associated with leptin levels in girls not meeting the PA recommendations (i.e. more than 60 min/day of MVPA) (β = ?0.096, P = 0.009), whereas no significant association was observed in those meeting the PA recommendations (β = ?0.061, P = 0.433). In conclusion, meeting the PA recommendations may attenuate the negative effect of low birth weight on serum leptin levels in European female adolescents.     

The effect of birth weight on glucose tolerance in pigs at 3 and 12 months of age

AIMS/HYPOTHESIS: The aim of this study was to examine the effect of birth weight on glucose tolerance in juvenile and adult pigs. METHODS: Low (<1.47 kg) and high (>1.53 kg) birth weight piglets from 15 litters were studied at 3 ( n=47) and 12 ( n=17) months of age. At each age, selected pigs were tranquilised and catheters were inserted into the dorsal aorta and caudal vena cava under general anaesthesia. After recovery, glucose (0.5 g/kg; i.v.) was administered and regular arterial blood samples were taken for 2 h for plasma glucose and insulin measurements. Hepatic gluconeogenic enzyme activities were measured at post mortem. RESULTS: At 12, but not at 3 months of age, the area under the glucose and insulin curves after glucose administration were greater ( p<0.05) in low rather than in high birth weight pigs. The glucose area at 12 months was negatively correlated with body weight and BMI at birth. Disproportionate shape at birth was associated with reduced hepatic gluconeogenic enzyme concentrations and low birth weight pigs had reduced basal glucose concentrations at 12 months of age. CONCLUSION/INTERPRETATION: This study has shown an association between low birth weight and thinness at birth and glucose intolerance at 12 months of postnatal age, but not at 3 months. This effect was not due to insulin deficiency or increased hepatic gluconeogenic enzyme activity.     

The association of gestational diabetes mellitus with fetal birth weight

Aims

Gestational diabetes mellitus (GDM) and different time-point glucose levels might have different effects on fetal birth weight. The aim of this study was to further evaluate the associations of GDM and different time-point blood glucose levels with fetal birth weight in a prospective cohort study.

Impact of fetal programming, birth weight, and infant feeding on later hypertension

The concept of developmental origins of adult disease derives from both epidemiologic and basic sciences. This brief review considers the impact of the intrauterine milieu, intrauterine growth retardation, premature birth, and infant feeding on later hypertension and kidney disease.     

The interrelation of birth weight and regional lipid deposition: a twins study

This study examined the hypothesis that low birth weight is associated with changes in regional lipid deposition as well as insulin sensitivity in adult twins. Eleven adult female twin pairs were studied by magnetic resonance to determine regional adiposity. Their insulin sensitivity was assessed by the homeostasis model assessment. There were significant associations between birth weight and current homeostasis model assessment value (r=-0.528, P=.012), abdominal visceral (r=-0.581, P=.005), and subcutaneous fat volumes (r=-0.638, P=.001) if the group of 22 subjects were analyzed as individuals. There were no significant associations of the intratwin pair difference in birth weight and differences between adult twins in these same variables possibly because of limited patient numbers. Reduced birth weight does confer an increased risk of abdominal adiposity as well as insulin resistance in twin populations as it does in the general population.     

Body weight and glucose metabolism have a different effect on circulating levels of ICAM-1, E-selectin, and endothelin-1 in humans

BACKGROUND: Endothelial dysfunction and inflammation are present in both type 2 diabetes mellitus (T2DM) and obesity. In this paper we compared the role of weight loss and of glycaemic control in determining circulating levels of ICAM-1, endothelin-1 (ET-1), and E-selectin in patients with morbid (grade 3) obesity. METHODS AND RESULTS: ICAM-1, E-selectin, and ET-1 were higher in obese patients (n=96) than in lean controls (n=30); among obese patients, the three molecules were higher in T2DM patients (n=26) than in patients with normal (NGT, n=43) or impaired (IGT, n=27) glucose tolerance. Sixty-eight obese patients had a significant weight loss induced by bariatric surgery, and showed a significant decrease in blood glucose, HbA1c and all molecules, so that ICAM-1, E-selectin, and ET-1 were not different in NGT, IGT and T2DM patients, and in lean controls; in 13 patients with a small weight loss induced by diet, changes were not significant, in spite of a significant reduction in blood glucose and HbA1c. At stepwise regression, changes in ICAM-1, ET-1, and E-selectin significantly correlated only with change in body mass index. CONCLUSIONS: These data indicate that weight loss is more important than glycaemic control in regulating circulating levels of ICAM-1, ET-1, E-selectin in morbidly obese subjects.     

Placental GH,IGF-I,IGF-binding protein-1, and leptin during a glucose challenge test in pregnant women: relation with maternal body weight,glucose tolerance,and birth weight

The prediction of birth weight may be improved by the measurement of hormones or growth factors in the mother. We measured body weight (BW) and plasma levels of placental GH (PGH), IGF-I, IGF-binding protein-1 (IGFBP-1), and leptin at the time of the glucose challenge test (GCT) in 289 women, who were pregnant with a single fetus, between 24 and 29 wk gestational age (GA). Delivery occurred 12 +/- 2 (mean +/- SD) wk later. First, we examined which variables regulate these hormonal factors. Multiple regression showed that PGH concentrations were determined by GA at sampling and were negatively related to BW. IGF-I levels were mainly determined by PGH, and also by insulin, BW, and (negatively) age. IGFBP-1 concentrations were negatively determined by BW, insulin, and IGF-I. BW was also a powerful determinant of leptin levels, with insulin as a less robust determinant. Second, we examined the relation to glucose levels. PGH, IGF-I, and IGFBP-1 concentrations were not correlated with post-GCT glucose levels and were comparable in women with a normal or disturbed GCT (glucose >/=7.8 mmol/liter; n = 72). Finally, we examined the relation with birth weight and placental weight. Birth weight, corrected for GA and stratified into percentile groups, and the ponderal index at birth were strongly related to maternal BW, but not to maternal PGH, IGF-I, or IGFBP-1 levels. Neither was maternal leptin related to birth weight, but leptin concentrations were slightly higher in women who delivered obese babies. Placental weight was not related to any of the hormonal factors. This prospective study indicates that the variation in circulating PGH, IGF-I, IGFBP-1, and leptin between 24 and 29 wk of pregnancy is strongly dependent on maternal BW, but is unrelated to glucose tolerance. In addition, the measurement of PGH, IGF-I, IGFBP-1, or leptin at the time of the GCT is not useful clinically to predict birth weight.     

Home blood glucose monitoring in non-insulin-dependent diabetics: the effect of gliclazide on blood glucose and weight control, a multicentre trial

The efficacy of the sulphonylurea gliclazide was assessed in 229 non-insulin-dependent diabetics attending U.K. outpatient diabetic clinics. Patients inadequately controlled by diet alone or oral hypoglycaemic agents used reflectance meters to monitor their blood glucose. After a 4-week run-in, in those whose control remained unsatisfactory, gliclazide was either added to diet, or given in place of existing drugs. Patients continued home-monitoring and were followed for 3 months. Gliclazide reduced mean random blood glucose in all groups, particularly those previously treated by diet alone or a first-generation sulphonylurea. The patients improved in their ability to measure glucose at home and within 2 months a good correlation with laboratory measurements was found. Mean body weight was reduced, particularly in obese and elderly subjects and those treated previously with sulphonylurea drugs. Side effects were mild and only two patients were withdrawn for this reason.     

Adiponectin in human cord blood: relation to fetal birth weight and gender

Adiponectin is an adipocyte-derived plasma protein with insulin-sensitizing and antiatherosclerotic properties. The aim of this study was to examine whether adiponectin is present in human fetal blood, to define its association with fetal birth weight, and to evaluate whether dynamic changes in adiponectin levels occur during the early neonatal period. Cord blood adiponectin levels were extremely high (71.0 +/- 21.0 microg/ml; n = 51) compared with serum levels in children and adults and positively correlated with fetal birth weights (r = 0.4; P < 0.01). No significant differences in adiponectin levels were found between female and male neonates. In addition, there was no correlation between cord adiponectin levels and maternal body mass index, cord leptin, or insulin levels. Cord adiponectin levels were significantly higher compared with maternal levels at birth (61.1 +/- 19.0 vs. 17.6 +/- 4.9 microg/ml; P < 0.001; n = 17), and no correlation was found between cord and maternal adiponectin levels. There were no significant differences between adiponectin levels at birth and 4 d postpartum (61.1 +/- 19.0 vs. 63.8 +/- 22.0 microg/ml; n = 17). These findings indicate that adiponectin in cord blood is derived from fetal and not from placental or maternal tissues. The high adiponectin levels in newborns compared with adults may be due to lack of negative feedback on adiponectin production resulting from lack of adipocyte hypertrophy, low percentage of body fat, or a different distribution of fat depots in the newborns.     

The effect of nitrogen dioxide on low birth weight in women with inflammatory bowel disease: a Norwegian pregnancy cohort study (MoBa)

Abstract

Background: Adverse birth outcomes are more frequent among mothers with inflammatory bowel diseases (IBDs) than non-IBD mothers. In recent studies, air pollution, such as high concentrations of nitrogen dioxide (NO₂), is reckoned as a risk factor for preterm birth in the general population. In this study, we investigated whether IBD mothers are at higher risk of preterm birth when exposed to NO₂ compared to non-IBD mothers.

Methods: We used information from the Norwegian Mother, Father and Child Cohort Study (MoBa). The pregnancy cohort was linked to the Norwegian Medical Birth Registry and air-pollution exposure data available from a subset of the study cohort. The relevant outcome in this study was preterm birth. A total of 16,170 non-IBD and 92 IBD mothers were included in the study.

Results: The mean exposure of NO₂ during the pregnancy was similar for IBD and non-IBD mothers, 13.7 (6.9) μg/m³ and 13.6 (4.2) μg/m³, respectively.

IBD mothers with higher exposure of NO₂ in the second and third trimester were at significant risk of preterm birth compared to non-IBD mothers [OR = 1.28 (CI 95%: 1.04–1.59) and OR = 1.23 (95% CI: 1.06–1.43), respectively]. The mean NO₂ exposure was significantly higher in IBD mothers with preterm birth than in IBD mothers who delivered at term, at 19.58 (1.57) μg/m³ and 12.89 (6.37) μg/m³, respectively.

Conclusions: NO₂ exposure influenced the risk of preterm birth in IBD mothers. Higher risk of preterm birth in IBD was associated with higher exposure of NO₂, suggesting vulnerability of preterm birth in IBD when exposed to NO₂.     

Offspring birth weight,gestational age and maternal characteristics in relation to glucose status at age 53 years: evidence from a national birth cohort

Aims We investigated pathways linking offspring birth weight to maternal diabetes risk in later life by taking into account a range of prospective early-life and adult maternal factors. Methods In a national birth cohort study, we examined the relationship between offspring birth weight and maternal glycated haemoglobin (HbA_1c) at age 53 years in 581 mothers who had a first birth between age 19 and 25 years, and had data on potential confounders or mediators. Results Mean age at first birth was 21.5 years. After adjustment for maternal body mass index (BMI), mean percentage change in maternal HbA_1c per kilogram increase in offspring birth weight was −1.8%[95% confidence interval (CI) −3.5, −0.1; P = 0.03]. This relationship was mostly accounted for by gestational age that was inversely related to maternal HbA_1c (−0.9%; 95% CI −1.5, −0.4; P = 0.001). Other risk factors for high HbA_1c were smoking and high BMI at 53 years. There was a significant interaction between offspring birth weight and maternal childhood social class (P = 0.01). Mothers from a manual background with higher birth weight offspring had lower HbA_1c (BMI adjusted: −3.1%; 95% CI −5.0, −1.1); this was not observed for mothers from a non-manual background (BMI adjusted: 1.9%; 95% CI −1.3, 5.0). Conclusions Short gestational age and low offspring birth weight may be part of a pathway linking impaired early maternal growth to diabetes risk in later life. A second possible pathway linking higher offspring birth weight to later maternal glucose status was also identified. These potential pathways require further investigation in cohorts with a wider maternal age range so that the early targeting of public health initiatives can be assessed.     

The relationship between birth weight and pulse pressure in children: cross-sectional study

This cross-sectional study investigates the relationship between birth weight and pulse pressure in childhood, after adjusting for mean blood pressure values and for potential confounding factors. Blood pressure was measured in 937 schoolchildren, free from cardiovascular disease, aged between 6 and 16 years. Pulse pressure was estimated as the difference between the 24 h mean systolic and diastolic blood pressure values. Linear regression showed a significant negative association between birth weight and log-transformed pulse pressure, which after gender-specific analyses was found to be restricted to the girls in the study (adjusted regression coefficient log mmHg per kg -0.06, 95% CI -0.09 to -0.03). A previous investigation of this cohort reported a significant negative association between birth weight and both systolic and diastolic blood pressure, again restricted to the girls in the cohort. The results of the present study provide limited support for the hypothesis that pulse pressure in childhood is determined in utero, particularly for female subjects. However, as little research has been published in this area, further investigation is required and in particular it would be important to assess whether such gender differences are apparent in other cohorts.     

The effect of blood glucose levels on hemorheological parameters, platelet activation and aggregation in oral glucose tolerance tests

Rheological factors and increased platelet aggregation are convincingly implicated in the development of micro- and macrovascular disease associated with diabetes mellitus. The present examination has been designed to describe the effects of a standard oral glucose load on hemorheological parameters, platelet activation and aggregation in patients with normal and pathologic glucose tolerance. Oral glucose tolerance test (OGTT) was performed in 30 patients suspected to have diabetes mellitus. Hematocrit, erythrocyte aggregation, red blood cell filterability, plasma and whole blood viscosity, soluble P-selectin levels and platelet aggregation were tested paralelly with blood glucose measurements 1, 2, and 3 hours after glucose consumption. Patients were divided into two groups based on glucose tolerance. Patients with abnormal glucose tolerance (IGT/DM) showed significant elevation in red blood cell aggregability (Myrenne indices M and M1) at the 2- and 3-hour samplings (p<0.01 and p<0.001, respectively). Patients with normal glucose tolerance (NGT) showed significant elevation only in M1 index (p=0.01). Plasma viscosity decreased significantly compared to fasting values in IGT/DM patients in all samples, but remained unchanged in NGT patients. Hematocrit decreased in IGT/DM patients significantly from the 2-hour samplings on (p<0.05), in normoglycaemic patients its decrease reached a borderline significance at 3-hour measurements. No significant changes were detected in whole blood viscosity, red blood cell filterability and sP-selectin levels during OGTT in either examined groups. No examined parameters were significantly correlated to blood glucose levels at any sampling. Erythrocyte aggregation showed significant correlation with BMI (p<0.01). Our results demonstrate that after the intake of a standard amount of glucose the development of rheological alterations is not simultaneous with the elevation of blood glucose levels, and our data suggest that the observed elevation in erythrocyte aggregation during OGTT might be associated with hyperinsulinemia.     

Body fat distribution, relative weight, and liver enzyme levels: a population-based study

Regional body fat distribution may represent an independent risk factor for several conditions, especially metabolic and cardiovascular diseases; recent findings have shown that abdominal fat accumulation can be an independent predictor of hepatic steatosis. Very few studies, mostly using selected clinical samples, have focused on the relationship between indices of abdominal visceral fat accumulation and the most commonly used biochemical liver tests, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT). The aim of the present study was to evaluate the relation between central fat accumulation, as assessed by abdominal height, relative weight, as determined by body mass index (BMI), and liver function tests (ALT, AST, and GGT) in a random sample of 2,704 residents of Erie and Niagara Counties in New York State, 35-80 years of age and free from known hepatic disease. Multiple linear regression models were used, with liver enzymes as dependent variables with abdominal height and BMI as independent variables, and the inclusion of several covariates (age, race, education, smoking status, pack-years of smoking, drinking status, and total ounces of ethanol in the past 30 days). Abdominal height was consistently a better correlate of ALT and GGT levels than BMI in both sexes. In addition, abdominal height was the most powerful independent predictor of ALT in both sexes as well as of GGT among women. In conclusion, these findings support a role for central adiposity independent from BMI in predicting increased levels of hepatic enzymes, likely as a result of unrecognized fatty liver.