Background: Subjects born small for gestational age (SGA) were shown to be at higher risk for metabolic consequences in adulthood but less is known on their cardiovascular function.
Objective and Hypotheses: We aimed to investigate cardiovascular function and left ventricular mass index (LVMI) in adolescents born SGA and appropriate for gestational age (AGA) and their relationship with perinatal and postnatal factors.
Method: A prospective cohort of 47 SGA and 55 AGA children was followed-up from birth to adolescence (47 boys, 55 girls). At the time of the study, subjects were 11-14 years old (mean 12.5±0.1 years). 7 (14.9%) of SGA children were short (height below 3rd percentile according to Lithuanian growth standards).
All participants underwent anthropometric measurements. Systolic and diastolic blood pressure (BP) were measured twice after 30min rest using an automatic device. Blood cholesterol analysis was performed after overnight fast. Echocardiography was performed in two-dimensional-guided M-mode. Left ventricular mass was calculated using the Devereux equation. LVMI was obtained using formula: LVMI=LVM/height(cm)2.7.
Statistical analyses were adjusted for sex, age, pubertal stage and BMISDS. BP analysis was additionally adjusted for current height and LVMI for systolic BP.
Results: SGA children without catch-up growth (SGACU-) had higher systolic and diastolic BP than those with catch-up growth (SGACU+) and AGA (Systolic BP: 125.1±5.4 vs 111.2±1.9mmHg, P=0.015 and vs 109.0±1.7mmHg, P=0.009; diastolic BP: 76.9±3.7 vs 66.5±1.3mmHg, P=0.006 and vs 66.0±1.1mmHg, P=0.006, respectively). LVMI was higher in SGACU- adolescents compared with AGA (31.3±1.7 vs 27.5±0.5g/m2.7, P=0.044) but there was no difference in SGACU- vs SGACU+ adolescents. There was no difference in heart rate and cholesterol levels between SGACU-, SGACU+ and AGA groups.
LVMI in adolescence was directly related to current weightSDS, BMISDS, waist-to-height ratio, systolic BP, glycaemia 120-min post-load, ALT and cortisol levels (all P<0.05). Moreover, LVMI was inversely related to increase in BMISDS and limb skinfold thickness from 6 to 12 years of age (all P<0.005) but directly related to increase in BMISDS from birth to 2 years of age (r=0.328, P=0.023) and the last one was the only factor independently related to LVMI in multiple regression model.
Conclusion: SGA adolescents without catch-up growth had higher systolic and diastolic blood pressure and LVMI compared with those with catch-up growth and AGA. BMISDS gain from birth to 2 years of age was an independent predictor of LVMI in adolescence.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology