ESPE Abstracts

We recently assessed systolic heart function in children from IUGR and normal control pregnancies and reported early developmental impairment of left ventricular longitudinal strain – a sensitive echocardiographic measure – during the first 3 months of life in IUGR children. In accordance with previous studies, this suggest that the increased cardiovascular risk later in life imposed by IUGR/SGA may, at least to some extent, be primary and not entirely secondary to hormonal and metabolic programming including early insulin resistance. We investigated 192 cardiovascular protein biomarkers in cord serum in children from IUGR and normal control pregnancies (n=48) using linear regression models to explore their association with birth weight SDS. In our primary analysis we demonstrated that 7 cardiovascular protein biomarkers were associated with birth weight SDS. Two hormonal markers related to insulin resistance were among the top 4 associated and included Leptin, an adipokine signaling fat content in adipocytes and IGFBP-1, a liver derived and insulin suppressible regulator of IGF-I bioactivity. Of these, Leptin association with birth weight SDS was enriched in premature children while maternal BMI and diastolic blood pressure did not impact the association with birth weight SDS in secondary analysis. Other cardiovascular protein biomarkers known to affect birth size and metabolism such as PAPPA, FGF-23, FGF-21, IL-6 did not correlate with birth weight SDS (in some cases due to undetectable values in this setting). In conclusion, cardiovascular protein biomarkers that are associated with later metabolic phenotype in accordance with Barkers hypothesis of early in life programming of metabolism were demonstrated to be associated with birth weight SDS. Since we have previously reported impact of birth weight directly on developmental left ventricular function, these may be parallel phenomenon or there may be early cross-talk between metabolic and cardiovascular function.