RESUMO
OBJECTIVE: This work investigates the relationship between early body composition changes and neurodevelopment at 1 year age corrected for prematurity (CA). STUDY DESIGN: A prospective, longitudinal study to measure body composition weekly in 34 very low birth weight preterm infants using air displacement plethysmography, beginning when infants stabilized after birth until discharge. Neurodevelopmental testing (Bayley Scales of Infant Development-III) was performed at 12 months CA. Linear mixed effects models were used to obtain inpatient subject-specific changes in fat-free mass (FFM) and fat mass (FM), which were then used as predictors of Bayley subscale scores in subsequent linear regression models, adjusting for potential confounders. Protein and energy provision were calculated for the first week of life. RESULTS: Greater FFM gains while inpatient were associated with improved cognitive and motor scores at 12 months CA (P = .002 for both). These relationships remained significant when adjusting for birth weight, gestational age, and intraventricular hemorrhage (P ≤ .05 for both). Similar analysis was performed for FM gains without significant findings. Increased provision of protein and calories during the first week of life was positively associated with FFM gains (P ≤ .01 for both), but not FM gains (P ≥ .2 for both), throughout hospitalization. CONCLUSIONS: Increased FFM gains, but not FM gains, during hospitalization are associated with improved neurodevelopment at 12 months CA. As early FM gains may be associated with long-term risk, more research is needed to develop strategies that optimize FFM gains while minimizing FM gains in very low birth weight preterm infants.
Assuntos
Composição Corporal , Cognição , Recém-Nascido Prematuro/crescimento & desenvolvimento , Recém-Nascido de muito Baixo Peso , Desempenho Psicomotor , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Lineares , Estudos Longitudinais , Masculino , Pletismografia de Impedância , Estudos ProspectivosRESUMO
OBJECTIVE: To examine the association of menarche timing with cardiometabolic risk factors into early to mid-adulthood, comparing African American and White women. STUDY DESIGN: Analyses included 2583 women (African American = 1333; White = 1250) from the Coronary Artery Risk Development in Young Adults cohort study over 25 years of follow-up (1985-2011). Outcomes included type 2 diabetes, metabolic syndrome, adiposity, glucose, insulin, blood pressure, and blood lipids. Cox models or repeated measures linear regression models estimated the association between age at menarche and the outcomes. RESULTS: Each 1-year earlier age at menarche was associated with higher mean body mass index among African American (0.88 ± 0.12 kg/m(2), P < .0001) and White (0.89 ± 0.10 kg/m(2), P < .0001) women. After body mass index adjustment, each 1-year earlier age at menarche was associated with higher triglycerides (2.26 ± 0.68 mg/dL, P = .001) and glucose (0.34 ± 0.11 mg/dL, P = .002), and greater risk for incident impaired fasting glucose (hazard ratio = 1.13, 95% CI 1.04-1.20) and metabolic syndrome (hazard ratio 1.19, 95% CI 1.11-1.26) among White women only. CONCLUSIONS: Excess adiposity associated with earlier menarche is sustained through mid-adulthood, and primarily drives higher cardiometabolic risk factor levels. However, White women with earlier menarche had increased risk of a number of insulin-resistance related conditions independent of adiposity. The cardiometabolic impact of earlier menarche was weaker in African American women despite higher average adiposity. Weight maintenance would likely reduce but may not completely eliminate the elevated cardiometabolic risk of earlier menarche.
Assuntos
Negro ou Afro-Americano/estatística & dados numéricos , Doenças Cardiovasculares/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Menarca , Síndrome Metabólica/epidemiologia , População Branca/estatística & dados numéricos , Adiposidade , Adulto , Fatores Etários , Glicemia , Pressão Sanguínea , Índice de Massa Corporal , Estudos de Coortes , Feminino , Humanos , Incidência , Lipídeos/sangue , Pessoa de Meia-Idade , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVES: Studies from developed societies have shown that individuals with short legs relative to height have higher risk of type 2 diabetes. This has been much less explored in less developed populations where influences on relative leg length and diabetes may differ. The Brazilian Longitudinal Study of Adult Health (in Portuguese, ELSA-Brasil) allows us to test, in a cohort born (1934-1975) and raised when undernutrition was common, whether short legs relative to height is positively associated with diabetes, independent of early-life factors, including birth weight, age at menarche, and young-adult BMI. METHODS: We used baseline, cross-sectional data from 15,105 participants aged 35-74 years participating in ELSA-Brasil. We created age-and-sex-specific Z scores for leg length index (leg length/height × 100) according to an external reference. Diabetes was defined by self-reported physician diagnosis, medication use, fasting and 2-h post-75-g-load glucose, and A1C. RESULTS: A one-unit decrement in leg-length-index Z score was associated with 12% (8-17%) higher prevalence of diabetes in Brazilian adults, after adjustment through Poisson regression for confounders, including race, maternal education, and birth weight. This association persisted after further adjustment for menarche age, BMI (at age 20), buttocks circumference, and waist circumference. It was stronger among women with early menarche (P interaction = 0.02). Leg length index was also inversely associated with fasting glucose, fasting insulin, 2-h glucose, and A1C (P < 0.05). CONCLUSIONS: In contemporary Brazilian adults, short legs relative to height is positively associated with diabetes independent of measures of intrauterine growth, pubertal timing, and young-adult adiposity. This association is stronger in women with early menarche.
Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Perna (Membro)/anatomia & histologia , Puberdade , Adulto , Idoso , Brasil/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/etiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , PrevalênciaRESUMO
OBJECTIVE: To investigate the relationship between maternal prepregnancy body mass index and early infant growth and body composition. STUDY DESIGN: Prospective cohort study performed at a university hospital/surrounding community. Ninety-seven nondiabetic mothers with singleton, term, healthy infants completed study visits at 2 weeks and 3 months of age. Before pregnancy, 59 mothers were normal weight, 18 were overweight, and 20 were obese. Infant anthropometrics and body composition via air-displacement plethysmography were measured. Infant feeding information and maternal prepregnancy weight were self-reported. Additional data were obtained via self-report and the medical record. Main outcome measures were change in weight, length, fat-free mass, and fat mass from 2 weeks to 3 months of age. Analysis was done via multivariate linear regression. RESULTS: At 2 weeks, anthropometrics and body composition did not differ across maternal body mass index groups. At 3 months, infants of overweight or obese mothers had gained less weight (P = .02), grew less in length (P = .01), and gained less fat mass (P = .01). Adjustment for breastfeeding status and regression to the mean via conditional change variables did not alter the results. The results were not altered after adjusting for maternal glucose values from a 50-g glucose challenge and for maternal smoking in a subset including 80% of the women. CONCLUSIONS: Maternal overweight/obesity is associated with early deceleration in linear growth and adipose tissue accrual; replication of these findings is needed.
Assuntos
Adiposidade , Estatura , Desenvolvimento Infantil , Obesidade , Complicações na Gravidez , Aumento de Peso , Adulto , Índice de Massa Corporal , Aleitamento Materno , Estudos de Coortes , Feminino , Humanos , Lactente , Modelos Lineares , Masculino , Análise Multivariada , Sobrepeso , Pletismografia , Gravidez , Estudos Prospectivos , AutorrelatoRESUMO
OBJECTIVES: To investigate secular trends in weight and length growth from birth to 3 years of age in infants born from 1930 to 2008, and to assess whether these trends were associated with concurrent trends in pace of infant skeletal maturation and maternal body mass index. STUDY DESIGN: Longitudinal weight and length data from 620 infants (302 girls) were analyzed with mixed effects modeling to produce growth curves and predicted anthropometry for infants born from 1930 to 1949, 1950 to 1969, 1970 to 1989, and 1990 to 2008. RESULTS: The most pronounced differences in growth occurred in the first year of life. Infants born after 1970 were approximately 450 g heavier and 1.4 cm longer at birth, but demonstrated slower growth to 1 year of age than infants born before 1970. Growth trajectories converged after 1 year of age. There was no evidence that relative skeletal age, maternal body mass index, or maternal age together mediated associations between cohort and growth. CONCLUSIONS: Recent birth cohorts may be characterized not only by greater birth size, but also by subsequent catch-down growth. Trends over time in human growth do not increase monotonically, and growth velocity in the first year may have declined compared with preceding generations.
Assuntos
Peso ao Nascer , Estatura , Desenvolvimento Infantil/fisiologia , Crescimento e Desenvolvimento/fisiologia , Análise de Variância , Composição Corporal , Índice de Massa Corporal , Estudos de Coortes , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Modelos Lineares , Estudos Longitudinais , Masculino , Fatores de Risco , Fatores Sexuais , Fatores de TempoRESUMO
OBJECTIVE: To test the hypothesis that rapid infant weight gain is associated with advanced skeletal maturity in children from the United States and South Africa. STUDY DESIGN: Longitudinal data from 467 appropriate-for-gestational-age infants in the Fels Longitudinal Growth Study (Dayton, Ohio) and 196 appropriate-for-gestational-age infants in the Birth to Twenty birth cohort study (Johannesburg, South Africa) were used. Multiple linear regression models tested the association between internal SD score change in weight from 0 to 2 years and relative skeletal age at 9 years, adjusting for body mass index, stature, and other covariates. RESULTS: In both studies, faster infant weight gain was associated with more advanced skeletal maturity (approximately 0.2 years or 2.4 months per SD score) at age 9 years (P <.0001-.005), even when adjusting for the positive associations of both birth weight and body mass index at age 9 years. This effect appeared to be accounted for by the greater childhood stature of subjects with more rapid infant weight gain. CONCLUSIONS: Relatively rapid infant weight-gain is associated with advanced skeletal development in late childhood, perhaps via effects on stature.
Assuntos
Desenvolvimento Ósseo/fisiologia , Aumento de Peso/fisiologia , Adolescente , Fatores Etários , Peso ao Nascer , Índice de Massa Corporal , Tamanho Corporal , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , África do Sul , Estados Unidos , Adulto JovemRESUMO
During the 20th century, infectious disease morbidity and mortality generally waned whereas chronic degenerative diseases posed a growing burden at the global level. The population on Saba, Netherlands Antilles has recently experienced such an epidemiologic transition, and hypertension was reported to be extraordinarily high, although no prevalences have been reported and relationships with lifestyle factors associated with rapid modernization have not been explored. In this study, a medical and demographic questionnaires, as well as body composition and blood pressure measures were collected from 278 Saban men and women aged 18-91 years. When age and sex adjusted, 48% of the population was hypertensive. Age, BMI, and Afro-Caribbean descent were all associated with higher blood pressures. In a second phase, 124 individuals of the 278 were invited to receive a longer questionnaire on individual exposure to modernizing influences such as travel and education. Higher blood pressure was associated with having lived in fewer different places in the past; those who stayed only on Saba or Statia had higher blood pressures than those who had also lived in more modernized areas. However, this was no longer statistically significant after adjustment for age and BMI. Lifestyle incongruity was positively associated with higher blood pressure in that those with more discord between material wealth and income were more likely to be hypertensive, and this remained statistically significant after adjustment for age and adiposity. In summary, hypertension is highly prevalent on Saba and tended to be associated with greater age, adiposity, Afro-Caribbean ancestry, and lifestyle incongruity.