Newborn body composition and child cardiovascular risk markers: a prospective multi-ethnic Asian cohort study

Author:

Ong Yi Ying1,Tint Mya-Thway23,Aris Izzuddin M4ORCID,Yuan Wen Lun1ORCID,Chen Ling-Wei35,Fortier Marielle V36,Choo Jonathan7,Ling Lieng Hsi8,Shek Lynette139,Tan Kok Hian1011ORCID,Gluckman Peter D312,Yap Fabian710ORCID,Chong Yap-Seng23ORCID,Godfrey Keith M13,Chong Mary F-F314,Chan Shiao-Yng23,Eriksson Johan G231516ORCID,Wlodek Mary E23,De Lucia Rolfe Emanuella17,Ong Ken K17,Michael Navin3ORCID,Lee Yung Seng139ORCID

Affiliation:

1. Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore , Singapore

2. Department of Obstetrics and Gynaecology and Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore , Singapore

3. Singapore Institute for Clinical Science, Agency for Science, Technology, and Research , Singapore

4. Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute , Boston, MA, USA

5. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University , Taipei, Taiwan

6. Department of Diagnostic and Interventional Imaging, KK Women's and Children's Hospital , Singapore

7. Department of Paediatrics, KK Women's and Children's Hospital , Singapore

8. Department of Cardiology, National University Heart Centre , Singapore

9. Department of Paediatrics, Khoo Teck Puat-National University Children’s Medical Institute , Singapore

10. Academic Medicine Department, Duke-NUS Medical School , Singapore

11. Department of Maternal Fetal Medicine, KK Women's and Children's Hospital , Singapore

12. Liggins Institute, University of Auckland , Auckland, New Zealand

13. MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust , Southampton, UK

14. Saw Swee Hock School of Public Health, National University of Singapore , Singapore

15. Department of General Practice and Primary Health Care, University of Helsinki , Helsinki, Finland

16. Public Health Research Program, Folkhälsan Research Center , Helsinki, Finland

17. Medical Research Council Epidemiology Unit, Institute of Metabolic Science, University of Cambridge , Cambridge, UK

Abstract

Abstract Background Early epidemiological studies have associated low birthweight with increased cardiovascular risk. We aimed to examine whether the fat and fat-free components of birthweight have differing relationships with childhood cardiovascular risk markers. Methods In the Growing Up in Singapore Towards healthy Outcomes (GUSTO) cohort, air displacement plethysmography was conducted within 24 h after delivery in 290 naturally conceived singletons. We investigated associations of newborn cohort-specific standardized z-score of fat mass, fat-free mass, body fat percentage and birthweight on child (at 6 years of age) carotid intima-media thickness, pulse wave velocity, blood pressure, prehypertension/hypertension (>110/70 mmHg) and standardized systolic and diastolic blood pressure (SBP and DBP) trajectories (at 3–6 years of age), taking account of maternal education, height, tobacco exposure, parity, ethnicity, child’s sex, gestational age, age at follow-up, and other maternal factors. Results Clear inverse associations were seen for blood pressure with z-score of fat mass [SBP, β (95% CI): −1.31 mmHg (−2.57, −0.06); DBP: −0.79 mmHg (−1.74, 0.15)] and body fat percentage [SBP: −1.46 mmHg (−2.73, −0.19); DBP: −0.80 mmHg (−1.75, 0.16)], but not with fat-free mass [SBP: 0.27 mmHg (−1.29, 1.83)]; DBP: −0.14 mmHg (−1.30, 1.03)]. Being in the lowest tertile of fat mass or body fat percentage was associated with higher blood pressure trajectories and prehypertension/hypertension risk [OR (95% CI), fat mass: 4.23 (1.41, 12.68); body fat percentage: 3.22 (1.09, 9.53)] without concomitantly higher overweight/obesity risk. Conclusions At birth, low adiposity was associated with increased childhood blood pressure. Low newborn adiposity might serve as a marker of poor fetal growth or suboptimal intrauterine conditions associated with hypertension risk later in life.

Funder

Singapore National Research Foundation

Translational and Clinical Research

Singapore Ministry of Health’s National Medical Research Council

Medical Research Council

National Institute for Health Research

NIHR Southampton Biomedical Research Centre

British Heart Foundation

Publisher

Oxford University Press (OUP)

Subject

General Medicine,Epidemiology

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