Background: The long-term effects of perinatal growth and corticosteroid exposure on adrenal steroid concentrations in adults born very preterm are uncertain. Objectives: To examine the effect of... Show moreBackground: The long-term effects of perinatal growth and corticosteroid exposure on adrenal steroid concentrations in adults born very preterm are uncertain. Objectives: To examine the effect of birth weight, early postnatal growth, and pre- and postnatal corticosteroid administration on serum adrenal steroids in 19-year-old subjects born very preterm. Design and methods: Subjects born before 32 weeks of gestation in The Netherlands participating in the Project on Preterm and Small for Gestational Age Infants (POPS) were investigated at 19 years of age. Serum cortisol, DHEA sulfate (DHEAS), and androstenedione (Adione) concentrations were measured in 393 out of 676 eligible subjects, compared with controls, and associated with perinatal growth and pre- and postnatal corticosteroids administration using multiple linear regression analyses. Results: Serum DHEAS and Adione in men and women were higher than in controls. In the multiple regression analyses, birth weight SDS showed a statistically significant negative association with serum DHEAS concentrations in women (beta: -0.865, 95% confidence interval (CI): -1.254 to -0.476) and in men (beta: -0.758, 95% CI: -1.247 to -0.268) and with serum Adione concentrations in women (beta: -0.337, 95% CI: -0.593 to -0.082). Early postnatal weight gain showed no association with any of measured adrenal markers. In women, serum Adione was associated with postnatal dexamethasone exposure (beta: 0.932, 95% CI: 0.022 1.843). Conclusions: Young adults born very preterm show elevated adrenal androgens, particularly when born small for gestational age. Postnatal corticosteroid administration is positively associated with serum Adione in young women. Show less
Background The validity and appropriateness of the metabolic syndrome as a cardiovascular risk factor are increasingly debated, partly because of the lack of a unifying underlying... Show moreBackground The validity and appropriateness of the metabolic syndrome as a cardiovascular risk factor are increasingly debated, partly because of the lack of a unifying underlying pathophysiological mechanism. Intrauterine growth retardation (low birth weight by sex and gestational length) has been associated with several cardiovascular problems and could be an important underlying risk factor for the metabolic syndrome. Methods The association between intrauterine growth retardation (from the Norwegian Medical Birth Registry) and the metabolic syndrome in 7435 men and women aged 20-30 years from the population-based HUNT 2 study was studied with logistic regression using fractional polynomial models. Results In men, there were significant associations with several of the separate components of the metabolic syndrome: central obesity (exponential, P < 0.001), raised triglycerides (negative linear, P = 0.018), reduced HDL-cholesterol (U-shaped, P = 0.086), raised blood pressure (negative linear, P = 0.036), and impaired glucose tolerance (negative linear, P = 0.036). In women, there were significant associations with central obesity (positive linear, P < 0.001) and raised blood pressure (negative linear, P = 0.003) but not with the other components. When combining these components into the metabolic syndrome, an exponential association was found in men (P = 0.017), that is, increased risk in patients with high birth weight only. In women, there was no association at all (P = 0.959). Conclusion Low birth weight was not associated with the metabolic syndrome at young adult age. Several associations between birth weight and the separate components of the syndrome were found, however, but these associations were partly in different directions. Eur J Cardiovasc Prev Rehabil 17:314-320 (C) 2010 The European Society of Cardiology Show less
The content of this thesis is of two sorts: in one part, three topics about the early origins of adult disease are addressed, preceded by three related methodological studies which form the other... Show moreThe content of this thesis is of two sorts: in one part, three topics about the early origins of adult disease are addressed, preceded by three related methodological studies which form the other part. The thesis starts with a systematic review of the literature about the growth of infants born preterm. Next, three specific methodological issues related to early origins of adult disease studies are addressed. A: the most favorable regression model for analyzing and interpreting the effect of both prenatal and subsequent postnatal growth on adult health outcomes. B: the efficiency of reliability studies in the context of a multi-centre study. And C: the correct and clear assessment of reliability in case of log transformed outcomes. These methods are used ind the second part, in which three topics about the effects of prenatal and early postnatal growth on adult health outcomes are addressed, namely: A the association between birth weight and adult renal function in non-premature subjects. B: The association between birth weight and the adult metabolic syndrome, and its separate components in the same population. And finally, C: the association between early growth and adult body composition in subjects born very preterm. Show less
