Size at birth, weight gain over the life course, and low-grade inflammation in young adulthood: northern Finland 1966 Birth Cohort study.
ABSTRACT Low-grade inflammation might mediate associations between size at birth, early life growth, excessive weight gain, and subsequent risk of cardiovascular disease in adult life. Our aim was to investigate relationships between fetal growth, weight over the life course, and low-grade inflammation measured by serum high sensitivity C-reactive protein (CRP) levels at 31 years.
General population-based northern Finland 1966 Birth Cohort study of 5840 participants attending a clinical examination at 31 years, including measurement of CRP. Weight and height were assessed at birth, 12 months, and 14 and 31 years of age. CRP levels at 31 years were 16% [95% confidence interval (CI) 8, 23] higher per 1 kg lower birth weight, 21% (95% CI 2, 37) higher per 10 cm lower birth length, and 24% (95% CI 10, 36) higher per 1 kg/m3 lower ponderal index, after adjustment for potential confounders. Participants with highest tertile body mass index (BMI) at 31 years and lowest tertile birth weight had the highest average CRP levels. Per unit increase in BMI from 14 to 31 years was associated with 16% (95% CI 14, 17) higher CRP levels; the association was larger for those in the top BMI tertile at age 14 years.
Systemic low-grade inflammation may lie on the causal pathway that relates impaired fetal growth and weight gain from childhood to adulthood to adverse adult cardiovascular health. Lifestyle changes from early life might be an important step in reducing cardiovascular risk in adults.
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ABSTRACT: Chronic inflammation is a potentially important physiological mechanism linking early life environments and health in adulthood. Elevated concentrations of C-reactive protein (CRP)-a key biomarker of inflammation-predict increased cardiovascular and metabolic disease risk in adulthood, but the developmental factors that shape the regulation of inflammation are not known. We investigated birth weight and breastfeeding duration in infancy as predictors of CRP in young adulthood in a large representative cohort study (n = 6951). Birth weight was significantly associated with CRP in young adulthood, with a negative association for birth weights 2.8 kg and higher. Compared with individuals not breastfed, CRP concentrations were 20.1%, 26.7%, 29.6% and 29.8% lower among individuals breastfed for less than three months, three to six months, 6-12 months and greater than 12 months, respectively. In sibling comparison models, higher birth weight was associated with lower CRP for birth weights above 2.5 kg, and breastfeeding greater than or equal to three months was significantly associated with lower CRP. Efforts to promote breastfeeding and improve birth outcomes may have clinically relevant effects on reducing chronic inflammation and lowering risk for cardiovascular and metabolic diseases in adulthood.Proceedings of the Royal Society B: Biological Sciences 04/2014; 281(1784):20133116. · 5.29 Impact Factor
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ABSTRACT: Objective: Inflammation may constitute an underlying mechanism for increased risk of developing chronic diseases in later years, but few prospective studies have assessed the influence of low-grade inflammation on body weight gain, particularly among children in low-to middle-income settings with lower prevalence of overweight and obesity. We aimed to investigate whether C-reactive protein (CRP), as a biomarker of low-grade inflammation, predicts changes in body mass index-for-age z scores (BAZ) during childhood. Methods: A population-based longitudinal study was conducted in the Brazilian Amazon among children aged #10 years in 2007, with follow-up visits in 2009 and 2012. Outcome was annual change in BAZ. As the main exposure of interest, CRP concentrations were divided into four categories, with values ,1 mg/L divided in tertiles plus a fourth category with values ranging from 1 to 10 mg/L. Children were simultaneously screened for iron and vitamin A deficiencies, diarrhea, and wheezing. We used mixed-effect linear regression models to measure the effect of CRP concentrations on annual BAZ change and linear regression models to explore CRP predictors at baseline. Results: At baseline, 1007 children had CRP and anthropometric data [mean (SD) age: 5.3 (2.9) years; 50.9% male, 84.5% mulatto/mixed-race, 14.0% at risk for overweight or obesity, 4.8% stunted]; 737 were successfully followed up. Morbidities and nutritional deficiencies were widespread. Among participants aged .5 years, children in the highest tertile of CRP ,1 mg/L at baseline, regarded as an indicator of low-grade inflammation, had a 0.04 z/y higher gain in BAZ (95% CI: 0.01, 0.09 z/y) during follow-up. CRP was positively associated with household poverty and worse nutritional indicators. Conclusions: We found evidence of a role for low-grade inflammation in predicting annual BAZ gain among children aged .5 years. Citation: Lourenço BH, Cardoso MA, for the ACTION Study Team (2014) C-Reactive Protein Concentration Predicts Change in Body Mass Index during Childhood. PLoS ONE 9(3): e90357. doi:10.1371/journal.pone.0090357 Copyright: ß 2014 Lourenço and Cardoso. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Funding: This study was funded by the Brazilian National Counsel of Technological and Scientific Development, CNPq (Grant nos. 551359/2001-3, 502937/2003-3, 307728/2006-4, and 470573/2007-4) and the São Paulo Research Foundation, FAPESP (Grant no. 2007/53042-1). BHL received PhD scholarships from the FAPESP (Grant no. 2008/57796-3) and the Organization of American States (BR Self Grad 2010/11, ID 20100656). The views expressed in this paper are those of the authors and not necessarily those of any funding agencies or others whose support is acknowledged. The funders had no influence on the study design, data collection, analysis or interpretation, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist.PLoS ONE 03/2014; · 3.53 Impact Factor
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ABSTRACT: Fetal growth restriction is a risk factor for development of adulthood diseases, but the biological mechanism of this association remains unknown. Limited biomarkers have been studied in settings of preterm birth and maternal inflammation, but the relationship between a wide range of immune biomarkers and fetal growth has not been studied. The hypothesis of this study was that fetal growth restriction is associated with altered immune biomarker levels. We examined the relationship between small for gestational age (SGA) status and 27 umbilical cord blood immune biomarkers. This study was part of a large-scale cohort study of preterm birth and low birth weight conducted at Boston Medical Center, an inner city, predominantly minority patient population. Growth status was determined based on birth weight standardized to an internal reference. There were 74 SGA births and 319 appropriate for age (AGA) births with complete clinical and biomarker data. Adjusting for covariates and using AGA as reference, SGA births had lower levels of log IL-1β (ng/l; β −0.38, 95% CI −0.57, −0.19, P < 0.01), log BDNF (β −0.29, 95% CI −0.55, −0.03, P < 0.05) and log NT-3 (β −0.46, 95% CI −0.77, −0.15, P < 0.01). No associations were found between other biomarkers and SGA. In conclusion, three biomarkers were selectively associated with SGA status. Our results provide information that could be used to guide additional studied aimed at determining mechanisms that contribute to fetal growth.Journal of Developmental Origins of Health and Disease. 04/2011; 2(02).