Biochemical predictors for metabolic syndrome in preterm infants according to weight ratio.

OBJECTIVE: Prematurity and low birth weight predispose preterm infants to cardiovascular disease in later life. Is the metabolic profile of these children impacted by the relation between birth weight and gestational age (GA)? This study aimed to evaluate whether the relationship between birth weight and GA of preterm infants has a positive correlation with the metabolic profile from birth to the sixth month of corrected age. METHODS: This is a longitudinal, prospective study with a cohort of 70 preterm and 54 term infants, who were enrolled in the study and shared into two groups: Appropriate for GA (AGA) and Small for GA (SGA), both classified at birth by Fenton and Kim curves. Longitudinal evaluation of anthropometry measures and blood samples of total cholesterol, glucose, triglycerides, and insulin were collected at birth, NICU discharge, and the sixth month of corrected age. Data were analyzed using descriptive and inferential statistical analysis (ANOVA, Fisher test, Shapiro-Wilk, and Cochran test). The effect size was 0.15, power was 0.92, and confidence interval 95%. RESULTS: No significant statistical differences were observed in relation to biochemical tests between AGA and SGA groups. However, a significant increase in triglyceride results above the reference values for age in the SGA group was observed throughout the follow-up. CONCLUSION: Changes observed in the preterm infant metabolic profile show no correlation with adequacy of birth weight. Preterm lipid profile requires continuous evaluation at follow-up, due to the increased cardiovascular risk in later life.

Biochemical predictors for metabolic syndrome in preterm infants according to weight ratio

ABSTRACT Objective Prematurity and low birth weight predispose preterm infants to cardiovascular disease in later life. Is the metabolic profile of these children impacted by the relation between birth weight and gestational age (GA)? This study aimed to evaluate whether the relationship between birth weight and GA of preterm infants has a positive correlation with the metabolic profile from birth to the sixth month of corrected age. Subjects and methods This is a longitudinal, prospective study with a cohort of 70 preterm and 54 term infants, who were enrolled in the study and shared into two groups: Appropriate for GA (AGA) and Small for GA (SGA), both classified at birth by Fenton and Kim curves. Longitudinal evaluation of anthropometry measures and blood samples of total cholesterol, glucose, triglycerides, and insulin were collected at birth, NICU discharge, and the sixth month of corrected age. Data were analyzed using descriptive and inferential statistical analysis (ANOVA, Fisher test, Shapiro-Wilk, and Cochran test). The effect size was 0.15, power was 0.92, and confidence interval 95%. Results No significant statistical differences were observed in relation to biochemical tests between AGA and SGA groups. However, a significant increase in triglyceride results above the reference values for age in the SGA group was observed throughout the follow-up. Conclusions Changes observed in the preterm infant metabolic profile show no correlation with adequacy of birth weight. Preterm lipid profile requires continuous evaluation at follow-up, due to the increased cardiovascular risk in later life.

Evolução do perfil lipídico, glicêmico e pressórico de prematuros: estudo longitudinal / Evolution of the lipid, glycemic and blood pressure profile of premature infants: a longitudinal study

Objetivo: Relacionar a evolução do perfil lipídico, glicêmico e pressórico de prematuro do nascimento aos 2 anos de idade corrigida com a classificação de peso ao nascer e sexo. Metodologia: Estudo longitudinal, amostra inicial de 71 prematuros, destes, 31 completaram o acompanhamento ambulatorial. Avaliados ao nascer, alta, 6 meses e 2 anos de idade corrigida (peso, idade gestacional, perfil lipídico, glicêmico, pressão arterial). Resultados: Glicemia, colesterol total, pressão arterial e triglicerídeos, não foram estatisticamente significantes em relação ao peso ao nascer e ao longo do seguimento. Colesterol total (p=0,18) e glicemia sofreram efeito de interação com o sexo. Pressão arterial acima do esperado aos 2 anos. Crescimento foi uniforme independente do sexo. Conclusão: O perfil lipídico, glicêmico e pressórico dos prematuros ao longo do acompanhamento não foi influenciado pela classificação de peso ao nascer. O sexo influenciou as concentrações de colesterol e a glicemia.

Objective: To relate the evolution of the lipid, glycemic and blood pressure profile of premature infants from birth to 2 years corrected age with the classification of birth weight and sex. Methodology: Longitudinal study, initial sample of 71 premature infants, of which 31 completed outpatient follow-up. Evaluated at birth, discharge, 6 months and 2 years corrected age (weight, gestational age, lipid, glycemic, blood pressure profile). Results: Blood glucose, total cholesterol, blood pressure and triglycerides were not statistically significant in relation to birth weight nor throughout follow-up. Total cholesterol (p=0.18) and blood glucose underwent interaction with sex. Blood pressure was higher than expected at 2 years old. Growth was uniform regardless of sex. Conclusion: The lipid, glycemic and blood pressure profile of premature infants during follow-up was not influenced by the birth weight classification. The cholesterol and blood glucose concentrations were influenced by sex.

Crescimento e marcadores bioquímicos de recém-nascidos prematuros até os seis meses de idade corrigida / Growth and biochemical markers of preterm newborns up to six months of corrected age

INTRODUCTION: Due to advances in recent decades in maternal-foetal and neonatal medicine, a greater survival of preterm infants with progressively smaller birth weight and gestational age is observed, increasing the risk of future morbidities on those infants. Among these morbidities, alterations in growth and metabolism are found. OBJECTIVE: To analyze the evolution of the growth and the metabolic profile of preterm infants' cohort from birth at six months of corrected age (CA) METHODS: A descriptive and prospective study with a sample of 107 mothers and 115 preterm infants at birth and 72 preterm infants and 68 mothers at the end of follow-up. Growth (body weight, height, cephalic perimeter) was evaluated at six time points. Plasma concentrations of cholesterol, triglycerides, glucose and insulin of premature infants were assessed during three periods, from birth to 6 months of CA. Comparative analysis of the initial sample and the sample that finished the follow-up was used in chi-square family tests. To Evaluate the growth over the 6-month period by using repeated measurements. RESULTS: Sociodemographic variables and maternal biochemical profile without statistical differences in the comparison of the mothers of the initial sample with those who completed the follow-up. Linear growth of preterm infants at six months of CA, however without recovery of growth. Plasma concentrations of triglycerides (birth = 48.1, 6 months = 151.1) and cholesterol (birth = 82.7, 6 months = 139.9) increased during the evaluations. Glycaemia remained stable (birth 80.4, 6 months = 83.3) and insulin decreased from 11.0 to 4.2. CONCLUSION: Growth of preterm infants, although linear, was lower than expected for age. Lipid profiles presented an ascending curve from birth onward. Therefore, this group is prone to delayed growth and to developing cardiovascular changes throughout life.

INTRODUÇÃO: Com os avanços nas últimas décadas na medicina materno-fetal e neonatal, observa-se maior sobrevida de crianças prematuras com peso de nascimento e idade gestacional progressivamente menores, elevando riscos de morbidades futuras. Dentre as quais, alterações do crescimento e no metabolismo dessas crianças. OBJETIVO: Analisar a evolução do crescimento e o perfil metabólico de uma coorte de prematuros do nascimento aos seis meses de idade corrigida. MÉTODO: Estudo de descritivo, prospectivo, amostra de 107 mães e 115 recém-nascidos prematuros, ao nascimento e 72 lactentes prematuros e 68 mães ao término do seguimento. Crescimento (peso corporal, estatura, perímetro cefálico) avaliado em seis momentos. Concentrações plasmáticas de colesterol, triglicerídeos, glicose e insulina dos prematuros avaliadas em três períodos, do nascimento aos seis meses de Idade Corrigida (IC). Análise da comparação da amostra inicial com amostra que finalizou o seguimento mediante testes da família qui quadrado. Para a avaliação do crescimento ao longo dos seis meses, a análise ocorreu por meio de delineamento de medidas repetidas. RESULTADOS: Variáveis sociodemográficas e perfil bioquímico materno sem diferenças estatísticas entre mães da amostra inicial e aquelas que finalizaram o seguimento. Crescimento linear dos prema turos da alta aos seis meses de IC, contudo sem recuperação do crescimento. Concentrações plasmáticas de triglicerídeos (nascimento=48,1; 6 meses=151,1) e colesterol (nascimento=82,7; 6 meses=139,9), aumentaram no decorrer das avaliações. Glicemia permaneceu estável (nascimento=80,4; 6 meses=83,3) e insulina reduziu de 11,0, para 4,2). CONCLUSÃO: O crescimento dos recém-nascidos prematuros, apesar de linear, inferior ao esperado para idade. Perfil lipídico apresentou curva ascendente desde o nascimento.