Cardiovascular and metabolic outcomes of offspring born small or early : the Raine study

R.-C. Huang, School of Medicine and Pharmacology, and School of Paediatrics and Child Health Research, University of Western Australia, Crawley, WA 6009, Australia. (Introduced by Janna Morrison)

Extensive epidemiological evidence confirms that being born small is associated with increased cardiovascular and metabolic risk. Increasingly it is understood that it is suboptimal in-utero environment that is the precursor for fetal programming.

The West Australian Pregnancy Cohort (Raine Study) recruited 2900 pregnant women in 1989-1990. Two thousand and eighty six neonates were born. The offspring have been followed up at birth, 1, 2, 3, 5, 8, 10, 14 and 17 years of age. Blood pressure was measured at each follow up. Fasting blood samples were taken at 8, 14 and 17 years. From this longitudinal prospective study, we have investigated the role of early life factors on increased cardio-metabolic risk. Specifically we have investigated the role of low birth size, high birth size (Huang et al., 2006), maternal obesity, maternal obstetric complications, childhood growth trajectories (Huang et al., 2011), lifestyle, (O'Sullivan et al., 2010; Ambrosini et al., 2010) genetic and epigenetic influences upon these outcomes.

The conglomeration of influences upon increased cardio-metabolic risk (Huang et al., 2009) in this contemporary Australian population cohort, indicate that, in addition to low birthweight, many other suboptimal in-utero and early postnatal conditions increased cardiovascular risk. We have confirmed in this population, that there is a U shaped relationship between birth size and cardio-metabolic risk (Figure) (Huang et al., 2007).

Proportion in the high metabolic risk cluster in different birth size quintiles. *p<0.05 compared to 2nd birth size quintile. (Huang et al., 2007)

Ambrosini GL, Huang RC, Mori TA, Hands BP, O'Sullivan TA, de Klerk NH, Beilin LJ, Oddy WH. (2010) Dietary patterns and markers for the metabolic syndrome in Australian adolescents. Nutrition Metabolism and Cardiovascular Diseases 20(4): 274-83.

Huang RC, Burke V, Newnham JP, Stanley FJ, Kendall GE, Landau LI, Oddy WH, Blake KV, Palmer LJ, Beilin LJ. (2007) Perinatal and childhood origins of cardiovascular disease. International Journal of Obesity 31(2): 236-44.

Huang RC, de Klerk NH, Smith A, Kendall GE, Mori TA, Newnham JP, Stanley FJ, Oddy WH, Hands B, Landau LI, Beilin LJ. (2011) Lifecourse childhood adiposity trajectories associated with adolescent insulin iesistance. Diabetes Care 34: 1019-1025

Huang RC, Mori TA, Burke V, Newnham J, Stanley FJ, Landau LI, Kendall GE, Oddy WH, Beilin LJ. (2009) Synergy between adiposity, insulin resistance, metabolic risk factors, and inflammation in adolescents. Diabetes Care 32: 695-701.

O'Sullivan TA, Lyons-Wall P, Bremner AP, Ambrosini GL, Huang RC, Beilin LJ, Mori TA, Blair E, Oddy WH. (2010) Dietary glycaemic carbohydrate in relation to the metabolic syndrome in adolescents: comparison of different metabolic syndrome definitions. Diabetic Medicine 27(7): 770-8.