Progression of Cardio-Metabolic Risk Factors in Subjects Born Small and Large for Gestational Age

Background

Subjects born small (SGA) and large (LGA) for gestational age have an increased risk of cardio-metabolic alterations already during prepuberty. Nevertheless, the progression of their cardio-metabolic profile from childhood to adolescence has not been fully explored. Our aim was to assess potential changes in the cardio-metabolic profile from childhood to adolescence in subjects born SGA and LGA compared to those born appropriate (AGA) for gestational age.

Methods

This longitudinal study included 35 AGA, 24 SGA and 31 LGA subjects evaluated during childhood (mean age (±SD) 8.4±1.4 yr) and then re-assessed during adolescence (mean age 13.3±1.8 yr). BMI, blood pressure, insulin resistance (fasting insulin, HOMA-IR) and lipids were assessed. A cardio-metabolic risk z-score was applied and this consisted in calculating the sum of sex-specific z-scores for BMI, blood pressure, HOMA-IR, triglycerides and triglycerides:high-density lipoprotein cholesterol ratio.

Results

Fasting insulin and HOMA-IR were higher in SGA and LGA than AGA subjects both during childhood (all P<0.01) and adolescence (all P<0.01). Similarly, the clustered cardio-metabolic risk score was higher in SGA and LGA than AGA children (both P<0.05), and these differences among groups increased during adolescence (both P<0.05). Of note, a progression of the clustered cardio-metabolic risk score was observed from childhood to adolescence within SGA and within LGA subjects (both P<0.05).

Conclusions

SGA and LGA subjects showed an adverse cardio-metabolic profile during childhood when compared to AGA peers, with a worsening of this profile during adolescence. These findings indicate an overtime progression of insulin resistance and overall estimated cardiovascular risk from childhood to adolescence in SGA and LGA populations.     

Liver steatosis in obese prepubertal children: a possible role of insulin resistance

Objective: To determine whether in obese prepubertal children insulin resistance (IR) is associated with the development of liver steatosis. Methods and Procedures: Cross‐sectional study evaluating the prevalence of liver steatosis in 100 severely obese prepubertal children and comparing IR indexes between children with (group 1) and without steatosis (group 2). Furthermore, IR indexes were compared to values of 50 normal weight children. Fasting blood samples were collected for the evaluation of liver function tests, lipid profile, plasma glucose, and insulin levels. All children underwent an oral glucose tolerance test and anthropometric measurements. Hepatic ultrasound was performed according to international criteria and by one single operator. Analysis was performed by Mann–Whitney U‐test, Pearson correlation, and logistic regression. Results: Liver steatosis was found in 52% obese children and was equally distributed between the two sexes. Obese children were more insulin resistant when compared to controls (homeostasis model assessment of IR (HOMA‐IR): P = 0.0001; whole body insulin sensitivity index (WBISI): P = 0.0005; fasting glucose/fasting insulin ratio (G/I): P = 0.0001), and group 1 presented an even higher degree of IR when compared to group 2 (HOMA‐IR P = 0.0001; WBISI P = 0.0004; G/I P = 0.0001). The area under the curve (AUC) for insulin was significantly higher in group 1 when compared to group 2, while no difference was found in the AUC for glucose. There was no association between IR and adiposity indexes (P >0.05). The role of IR as a predictor for the development of steatosis was analyzed by multiple logistic regression, which documented that IR indexes were significantly related to steatosis independently of BMI‐SDS. Discussion: Liver steatosis is an emerging problem in prepubertal severely obese children, and it appears to be an association between liver steatosis and IR in these subjects.     

Mercury distribution in estuarine environments from Argentina: the detoxification and recovery of salt marshes after 15 years

Total Hg contents from abiotic (surface sediments and suspendedparticulate matter) and biological (crabs, fishes and halophytes)compartments from Bahía Blanca estuary and Mar Chiquita CoastalLagoon, Argentina, have been monitored since the 1980's. At BahíaBlanca estuary, high Hg concentrations were recorded during the early1980's in surface sediments (0.34 ± 0.22 g/g) andsuspended particulate matter (0.19 ± 0.10 g/g). Fishspecies, Mustelus schmitti (0.89 ± 0.29 g/g), Paralichthys brasiliensis (0.85 ± 0.18 g/g) and Micropogonias furnieri (0.37 ± 0.11 g/g) also presentedhigh Hg concentrations. The large industrial nucleus located within theestuary has been identified as the main metal source for this environment.Hg contents from the same area during 1996–1998 were significantlylower: surface sediments (0.164 ± 0.023 g/g), suspendedparticulate matter (0.048 ± 0.0017 g/g), fish Micropogonias furnieri (0.13 ± 0.02 g/g) and crab Chasmagnathus granulata (0.334 ± 0.071 g/g). This trendof environmental detoxification is probably related with (i) thetechnological changes incorporated by the local industry, (ii) a mostadequate management of industrial effluents, and (iii) the removal ofgreat sediment volume by dredging and refill.During the 1980's Mar Chiquita Lagoon Hg concentrations reached 0.08± 0.01 g/g in surface sediments and 0.09 ±0.025 g/g in suspended particulate matter, and 0.14 ±0.04 g/g in the fish Basilichthys bonariensis and 0.22 ±0.08 g/g in Paralichthys brasiliensis, and 0.08 ±0.01 g/g in the crab C. granulata, Hg concentrations werelower than at Bahía Blanca. Remote Hg sources for this Coastal Lagoonand atmospheric and stream transport of Hg is proposed as major Hgsources, since no Hg point sources exists nearby. Mercury concentrationsrecorded in the 1996–1998 period were lower than those recorded inthe previous decade: surface sediments (0.019 ± 0.004 g/g), suspended particulate matter (0.030 ± 0.008 g/g), halophyte Spartina densiflora (0.013 ± 0.008 g/g) or crab C. granulata (0.011 ± 0.009 g/g).Both Hg bioaccumulation and biomagnification processes were verified inBahía Blanca estuary and in Mar Chiquita Coastal Lagoon. This apparentrecovery of both estuarine environments deserves to be carefully analyzed,in order to fully understand the foundations of these processes.