Catch-up growth in the first two years of life in Extremely Low Birth Weight (ELBW) infants is associated with lower body fat in young adolescence.
Catch-up growth in the first two years of life in Extremely Low Birth Weight (ELBW) infants is associated with lower body fat in young adolescence.
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DOI：
10.1371/journal.pone.0173349
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发表时间：
2017
期刊：
影响因子：
3.7
通讯作者：
Allegaert K
中科院分区：
文献类型：
--
作者：
Raaijmakers A;Jacobs L;Rayyan M;van Tienoven TP;Ortibus E;Levtchenko E;Staessen JA;Allegaert K
调查曾经的极低出生体重(ELBW，<；1000 g)儿童的生长模式和人体测量学，并将这些结果与童年时期的神经认知和身体成分联系起来。早产儿在出生时(n=140)、9个月和24个月(n≥96)以及大约11岁时在配对前(早产儿作为儿童心血管和肾脏健康的预测指标)病例对照研究(n=93-87)的框架内进行检查。使用区域生长图表将人体测量数据转换为Z分数。如果ΔZ-Score>；0.67SD，则生命头两年的追赶生长符合现在的条件。在11岁时，对人体测量学、神经认知能力、身体成分、握力和青春期分数进行了评估。低出生体重儿出生时身高、体重和头围Z值分别为-0.77、-0.93和-0.46，9个月时为-1.61、-1.67和-0.72，24个月时为-1.22、-1.61和-0.84，11岁时为-0.42、-0.49和-1.09。ELBW儿童在神经认知测试中的表现一直较差，平均智商相当于11岁的92.5岁(SD 13.1)。追赶成长与神经认知表现无关。与对照组相比，低体重组11岁时握力(13.6vs.15.9kgvs.15.9 kg)和瘦体重百分比(75.1vs.80.5%)较低，而体脂(24.6vs.19.2%)和青春期评分提前(均P≤0.025)。出生后头两年体重和身高的追赶增长与体脂百分比较低(体重追赶增长16.8%vs.25.7%，P<；0.001；身高追赶20.9%vs.25.8%，P=0.049)。在青春期，以前的低出生体重儿童仍然很难达到他们的目标身高。与正常的出生体重控制相比，ELBW青少年表现出较低的神经认知能力和握力，而较高的体脂百分比，这是成年后不利健康结果的潜在风险因素。我们的主要发现是，低出生体重儿童在出生后头两年的追赶生长与较低比例的体脂有关，因此可能是有益的。
To investigate growth patterns and anthropometrics in former extremely low birth weight (ELBW, <1000 g) children and link these outcomes to neurocognition and body composition in childhood. ELBW children were examined at birth (n = 140), at 9 and 24 months (n≥96) and at approximately 11 years within the framework of the PREMATCH (PREMATurity as predictor children’s of Cardiovascular and renal Health) case–control (n = 93–87) study. Regional growth charts were used to convert anthropometrics into Z–scores. Catch–up growth in the first two years of life was qualified as present if ΔZ–score >0.67 SDS. At 11 years, anthropometrics, neurocognitive performance, body composition, grip strength and puberty scores were assessed. ELBW neonates displayed extra–uterine growth restriction with mean Z–scores for height, weight and head circumference of –0.77, –0.93 and –0.46 at birth, –1.61, –1.67 and –0.72 at 9 months, –1.22, –1.61 and –0.84 at 24 months, and –0.42, –0.49 and –1.09 at 11 years. ELBW children performed consistently worse on neurocognitive testing with an average intelligence quotient equivalent at 11 years of 92.5 (SD 13.1). Catch–up growth was not associated with neurocognitive performance. Compared to controls, ELBW cases had lower grip strength (13.6 vs. 15.9 kg) and percentage lean body weight (75.1 vs. 80.5%), but higher body fat (24.6 vs. 19.2%) and advanced puberty scores at 11 years (all P≤0.025). Catch–up growth for weight and height in the first two years of life in cases was associated with a lower percentage body fat compared to cases without catch–up growth (16.8% catch-up growth for weight vs. 25.7%, P<0.001; 20.9% catch-up for height vs. 25.8%, P = 0.049). In young adolescence, former ELBW children still have difficulties to reach their target height. Compared to normal birth weight controls, ELBW adolescents show lower neurocognitive performance and grip strength and a higher percentage body fat, a potential risk factor for adverse health outcomes in adulthood. Our key finding is that catch–up growth in ELBW children in the first two years of life is associated with a lower percentage body fat and is therefore likely to be beneficial.