The long-term consequences of prematurity - the metabolic syndrome in children and adolescents: is there a risk?

• Yuliya S. Rafikova
• Mariya A. Podporina
• Tatiyana V. Saprina
• Elena V. Loshkova
• Evgeniy V. Mikhalev

Abstract

Aim - to assess the burden of family history of metabolic syndromecomponents and prematurity, and the presence of metabolic syndromecomponents in children and adolescents born prematurely.

Material and methods. The study involved 123 people born during the period 1997-2008. 58 children born prematurely, age (12±1.3) years, gestation period (33.07±1.9) weeks (main group). The control group comprised 65 full-term peers, age (12.7±2.2) years, duration of gestation (39.5±0.8) weeks. Participants were evaluated for PD (height, weight, body mass index (BMI), waist circumference (OT), hip circumference (OB)) in the WHO AnthroPlus program, MS Components, assessed according to the recommendations of the International Diabetes Federation (IDF).

Results. In the main group, cases of preterm labor were 44.8% versus 3.07% in the control group (p<0.0001). In mothers of the main group AH was registered in 27.6% against 4.6% in the control group (p=0.002). In grandmothers, the mother in the main group AH: 69%, compared with 10.8% in the control group (p<0.0001). Mothers of premature babies were more likely to suffer from obesty: 29.3% versus 9.2% in mothers of the term infants (p=0.008). Obesity at grandmothers on a line of mother in the basic group was registered 44.8%, in group of the control - 10.8% (p<0.0001). Overweight of 31% in the main group and 9.2% in the control group (p=0.002). Abdominal type of fat release (R/OB>0.8) had 21 people, in the control group 4 (p<0.0001). From >90 percentile had 5.2% of preterm. The Z-score of BMI in boys and girls, WC/TC higher in the main group than in the control group (p=0.04, p=0.01, p<0.0001) respectively. In preterm girls of pubertal age, the level of LDL and IA is higher than in term donors (p=0.04) and (p=0.02), respectively. Weight, height, z-score of growth, WC, TC, BMI in them are interrelated with the level of TAG in the serum of preterm girls, p=0.002; p=0.03; p=0.03; p=0.005; p<0.0001; p=0.02, respectively. AH as a component of MS was registered in 37.9% in the main group, in the control group in 1.5% (p<0.0001). Normal blood pressure was 51.7% of the main group, in the control group 89.2% (p<0.0001). AH among children and adolescents born prematurely 34.5%, in the group of healthy peers 1.5% (p<0.0001). In preterm girls, the blood pressure level is associated with the Tyg index (p=0.004).

Conclusion. The anamnesis of premature infants and adolescents is highly burdensome in terms of prematurity and MS components. Abdominal type of fat deposits along with excess body weight are more common in the cohort of prematurity. The level of fasting glycaemia and lipidogram indices did not have significant deviations from the norm in the general sample, however, preterm girls of the pubertal period showed an increase in the level of low-density lipoproteins and a high degree of association of physical development (PD) indices with the level of TAG. About 40% of children and adolescents born prematurely have BP >90 percentile, and a little less registered arterial hypertension I degree. The level of blood pressure in preterm girls is associated with the Tyg index, and the PD indices are associated with the TAG level.

Keywords:feeding behavior, prematurity, physical development, children

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