Article type: Research Article
Authors: Mestan, Karen | Ouyang, Fengxiu | Matoba, Nana | Pearson, Colleen | Ortiz, Katherin | Wang, Xiaobin
Affiliations: Division of Neonatology, Children's Memorial Hospital,
and Department of Pediatrics, Feinberg School of Medicine, Northwestern
University, Chicago, IL, USA | Mary Ann and J. Milburn Smith Child Health Research
Program, Children's Memorial Hospital and Children's Memorial Research Center,
and Department of Pediatrics, Feinberg School of Medicine, Northwestern
University, Chicago, IL, USA | Department of Pediatrics, Boston University School of
Medicine and Boston Medical Center, Boston, MA, USA
Note: [] Correspondence: Karen Mestan, MD, Division of Neonatology,
Children's Memorial Hospital, 2300 Children's Plaza, Box 45 Chicago, IL 60614,
USA. Tel.: +1 773 880 4536; Fax: +1 773 880 3061; E-mail:
[email protected]
Abstract: Infants born large-for-gestational age (LGA) are at risk for early
childhood obesity. The aims of this study were to investigate factors
associated with LGA status and their relationship to inflammatory biomarkers
that have been implicated in the LGA infant at birth. Included were 364
mother-infant pairs enrolled as part of an ongoing longitudinal cohort study of
infant birth weight being conducted at Boston Medical Center (BMC). LGA was
defined as birth weight (BW) ⩾ 90th percentile of the
reference population at BMC (N=45).
Appropriate-for-gestational age (AGA) was defined as BW<90th
and >10th percentile (N=319). Cord
blood IL-6, IL-8, TNF-alpha and RANTES levels were analyzed from a larger panel
of immune biomarkers measured using multiplex immunoassay. Multivariate
regression models were used to determine the associations between LGA status,
maternal BMI and diabetes (DM), which included either gestational or type 2
diabetes (T2DM), and cord blood biomarkers, with adjustment for important
demographic and clinical variables. Maternal pre-pregnancy BMI within the
obesity range (⩾30 kg/m^{2}), as well
as DM, were each associated with increased risk of LGA (OR=2.64, 95%CI 1.31–6.20; OR=5.58, 95%CI 2.06–15.13, respectively).
Among the 4 biomarkers, only RANTES (regulated on activation, normal T cell
express and secreted upon uptake), which is a chemokine secreted by white
adipose tissue, was significantly increased in LGA infants (beta-coefficient
=0.37; 95%CI: 0.09, 0.65; P<0.01).
This association remained essentially unchanged after adjustment for maternal
DM and BMI (beta-coefficient=0.37; 95%: 0.08, 0.65; P=0.01). Ponderal index (PI=BWx100/length^{3}) was also positively correlated with
RANTES. Cord blood RANTES is selectively elevated with fetal macrosomia,
independent of maternal factors. Further investigation of RANTES as a marker of
LGA and future childhood health is warranted.
Keywords: Birth weight, large-for-gestational age, cord blood, inflammation, obesity, diabetes
DOI: 10.3233/JPB-2010-0023
Journal: Journal of Pediatric Biochemistry, vol. 1, no. 3, pp. 217-224, 2010/2011
Received 3 September 2010
|
Accepted 21 October 2010
|
Published: 2010/2011