Birth weight, subsequent growth, and cholesterol metabolism in children 8-12 years old born preterm

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Abstract
AIMS To test the hypothesis that plasma lipids, lipoproteins, and markers of cholesterol biosynthesis (lathosterol) and absorption efficiency (campesterol) in children aged 8–12 years are related to birth size and subsequent growth. METHODS A total of 412 girls and boys weighing less than 1850 g at birth were studied. Birth weight, gestation, and weight at 18 months were recorded and followed up at 8–12 years. Plasma total cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol, apolipoprotein A1, apolipoprotein B, triacylglycerol, lathosterol, and campesterol were measured. RESULTS Birth weight for gestational age was positively related to plasma campesterol, and remained so after adjusting for current body size or fatness. Birth weight was negatively related to current plasma lathosterol but only after adjusting for current body size or fatness. For both lathosterol and campesterol the significant relation with birth size adjusted for current size indicates that the change in size between these points (postnatal upward centile crossing) was influential. These relations were absent for total cholesterol, lipoproteins, apolipoproteins, and triacylglycerol. CONCLUSION Preterm children who were smaller for gestational age at birth had lower predicted cholesterol absorption efficiency 8–12 years later. Among children of the same current size, predicted endogenous cholesterol synthesis was higher and cholesterol absorption efficiency lower in those who showed the greatest increase in weight centile between birth and follow up. This finding was not confined to children with the smallest birth weights for gestational age. We suggest that both fetal and childhood growth relate to programming of cholesterol metabolism in children born preterm. Key messages Reduced birth size for gestational age was associated with decreased cholesterol absorption efficiency at 8–12 years old children born preterm Greater catch up in weight between birth and 8–12 years was strongly related to increased cholesterol synthesis and decreased absorption efficiency in all birth weight groups Current childhood fatness was related to increased cholesterol synthesis and decreased absorption efficiency even within the normal range of fatness Influence of pre- and postnatal growth on key markers of cholesterol metabolism during childhood may be important in adult cholesterol handling