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Prenatal growth and metabolic syndrome components among Chilean children

  • F. Mardones (a1), L. Villarroel (a1), P. Arnaiz (a2), S. Barja (a2), A. Domínguez (a1), O. Castillo (a3), M. Farías (a4), J. G. Eriksson (a5) (a6) (a7) and P. Pacheco (a1)...


The association of prenatal growth with metabolic syndrome (MS) components and insulin resistance (IR) in children has not been studied in Chile and most developing countries. Some associations found in developed countries are controversial. A retrospective cohort study was designed linking present information on MS components and IR in children with register-based information on birth weight (BW), birth length (BL) and gestational age (GA). Examinations included anthropometry and blood pressure (BP), as well as self-report of pubertal status. A fasting blood sample was taken to determine lipids, glucose, insulin and homeostasis model assessment (HOMA)-IR was calculated. The study cohort of 2152 children was on average 11.4 ± 1.0 years old. The prevalence of MS, IR and overweight were 7.6%, 24.5% and 34%, respectively. Elevated BP was negatively associated with dichotomized risk categories of the perinatal factors studied (BW, BL and GA). Contingency tables showed that high waist circumference (WC) and elevated BP had a U-shaped association with various categories of BW and BL, respectively. Stepwise linear regressions selected: (a) WC as inversely associated to GA and directly associated to BW, (b) BP as inversely associated to GA and (c) HOMA-IR as inversely associated to BL. Non-optimal prenatal growth seems to predispose to high WC, elevated BP and IR in school-age children, supporting the early life origin of several non-communicable diseases. Those associations were rather weak as estimated by the slopes of the regressions and probably reduced by their U-shaped nature; they would reasonably become stronger with a longer follow-up.


Corresponding author

*Address for correspondence: Dr F. Mardones, Department of Public Health, Pontificia Universidad Católica de Chile, Código Postal 833-0073, Marcoleta 434, Santiago, Chile. (Emails:,


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1. Expert panel on detection, evaluation and treatment of high blood cholesterol in adults. Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001; 285, 2486–2497.
2.Cook, S, Weitzman, M, Auinguer, P, et al. . Prevalence of a metabolic syndrome phenotype in adolescents: findings from the third National Health and Nutrition Examination Survey, 1988–1994. Arch Pediatr Adolesc Med. 2003; 157, 821827.
3.Prentice, A. Impact of early nutrition on later chronic disease outcomes epidemiological studies. In The Influence of Maternal, Fetal and Child Nutrition on the Development of Chronic Disease in Later Life (ed. Prentice A), 2011; pp. 5779. Stationery Office Limited: London.
4.Barker, D, Osmond, C, Golding, J, et al. . Growth in utero, blood pressure in childhood and adult life, and mortality from cardiovascular disease. BMJ. 1989; 298, 564567.
5.Hales, CN, Barker, DJ, Clark, PM, et al. . Fetal and infant growth and impaired glucose tolerance at age 64. BMJ. 1991; 303, 10191022.
6.Mardones, F, Urrutia, MT, Villarroel, L, et al. . Effects of a dairy product fortified with multiple micronutrients and omega-3 fatty acids on birth weight and gestation duration in pregnant Chilean women. Public Health Nutr. 2008; 11, 3040.
7.Mardones, F, García-Huidobro, T, Ralph, C, et al. . Combined influence of preconception body mass index and gestational weight gain on fetal growth. Rev Med Chile. 2011; 139, 710716.
8.Casanueva, V, Milos, C, Lopetegui, B, et al. . Influence of ethnic and environmental factors the lipid profile in school children from the VIII Region. Rev Med Chile. 1995; 122, 496502.
9.Berríos, X, Jadue, L. Primary prevention of adult chronic diseases: interventions at school age. Rev Chil Pediatr. 1994; 64, 397402.
10.Burrows, R, Gattas, V, Leiva, L, et al. . Biological, familial and metabolic characteristics of infantile and juvenile obesity. Rev Med Chile. 2001; 129, 11551162.
11.Barja, S, Arteaga, A, Acosta, AM, et al. . Insulin resistance and other expressions of metabolic syndrome in obese Chilean children. Rev Med Chile. 2003; 131, 259268.
12.Burrows, R, Leiva, L, Weistaub, G, et al. . Prevalence of metabolic syndrome in a sample of Chilean children consulting in an obesity clinic. Rev Med Chile. 2007; 135, 174181.
13.Barja, S, Arnaíz, P, Acevedo, M, et al. . Early markers for atherosclerosis and metabolic syndrome in children. Rev Med Chile. 2009; 137, 522530.
14.Eyzaguirre, F, Silva, R, Román, R, et al. . Prevalence of metabolic syndrome in children and adolescents who consult with obesity. Rev Med Chile. 2011; 139, 732738.
15. Instituto Nacional de Estadística, Chile. Yearly report of vital statistics [Internet], 2008. Retrieved from [accessed December 27, 2011].
16.Mardones, F, Villarroel, L, Karzulovic, L, et al. . Association of perinatal factors and obesity in 6- to 8-year-old Chilean children. Int J Epidemiol. 2008; 37, 902910.
17.Fernandez, J, Redden, D, Pietrobelli, A, et al. . Waist circumference percentiles in nationally representative samples of African-American, European American and Mexican American children and adolescents. J Pediatr. 2004; 145, 439444.
18. The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents. National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents. Pediatrics. 2004; 114, 555–576.
19.Barja, S, Arnaiz, P, Domínguez, A, et al. . Normal plasma insulin and HOMA values among Chilean children and adolescents. Rev Med Chile. 2011; 139, 14441452.
20. Centers for Disease Control and Prevention. Overview of the CDC Clinical Growth Charts [Internet]. Retrieved from [accessed December 27, 2011].
21.National Health and Nutrition Examination Survey [Internet]. Anthropometry Procedures Manual, January 2004. Retrieved from [accessed December 27, 2011].
22.Slaughter, M, Lohman, T, Boileau, R, et al. . Skinfold equations for estimation of body fatness in children and youth. Hum Biol. 1988; 60, 709723.
23.Urrejola, P, Hodgson, M, Icaza, M. Evaluación de la composición corporal en niñas usando impedanciometría bioeléctrica y pliegues subcutáneos. Rev Chil Pediatr. 2001; 72, 2633.
24.Liberona, Y, Castillo, O, Engler, V, et al. . Nutritional profile of schoolchildren from different socio-economic levels in Santiago, Chile. Public Health Nutr. 2011; 14, 142149.
25.Tanner, J. Growth at Adolescence, 2nd edn, 1962. Blackwell Scientific Publications: Oxford.
26.Matthews, DR, Hosker, JP, Rudenski, AS, et al. . Homeostasis model assessment: insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia. 1985; 28, 412419.
27.Ying Lee, CM, Huxley, RR, Wildman, RP, et al. . Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: a meta-analysis. J Clin Epidemiol. 2008; 61, 646653.
28.Freedman, DS, Serdula, MK, Srinivasan, MK, et al. . Relation of circumferences and skinfold thicknesses to lipid and insulin concentrations in children and adolescents: the Bogalusa Heart Study. Am J Clin Nutr. 1999; 69, 308317.
29.Acevedo, M, Tagle, R, Kramer, V, et al. . Hipertensión arterial: el factor de riesgo más importante para grosor íntima-media carotídeo elevado y placa carotídea en adultos de Santiago. Rev Med Chile. 2011; 139, 290297.
30.Eriksson, J, Forsén, T, Tuomilehto, J, et al. . Size at birth, fat-free mass and resting metabolic rate in adult life. Horm Metab Res. 2002; 34, 7276.
31.Eriksson, J, Yliharsila, H, Forse′n, T, et al. . Exercise protects against glucose intolerance in individuals with a small body size at birth. Prev Med. 2004; 39, 164167.
32.Murtaugh, M, Jacobs, D, Moran, A, et al. . Relation of birth weight to fasting insulin, insulin resistance, and body size in adolescence. Diabetes Care. 2003; 26, 187192.
33.Kytnarova, J, Zlatohlavková, B, Kubena, A, et al. . Post-natal growth of 157 children born as extremely premature neonates. J Paediatr Child Health. 2001; 47, 111116.
34.Durmuş, B, Ay, L, Hokken-Koelega, AC, et al. . Maternal smoking during pregnancy and subcutaneous fat mass in early childhood. The Generation R Study. Eur J Epidemiol. 2011; 26, 295304.
35.Coelli, AP, Nascimento, LR, Mill, JG, et al. . Preterm birth as a risk factor for high blood pressure in children: a systematic review. Cad Saude Publica. 2011; 27, 207218.
36.Rahiala, E, Tenhola, S, Vanninen, E, et al. . Ambulatory blood pressure in 12-year-old children born small for gestational age. Hypertension. 2002; 39, 909913.
37.Adair, L, Martorell, R, Stein, A, et al. . Size at birth, weight gain in infancy and childhood, and adult blood pressure in 5 low- and middle-income-country cohorts: when does weight gain matter? Am J Clin Nutr. 2009; 89, 13831392.
38.Martinez-Aguayo, A, Aglony, M, Bancalari, R, et al. . Birth weight is inversely associated with blood pressure and serum aldosterone and cortisol levels in children. Clin Endocrinol (Oxf). 2011; E-pub ahead of print; doi: 10.1111/j.1365-2265.2011.04308.x.
39.Law, CM, Egger, P, Dada, O, et al. . Body size at birth and blood pressure among children in developing countries. Int J Epidemiol. 2001; 30, 5257.
40.Tian, JY, Cheng, Q, Song, XM, et al. . Birth weight and risk of type 2 diabetes, abdominal obesity and hypertension among Chinese adults. Eur J Endocrinol. 2006; 155, 601607.
41.Law, CM, Barker, DJ, Osmond, C, et al. . Early growth and abdominal fatness in adult life. J Epidemiol Community Health. 1992; 46, 184186.
42.Laitinen, J, Pietiläinen, K, Wadsworth, M, et al. . Predictors of abdominal obesity among 31-y-old men and women born in Northern Finland in 1966. Eur J Clin Nutr. 2004; 58, 180190.
43.Dolan, MS, Sorkin, JD, Hoffman, DJ. Birth weight is inversely associated with central adipose tissue in healthy children and adolescents. Obesity. 2007; 15, 16001608.
44.Oken, E, Gillman, M. Fetal origins of obesity. Obes Res. 2003; 11, 496506.
45.Rolfe, E, Loos, R, Druet, C, et al. . Association between birth weight and visceral fat in adults. Am J Clin Nutr. 2010; 92, 347352.
46.Uauy, R, Kain, K, Corvalan, C. How can the developmental origins of health and disease (DOHaD) hypothesis contribute to improving health in developing countries? Am J Clin Nutr. 2011; 94 (Suppl. 6), 1759S1764S.
47.Mardones, F. Origen temprano de las enfermedades crónicas: Implicancias en Pediatría. [Early origins of chronic diseases: implications for Pediatrics]. In Meneghello Pediatria (eds. Paris E, Sánchez I, Beltramino D, Copto A), 6th edn, 2011; pp. 4551. Editorial Panamericana: Buenos Aires.
48.Victora, CG, Adair, L, Fall, C, et al. . Maternal and child undernutrition study group – Maternal and child undernutrition: consequences for adult health and human capital. Lancet. 2008; 371, 340357.
49.Li, C, Huang, TT-K, Cruz, ML, et al. . Birth weight, puberty, and systolic blood pressure in children and adolescents: a longitudinal analysis. J Hum Hypertens. 2006; 20, 444450.
50.Coleman, L, Coleman, J. The measurement of puberty: a review. J Adolesc. 2002; 25, 535550.
51.Chan, NP, Sung, RY, Kong, AP, et al. . Reliability of pubertal self-assessment in Hong Kong Chinese children. J Paediatr Child Health. 2008; 44, 353358.
52.Chan, NP, Sung, RY, Nelson, EA, et al. . Measurement of pubertal status with a Chinese self-reported pubertal development scale. Matern Child Health J. 2010; 14, 466473.


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Prenatal growth and metabolic syndrome components among Chilean children

  • F. Mardones (a1), L. Villarroel (a1), P. Arnaiz (a2), S. Barja (a2), A. Domínguez (a1), O. Castillo (a3), M. Farías (a4), J. G. Eriksson (a5) (a6) (a7) and P. Pacheco (a1)...


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