Poland: Study on SGA Children and Lipid Profiles

Children born small for gestational age (SGA), even those not suffering from obesity or overweight in early childhood, have an abnormal lipid profile that may contribute to the development of cardiovascular disease (CVD) in adulthood, a recent study published in Nutrients has claimed.

The issue of low birth weight (LBW) remains a significant public health concern worldwide. Birth weight is regarded as one of the predictors of child morbidity and mortality. According to the WHO, LBW newborns are defined as those weighing below 2500 g (up to and including 2499 g). LBW refers to an absolute weight of <2500 g, independent of gestational age.

SGA is defined as birth weight below the tenth centile for gestational age and impacts about 5 to 10% of neonates in developed countries. Lipid disorders are one of the risk factors for cardiovascular diseases. Justyna Zamojska, Medical University of Lodz, Lodz, Poland, and colleagues aimed to estimate the lipid profile in early childhood in the population of Polish children born small for gestational age.

The study included 140 patients (93 SGA children and 48 controls) aged 5 to 11 years. All children underwent blood laboratory tests and physical examinations for the lipid and glucose profiles. The SGA group was categorized into subgroups, i.e., symmetrical and asymmetrical intrauterine growth restriction (IUGR).

Study Findings

• Blood sample analysis revealed higher levels of total cholesterol (SGA group 190.61 ± 24.66 mg/dL vs. controls 143.23 ± 23.90).
• The analysis of particular cholesterol fractions showed significantly higher mean values of triglycerides and LDL cholesterol and lower mean values of HDL cholesterol in SGA children.
• Children in both groups did not differ significantly concerning weight or body mass index.
• A statistically significantly higher glucose concentration was observed in SGA patients with the symmetrical type of IUGR.
• Analyzing the differences regarding metabolic factors, we obtained a statistically significant difference only in fasting glucose concentration (asymmetrical IUGR = 90.56 ± 10.21 vs. symmetrical IUGR = 98.95 ± 14.79).

The study contributes to the professional literature by demonstrating that children born SGA, with no differences in BMI and weight, have an abnormal lipid profile compared to AGA children. This could be a potential risk factor for CVD in adulthood. Therefore, it is justified to conduct a study on a larger group of patients born with SGA.

"It would be also important to investigate the correlation between the results of metabolic tests and assessment of the intima-media complex, as an independent marker of cardiovascular risk in SGA patients," the researchers wrote.

"This group should be closely monitored by a team of specialists, including cardiologists, paediatricians, endocrinologists, pediatric cardiologists, and pediatric nutritionists to prevent cardiovascular complications," they concluded.

The major limitation was that the study was multi-centre, hence, was carried out on a relatively small group of patients. Secondly, the study design was based on collected retrospective data.

Reference

Zamojska, J., Kierzkowska, B., Gruca, M., Wosiak, A., & Smolewska, E. (2022). Lipid Profile in Children Born Small for Gestational Age. Nutrients, 15(22), 4781. https://doi.org/10.3390/nu15224781