Higher Metabolic Dysfunction in Adolescents Who Were Born Very Preterm: Case Control Study

• Author(s): de Brito Chagas, Joana ; Dinis, Isabel ; Oliveiros, Bárbara ; Mimoso, Gabriela ; Morais, Sofia
• Date: 2023
• Origin: Portuguese Journal of Pediatrics
• Subject(s): Original articles
• Document Type: Journal article
• Language: English

Description

Introduction: Literature has shown an increase in cardiovascular risk and metabolic changes in adolescents and young adults who were born preterm. In this regard, the present study aimed to assess metabolic dysfunction in adolescents who were born at less than 32 weeks of gestational age. Methods: This case-control study was performed on adolescents within the age range of 10-17 years and born in a level III maternity, with gestational age of < 32 weeks. Controls were healthy adolescents with gestational age of ≥ 37 weeks. Demographic data, cardiovascular risk history, and clinical data were evaluated and blood tests were performed. Results: In total, 110 preterm and 48 controls were enrolled in the study. Based on the results, mean systolic (118.8 vs 112.6 mmHg, p = 0.001) and diastolic (61.7 vs 58.5 mmHg, p = 0.014) blood pressures were statistically higher in preterm infants, compared to the controls. The preterm adolescents had a higher waist-to-height ratio, fat mass, fasting blood glucose, insulin, homeostasis model assessment for insulin resistance, total cholesterol, low-density lipoprotein, and apolipoprotein B100, compared to the controls. However, none of these differences were statistically significant. It was found that preterm adolescents had more metabolic dysfunction risk factors, compared to the controls (p = 0.007). Discussion: Prematurity contributes to higher cardiovascular risk and metabolic dysfunction. Moreover, higher arterial blood pressure seems to be the most important clinical finding in this study. Close monitoring of risk factors, particularly blood pressure, in adolescents who were born at less than 32 weeks is important for the prevention and early diagnosis of metabolic and cardiovascular comorbidities in adulthood.

Introdução A literatura internacional tem demonstrado aumento do risco cardiovascular em adolescentes e adultos jovens, que nasceram prematuros. Foi objetivo do estudo avaliar a disfunção metabólica em adolescentes que nasceram com menos de 32 semanas de idade gestacional. Métodos Estudo caso-controlo, de adolescentes entre os 10 e 17 anos, nascidos numa maternidade de nível III, com idade gestacional (IG) < 32 semanas. Os controlos são adolescentes saudáveis, com IG ≥ 37 semanas. Foram avaliados dados demográficos, antecedentes de risco cardiovascular, dados clínicos e foi realizada avaliação analítica. Para análise estatística foi utilizado o SPSS®, ao nível de significância de 0,05. Resultados Foi obtida uma amostra de 110 prematuros e 48 controlos. A pressão arterial sistólica (118.8 vs 112.6, p=0.001) e diastólica (61.7 vs 58.5, p=0.014) foi mais elevada nos prematuros do que nos controlos, de forma estatisticamente significativa. Apesar de os prematuros apresentarem maior razão cintura/altura, percentagem de massa gorda, glicémias em jejum, insulina, HOMA-IR, colesterol total, LDL, apolipoproteína B100, não houve significado estatístico. Verificámos que os prematuros apresentaram mais fatores de risco de disfunção metabólica relativamente aos controlos (p=0.008). Conclusões A prematuridade contribui para maior risco cardiovascular e disfunção metabólica. A pressão arterial mais elevada parece ser o achado clínico mais importante. Uma monitorização cuidada dos factores de risco, da pressão arterial em particular, em adolescentes que nasceram com < 32 semanas será importante para prevenir comorbilidades metabólicas e cardiovasculares na idade adulta.