Jussinniemi Laura, Kulmala Maarit K, Aakvik Kristina A D, Benum Silje D, Jørgensen Anna P M, Balasuriya Chandima N D, Stunes Astrid K, Syversen Unni, Indredavik Marit S, Andersson Sture, Hovi Petteri, Evensen Kari Anne I, Kajantie Eero
Clinical Medicine Research Unit, Oulu University Hospital and University of Oulu, Oulu, Finland.
Public Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland.
Pediatr Res. 2024 Apr;95(5):1316-1324. doi: 10.1038/s41390-023-02896-5. Epub 2023 Nov 16.
Studies on body composition in preterm very low birth weight (VLBW < 1500 g) survivors are inconsistent and trajectories later in life unknown. We assessed body composition and its change from young to mid-adulthood in VLBW adults.
We studied 137 VLBW adults and 158 term-born controls from two birth cohorts in Finland and Norway at mean age 36 years. Body composition was assessed by 8-polar bioelectrical impedance. We compared results with dual-energy x-ray absorptiometry measurements at 24 years.
In mid-adulthood, VLBW women and men were shorter than controls. Fat percentage (mean difference in women 1.1%; 95% CI, -1.5% to 3.5%, men 0.8%; -2.0% to 3.6%) and BMI were similar. VLBW women had 2.9 (0.9 to 4.8) kg and VLBW men 5.3 (2.7 to 8.1) kg lower lean body mass than controls, mostly attributable to shorter height. Between young and mid-adulthood, both groups gained fat and lean body mass (p for interaction VLBW x age>0.3).
Compared with term-born controls, VLBW adults had similar body fat percentage but lower lean body mass, largely explained by their shorter height. This could contribute to lower insulin sensitivity and muscular fitness previously found in VLBW survivors and predispose to functional limitations with increasing age.
In mid-adulthood, individuals born preterm with very low birth weight had similar body fat percentage but lower lean body mass than those born at term. This was largely explained by their shorter height. First study to report longitudinal assessments of body size and composition from young to mid-adulthood in very low birth weight adults. Lower lean body mass in very low birth weight adults could contribute to lower insulin sensitivity and muscular fitness and lead to earlier functional limitations with increasing age.
关于极低出生体重（VLBW＜1500g）早产儿成年后的身体成分研究结果并不一致，其成年后的身体变化轨迹也尚不明确。我们评估了极低出生体重成年人从青年到中年的身体成分及其变化情况。
我们对来自芬兰和挪威两个出生队列的137名极低出生体重成年人和158名足月儿对照者进行了研究，平均年龄为36岁。采用八电极生物电阻抗法评估身体成分。我们将结果与24岁时的双能X线吸收法测量结果进行了比较。
在中年时，极低出生体重的女性和男性比对照组矮。脂肪百分比（女性平均差异为1.1%；95%可信区间，-1.5%至3.5%，男性为0.8%；-2.0%至3.6%）和体重指数相似。极低出生体重的女性比对照组瘦体重低2.9（0.9至4.8）kg，极低出生体重的男性比对照组低5.3（2.7至8.1）kg，这主要归因于身高较矮。在青年到中年期间，两组的脂肪和瘦体重均有所增加（极低出生体重与年龄交互作用的p值＞0.3）。
与足月儿对照组相比，极低出生体重的成年人脂肪百分比相似，但瘦体重较低，这在很大程度上是由他们较矮的身高所导致的。这可能是先前在极低出生体重幸存者中发现的胰岛素敏感性降低和肌肉适应性较差的原因，并随着年龄增长易导致功能受限。
在中年时，出生时极低体重的早产儿与足月儿相比，脂肪百分比相似，但瘦体重较低。这在很大程度上是由他们较矮的身高所导致的。这是第一项报告极低出生体重成年人从青年到中年身体大小和成分纵向评估的研究。极低出生体重成年人较低的瘦体重可能会导致胰岛素敏感性降低和肌肉适应性较差，并随着年龄增长导致更早的功能受限。
