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

AIMS—To test the hypothesis thatplasma lipids, lipoproteins, and markers of cholesterol biosynthesis(lathosterol) and absorption efficiency (campesterol) in children aged8-12 years are related to birth size and subsequent growth.
METHODS—A total of 412 girls andboys weighing less than 1850 g at birth were studied. Birth weight,gestation, and weight at 18 months were recorded and followed up at8-12 years. Plasma total cholesterol, low density lipoproteincholesterol, high density lipoprotein cholesterol, apolipoprotein A1,apolipoprotein B, triacylglycerol, lathosterol, and campesterol were measured.
RESULTS—Birth weight forgestational age was positively related to plasma campesterol, andremained so after adjusting for current body size or fatness. Birthweight was negatively related to current plasma lathosterol but onlyafter adjusting for current body size or fatness. For both lathosteroland campesterol the significant relation with birth size adjusted forcurrent size indicates that the change in size between these points(postnatal upward centile crossing) was influential. These relationswere absent for total cholesterol, lipoproteins, apolipoproteins, and triacylglycerol.
CONCLUSION—Preterm children whowere smaller for gestational age at birth had lower predictedcholesterol absorption efficiency 8-12 years later. Among children ofthe same current size, predicted endogenous cholesterol synthesis washigher and cholesterol absorption efficiency lower in those who showedthe greatest increase in weight centile between birth and follow up.This finding was not confined to children with the smallest birthweights for gestational age. We suggest that both fetal and childhoodgrowth relate to programming of cholesterol metabolism in children born preterm.