Abstract Body: Introduction: A lipid profile with high concentrations of apolipoprotein B-containing lipoproteins - non-HDL cholesterol - is a risk factor for atherosclerotic cardiovascular disease. Accumulation of these lipoproteins is cumulative over the lifespan and high concentrations in childhood are associated with high concentrations later in life. Recently, we described developments of lipid traits from birth to 14-16 months of age, and showed that sex of the child, gestational age, and breastfeeding are influencing factors during this period. It is however unknown whether small for gestational age –a state with an unfavorable metabolic profile – influences lipid traits in early life.
Hypothesis: We tested the hypothesis that small for gestational age children have a more atherogenic lipid profile.
Methods: For this purpose, we used the Copenhagen Baby Heart Study comprising 13,354 umbilical cord blood samples and parallel venous blood samples from children and parents at birth (n=444), at two months (n=363), and at 14-16 months (n=158). All lipid traits were measured in mmol/L.
Results: In cord blood medians (25^th-75^th percentiles) for small, appropriate, and large for gestational age newborns were 0.98 (0.81-1.18), 0.95 (0.77-1.15), and 0.92 (0.72-1.15) for non-HDL cholesterol, 0.22 (0.17-0.31), 0.18 (0.13-0.23), and 0.14 (0.11-0.20) for remnant cholesterol, 0.50 (0.37-0.68), 0.39 (0.29-0.51), and 0.32 (0.25-0.44) for triglycerides, and 0.62 (0.46-0.79), 0.73 (0.58-0.91), and 0.78 (0.62-0.96) for HDL cholesterol (all p-values=0.0001). For total cholesterol and LDL cholesterol no differences were found according to size for gestational age. Girls have higher concentrations of lipid traits compared to boys but differences according to size for gestational age were similar in both sexes. Small for gestational age newborns of mothers with preeclampsia had the highest concentrations of non-HDL cholesterol, remnant cholesterol, and triglycerides. Differences according to size for gestational age were also found in venous blood samples at birth, at two months, and at 14-16 months for remnant cholesterol, triglycerides, and HDL cholesterol.
Conclusion: Small for gestational age newborns have higher concentrations of the atherogenic lipoprotein fractions non-HDL cholesterol and remnant cholesterol. These differences between small, appropriate, and large for gestational age observed early in life suggest increased risk of atherosclerotic cardiovascular disease later in life.