A1 Refereed original research article in a scientific journal
Indicators of fetal growth and adult liver enzymes: the Bogalusa Heart Study and the Cardiovascular Risk in Young Finns Study
Authors: Harville EW, Chen W, Bazzano L, Oikonen M, Hutri-Kahonen N, Raitakari O
Publisher: CAMBRIDGE UNIV PRESS
Publication year: 2017
Journal: Journal of Developmental Origins of Health and Disease
Journal name in source: JOURNAL OF DEVELOPMENTAL ORIGINS OF HEALTH AND DISEASE
Journal acronym: J DEV ORIG HLTH DIS
Volume: 8
Issue: 2
First page : 226
Last page: 235
Number of pages: 10
ISSN: 2040-1744
eISSN: 2040-1752
DOI: https://doi.org/10.1017/S2040174416000635
Abstract
Despite the interest in the relationship of fetal exposures to adult cardiovascular disease, few studies have examined indicators of adult fatty liver disease as an outcome. Previous results are inconsistent, and indicate possible variation by sex. Adult liver enzymes [gamma-glutamyl transferase (GGT), alanine transaminase (ALT) and aspartase transaminase (AST)] were measured in two cohort studies: the Bogalusa Heart Study (BHS; n=1803) and the Cardiovascular Risk in Young Finns (YF; n=3571) study, which also had ultrasound measures of liver fat (n=2546). Predictors of dichotomized (clinical cut-offs) and continuous (within the reference range) liver enzymes included low birthweight (<2500 g), macrosomia (>4000 g), small-for-gestational-age (birthweight <10th percentile for gestational age for population), large-for-gestational-age (>90th percentile), and preterm birth. Multiple logistic and linear regression were conducted, adjusted for medical, behavioral and socioeconomic indicators. Interactions with sex were also examined. In BHS, birth measures were not strongly associated with clinically high levels of liver enzymes, and within the reference range measures of reduced growth were associated with increased AST in women. In the YF study, at least one marker of reduced growth was associated with higher GGT, higher ALT and higher AST (in women). Probable fatty liver on ultrasound was associated with low birthweight (2.41, 1.42-4.09) and preterm birth (2.84, 1.70-4.76). These results suggest a link between birth parameters and adult fatty liver, but encourage consideration of population variation in these relationships.
Despite the interest in the relationship of fetal exposures to adult cardiovascular disease, few studies have examined indicators of adult fatty liver disease as an outcome. Previous results are inconsistent, and indicate possible variation by sex. Adult liver enzymes [gamma-glutamyl transferase (GGT), alanine transaminase (ALT) and aspartase transaminase (AST)] were measured in two cohort studies: the Bogalusa Heart Study (BHS; n=1803) and the Cardiovascular Risk in Young Finns (YF; n=3571) study, which also had ultrasound measures of liver fat (n=2546). Predictors of dichotomized (clinical cut-offs) and continuous (within the reference range) liver enzymes included low birthweight (<2500 g), macrosomia (>4000 g), small-for-gestational-age (birthweight <10th percentile for gestational age for population), large-for-gestational-age (>90th percentile), and preterm birth. Multiple logistic and linear regression were conducted, adjusted for medical, behavioral and socioeconomic indicators. Interactions with sex were also examined. In BHS, birth measures were not strongly associated with clinically high levels of liver enzymes, and within the reference range measures of reduced growth were associated with increased AST in women. In the YF study, at least one marker of reduced growth was associated with higher GGT, higher ALT and higher AST (in women). Probable fatty liver on ultrasound was associated with low birthweight (2.41, 1.42-4.09) and preterm birth (2.84, 1.70-4.76). These results suggest a link between birth parameters and adult fatty liver, but encourage consideration of population variation in these relationships.
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