Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism
Animal studies have demonstrated long-term effects of in utero glucocortcoid exposure on vascular development and glucose metabolism. We hypothesized that there would be a similar impact in humans. One hundred and two young adults born preterm aged 23 to 28 years, with prospective data collection fr...
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| Veröffentlicht in: | Pediatrics (Evanston) 2012-05, Vol.129 (5), p.e1282-e1290 |
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| creator | Kelly, Brenda A Lewandowski, Adam J Worton, Stephanie A Davis, Esther F Lazdam, Merzaka Francis, Jane Neubauer, Stefan Lucas, Alan Singhal, Atul Leeson, Paul |
| description | Animal studies have demonstrated long-term effects of in utero glucocortcoid exposure on vascular development and glucose metabolism. We hypothesized that there would be a similar impact in humans.
One hundred and two young adults born preterm aged 23 to 28 years, with prospective data collection from birth, and 95 adults born term after uncomplicated pregnancies underwent cardiovascular MRI. We compared cardiac and aortic structure and function, as well as cardiovascular risk profile, in a nested case-control study of 16 participants exposed to antenatal steroids and 32 who were not, but with otherwise similar perinatal care. Outcomes were compared with normal ranges in those born term.
Adults whose mothers had received antenatal steroids had decreased ascending aortic distensibility (9.88 ± 3.21 vs 13.62 ± 3.88 mm Hg(-1) × 10(3), P = .002) and increased aortic arch pulse wave velocity (5.45 ± 1.41 vs 4.47 ± 0.91 m/s, P = .006). The increase in stiffness was equivalent to that of term adults a decade older. Those who had in utero exposure to antenatal steroids also had significant differences in homeostatic model assessments for β-cell function (P = .010), but in multiple regression analysis this did not explain the impact of steroids on aortic function.
Antenatal glucocorticoid exposure in preterm infants is associated with increased aortic arch stiffness and altered glucose metabolism in early adulthood. |
| doi_str_mv | 10.1542/peds.2011-3175 |
| format | Article |
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One hundred and two young adults born preterm aged 23 to 28 years, with prospective data collection from birth, and 95 adults born term after uncomplicated pregnancies underwent cardiovascular MRI. We compared cardiac and aortic structure and function, as well as cardiovascular risk profile, in a nested case-control study of 16 participants exposed to antenatal steroids and 32 who were not, but with otherwise similar perinatal care. Outcomes were compared with normal ranges in those born term.
Adults whose mothers had received antenatal steroids had decreased ascending aortic distensibility (9.88 ± 3.21 vs 13.62 ± 3.88 mm Hg(-1) × 10(3), P = .002) and increased aortic arch pulse wave velocity (5.45 ± 1.41 vs 4.47 ± 0.91 m/s, P = .006). The increase in stiffness was equivalent to that of term adults a decade older. Those who had in utero exposure to antenatal steroids also had significant differences in homeostatic model assessments for β-cell function (P = .010), but in multiple regression analysis this did not explain the impact of steroids on aortic function.
Antenatal glucocorticoid exposure in preterm infants is associated with increased aortic arch stiffness and altered glucose metabolism in early adulthood.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.2011-3175</identifier><identifier>PMID: 22508917</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: American Academy of Pediatrics</publisher><subject>Adult ; Aorta, Thoracic - drug effects ; Blood Flow Velocity - drug effects ; Blood Glucose - metabolism ; Blood Pressure - drug effects ; Cardiovascular diseases ; Care and treatment ; Case-Control Studies ; Coronary vessels ; Corticosteroids ; Female ; Glucocorticoids ; Glucocorticoids - administration & dosage ; Glucocorticoids - adverse effects ; Glucose ; Health aspects ; Humans ; Infants (Premature) ; Insulin-Secreting Cells - drug effects ; Male ; Metabolism ; Pediatrics ; Pregnancy ; Premature birth ; Premature infants ; Prenatal Exposure Delayed Effects - diagnosis ; Risk factors ; Steroids ; Vascular Resistance - drug effects ; Young Adult</subject><ispartof>Pediatrics (Evanston), 2012-05, Vol.129 (5), p.e1282-e1290</ispartof><rights>Copyright American Academy of Pediatrics May 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-c689b42b2b92c64baf851fe0927cc03abde9ca5a2cf39750b6a7c170491887c3</citedby><cites>FETCH-LOGICAL-c361t-c689b42b2b92c64baf851fe0927cc03abde9ca5a2cf39750b6a7c170491887c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22508917$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kelly, Brenda A</creatorcontrib><creatorcontrib>Lewandowski, Adam J</creatorcontrib><creatorcontrib>Worton, Stephanie A</creatorcontrib><creatorcontrib>Davis, Esther F</creatorcontrib><creatorcontrib>Lazdam, Merzaka</creatorcontrib><creatorcontrib>Francis, Jane</creatorcontrib><creatorcontrib>Neubauer, Stefan</creatorcontrib><creatorcontrib>Lucas, Alan</creatorcontrib><creatorcontrib>Singhal, Atul</creatorcontrib><creatorcontrib>Leeson, Paul</creatorcontrib><title>Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>Animal studies have demonstrated long-term effects of in utero glucocortcoid exposure on vascular development and glucose metabolism. We hypothesized that there would be a similar impact in humans.
One hundred and two young adults born preterm aged 23 to 28 years, with prospective data collection from birth, and 95 adults born term after uncomplicated pregnancies underwent cardiovascular MRI. We compared cardiac and aortic structure and function, as well as cardiovascular risk profile, in a nested case-control study of 16 participants exposed to antenatal steroids and 32 who were not, but with otherwise similar perinatal care. Outcomes were compared with normal ranges in those born term.
Adults whose mothers had received antenatal steroids had decreased ascending aortic distensibility (9.88 ± 3.21 vs 13.62 ± 3.88 mm Hg(-1) × 10(3), P = .002) and increased aortic arch pulse wave velocity (5.45 ± 1.41 vs 4.47 ± 0.91 m/s, P = .006). The increase in stiffness was equivalent to that of term adults a decade older. Those who had in utero exposure to antenatal steroids also had significant differences in homeostatic model assessments for β-cell function (P = .010), but in multiple regression analysis this did not explain the impact of steroids on aortic function.
Antenatal glucocorticoid exposure in preterm infants is associated with increased aortic arch stiffness and altered glucose metabolism in early adulthood.</description><subject>Adult</subject><subject>Aorta, Thoracic - drug effects</subject><subject>Blood Flow Velocity - drug effects</subject><subject>Blood Glucose - metabolism</subject><subject>Blood Pressure - drug effects</subject><subject>Cardiovascular diseases</subject><subject>Care and treatment</subject><subject>Case-Control Studies</subject><subject>Coronary vessels</subject><subject>Corticosteroids</subject><subject>Female</subject><subject>Glucocorticoids</subject><subject>Glucocorticoids - administration & dosage</subject><subject>Glucocorticoids - adverse effects</subject><subject>Glucose</subject><subject>Health aspects</subject><subject>Humans</subject><subject>Infants (Premature)</subject><subject>Insulin-Secreting Cells - drug effects</subject><subject>Male</subject><subject>Metabolism</subject><subject>Pediatrics</subject><subject>Pregnancy</subject><subject>Premature birth</subject><subject>Premature infants</subject><subject>Prenatal Exposure Delayed Effects - diagnosis</subject><subject>Risk factors</subject><subject>Steroids</subject><subject>Vascular Resistance - drug effects</subject><subject>Young Adult</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kc1r3DAQxUVpaDZJrz0GQc_e6NOyjsvSNIGFXHIXsjxeHGRpI8mQ_veVd9OeBobfvHm8h9APSrZUCvZwgiFvGaG04VTJL2hDie4awZT8ijaEcNoIQuQ1usn5jRAipGLf0DVjknSaqg2CXSgQbLEeH_3iooupTC5OA4aPU8xLAmzDgH0Mx6ZAmrH1ddgyxZDxFLA983hcglt3Z_gslAHPUGwf_ZTnO3Q1Wp_h--e8Ra-Pv173T83h5ffzfndoHG9paVzb6V6wnvWauVb0duwkHYFoppwj3PYDaGelZW7kWknSt1Y5qojQtOuU47fo50X2lOL7ArmYt7ikUD8aWiMSLaGtqFRzoY7Wg5mCizWCj-Ki93AEUw3tX8yOacVFKwSv_PbCuxRzTjCaU5pmm_5UUbOWYNYSzFqCWUuoB_efNpZ-huE__i91_hfDS4Ov</recordid><startdate>201205</startdate><enddate>201205</enddate><creator>Kelly, Brenda A</creator><creator>Lewandowski, Adam J</creator><creator>Worton, Stephanie A</creator><creator>Davis, Esther F</creator><creator>Lazdam, Merzaka</creator><creator>Francis, Jane</creator><creator>Neubauer, Stefan</creator><creator>Lucas, Alan</creator><creator>Singhal, Atul</creator><creator>Leeson, Paul</creator><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope></search><sort><creationdate>201205</creationdate><title>Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism</title><author>Kelly, Brenda A ; Lewandowski, Adam J ; Worton, Stephanie A ; Davis, Esther F ; Lazdam, Merzaka ; Francis, Jane ; Neubauer, Stefan ; Lucas, Alan ; Singhal, Atul ; Leeson, Paul</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-c689b42b2b92c64baf851fe0927cc03abde9ca5a2cf39750b6a7c170491887c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adult</topic><topic>Aorta, Thoracic - drug effects</topic><topic>Blood Flow Velocity - drug effects</topic><topic>Blood Glucose - metabolism</topic><topic>Blood Pressure - drug effects</topic><topic>Cardiovascular diseases</topic><topic>Care and treatment</topic><topic>Case-Control Studies</topic><topic>Coronary vessels</topic><topic>Corticosteroids</topic><topic>Female</topic><topic>Glucocorticoids</topic><topic>Glucocorticoids - administration & dosage</topic><topic>Glucocorticoids - adverse effects</topic><topic>Glucose</topic><topic>Health aspects</topic><topic>Humans</topic><topic>Infants (Premature)</topic><topic>Insulin-Secreting Cells - drug effects</topic><topic>Male</topic><topic>Metabolism</topic><topic>Pediatrics</topic><topic>Pregnancy</topic><topic>Premature birth</topic><topic>Premature infants</topic><topic>Prenatal Exposure Delayed Effects - diagnosis</topic><topic>Risk factors</topic><topic>Steroids</topic><topic>Vascular Resistance - drug effects</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kelly, Brenda A</creatorcontrib><creatorcontrib>Lewandowski, Adam J</creatorcontrib><creatorcontrib>Worton, Stephanie A</creatorcontrib><creatorcontrib>Davis, Esther F</creatorcontrib><creatorcontrib>Lazdam, Merzaka</creatorcontrib><creatorcontrib>Francis, Jane</creatorcontrib><creatorcontrib>Neubauer, Stefan</creatorcontrib><creatorcontrib>Lucas, Alan</creatorcontrib><creatorcontrib>Singhal, Atul</creatorcontrib><creatorcontrib>Leeson, Paul</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kelly, Brenda A</au><au>Lewandowski, Adam J</au><au>Worton, Stephanie A</au><au>Davis, Esther F</au><au>Lazdam, Merzaka</au><au>Francis, Jane</au><au>Neubauer, Stefan</au><au>Lucas, Alan</au><au>Singhal, Atul</au><au>Leeson, Paul</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2012-05</date><risdate>2012</risdate><volume>129</volume><issue>5</issue><spage>e1282</spage><epage>e1290</epage><pages>e1282-e1290</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>Animal studies have demonstrated long-term effects of in utero glucocortcoid exposure on vascular development and glucose metabolism. We hypothesized that there would be a similar impact in humans.
One hundred and two young adults born preterm aged 23 to 28 years, with prospective data collection from birth, and 95 adults born term after uncomplicated pregnancies underwent cardiovascular MRI. We compared cardiac and aortic structure and function, as well as cardiovascular risk profile, in a nested case-control study of 16 participants exposed to antenatal steroids and 32 who were not, but with otherwise similar perinatal care. Outcomes were compared with normal ranges in those born term.
Adults whose mothers had received antenatal steroids had decreased ascending aortic distensibility (9.88 ± 3.21 vs 13.62 ± 3.88 mm Hg(-1) × 10(3), P = .002) and increased aortic arch pulse wave velocity (5.45 ± 1.41 vs 4.47 ± 0.91 m/s, P = .006). The increase in stiffness was equivalent to that of term adults a decade older. Those who had in utero exposure to antenatal steroids also had significant differences in homeostatic model assessments for β-cell function (P = .010), but in multiple regression analysis this did not explain the impact of steroids on aortic function.
Antenatal glucocorticoid exposure in preterm infants is associated with increased aortic arch stiffness and altered glucose metabolism in early adulthood.</abstract><cop>United States</cop><pub>American Academy of Pediatrics</pub><pmid>22508917</pmid><doi>10.1542/peds.2011-3175</doi></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adult Aorta, Thoracic - drug effects Blood Flow Velocity - drug effects Blood Glucose - metabolism Blood Pressure - drug effects Cardiovascular diseases Care and treatment Case-Control Studies Coronary vessels Corticosteroids Female Glucocorticoids Glucocorticoids - administration & dosage Glucocorticoids - adverse effects Glucose Health aspects Humans Infants (Premature) Insulin-Secreting Cells - drug effects Male Metabolism Pediatrics Pregnancy Premature birth Premature infants Prenatal Exposure Delayed Effects - diagnosis Risk factors Steroids Vascular Resistance - drug effects Young Adult |
| title | Antenatal glucocorticoid exposure and long-term alterations in aortic function and glucose metabolism |
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