Early Origins of Adult Health Profile: Cardiovascular and Metabolic Profile and Gonadal Function in Early Adulthood

In the early 90’s epidemiological studies revealed an association between low birth weight and increased risk for cardiovascular disease (CVD) and type 2 diabetes. These observations led to the initiation of studies investigating Developmental Origins of Health and Disease (DOHaD). Some aspects in DOHaD, however, remained controversial, such as the role of preterm birth and postnatal growth patterns, which are highly related to low birth weight. In this doctoral thesis we investigated associations of size at birth, preterm birth, and different growth patterns during childhood, with individual as well as combined determinants of cardiovascular disease, type 2 diabetes, and gonadal function, to add to the current body of knowledge on DOHaD. Additionally, novel statistical approaches in this field were used to unravel mechanisms involved. We show that increased gain in weight relative to length in the period immediately after birth is associated with increased risk for obesity, MetS, type 2 diabetes, and CVD in early adulthood. This critical window comprises the first three months after term birth in infants born term, and the period from birth up until three months after term age in infants born preterm. We also show that young adults born preterm might be at increased risk to develop CVD. We found no evidence that small size at birth for gestational age influences risk for later disease or gonadal function.

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