Cardiometabolic sex differences in adults born small for gestational age

Abstract

Aim: This study aimed to assess the cardiometabolic sex similarities and differences in adults born small for gestational age. Methods: This study was an ambispective cohort study from a birth registry in Barcelona, Spain, including 523 adult participants (20–40 years-old) subdivided as born small for gestational age (SGA, if birth weight <10th centile) or adequate fetal growth for gestational age (AGA). Cardiometabolic health was assessed by echocardiography, electrocardiogram, blood pressure measurement, vascular ultrasound, anthropometric measurements, and serum glycemia and lipid profile. Stratified analyses by sex were performed by estimation of adjusted absolute difference (AAD) using inverse probability weighting. Results: Compared with AGA, the stratified analyses by sex showed a more pronounced reduction in ejection fraction [AAD: female −1.73 (95% CI −3.2 to −0.28) vs. male −1.33 (−3.19 to 0.52)] and increment in heart rate [female 3.04 (0.29–5.8) vs. male 2.25 (−0.82 to 5.31)] in SGA females compared with SGA males. In contrast, a more pronounced reduction in PR interval [female −1.36 (−6.15 to 3.42) vs. male −6.61 (−11.67 to −1.54)] and an increase in systolic blood pressure [female 0.06 (−2.7 to 2.81) vs. male 2.71 (−0.48 to 5.9)] and central-to-peripheral fat ratio [female 0.05 (−0.03 to 0.12) vs. male 0.40 (0.17–0.62)] were mainly observed in SGA male compared with SGA female. Conclusions: Sex differences were observed in the effect of SGA on cardiometabolic endpoints with female being more prone to cardiac dysfunction and male to electrocardiographic, vascular, and metabolic changes. Future research including sex-stratification data is warranted.

This project was partially funded with the support of the Erasmus+ Programme of the European Union (Framework Agreement number: 2013-0040) and the European Union Horizon 2020 Programme for Research and Innovation, under grant agreement No. 642676 (CardioFunXion). This publication reflects the views only of the authors, and the Commission cannot be held responsible for any use which may be made of the information contained therein. Additionally, the research leading to these results received funding from the “la Caixa” Foundation under grant agreement LCF/PR/GN18/10310003 (Spain) and the Instituto de Salud Carlos III through the projects (INT21/00027, PI18/00073, and PI14/00226), and was co-funded by the European Union (Spain), Cerebra Foundation for the Brain Injured Child (Carmarthen, Wales, UK), the Centro de Investigación Biomédica en Red de Enfermedades Raras (ERPR04G719/2016) (Spain), and Agència de Gestió d'Ajuts Universitaris i de Recerca (AGAUR) under grant 2017 SGR No. 1531) (Spain). Lastly, we would like to thank the Fundació Jesús Serra of the Grupo Catalana Occidente for the Fundació Jesús Serra Research Awards in the Clinical category granted to the researcher Fàtima Crispi in its 4th edition for the project titled “Cardiovascular prevention from fetal life: benefits of Mediterranean diet during gestation”.