Cord Blood Appetite Hormones and Early-Life Growth and Childhood Adiposity in the ENVIRONAGE Cohort

Abstract

Importance Understanding early-life origins of increased body mass is crucial because childhood obesity increases the risk of later development of obesity and related metabolic disorders. Appetite hormones have been investigated in relation to fat accumulation in adults, but little is known about the association between cord blood levels of these hormones and obesity-related outcomes in early childhood.

Objective To examine whether cord blood appetite hormone levels are associated with early-life growth trajectories and childhood adiposity.

Design, Setting, and Participants This prospective birth cohort study was conducted within the Environmental Influence on Early Aging (ENVIRONAGE) birth cohort, with follow-up data collected at 4 to 6 years of age. The study includes children from a population-based cohort in Belgium recruited between January 1, 2010, and December 31, 2016, with available cord blood appetite hormone levels and participating in follow-up visits.

Exposures Cord blood levels of glucagon-like peptide 1 (GLP-1), peptide tyrosine tyrosine (PYY), pancreatic polypeptide (PP), and leptin.

Main Outcomes and Measures Adiposity peak, anthropometric measures at 4 to 6 years of age (waist to height ratio and body mass index z score), and rapid growth and slow growth from birth to 6, 12, and 24 months.

Results A total of 325 children (median [IQR] age, 4.49 [4.04-4.95] years; 151 [46.5%] male) were studied. Analyses were performed in 2 subgroups based on availability of appetite hormones: 226 children with cord blood PP and leptin (median [IQR] age at follow-up, 4.5 [4.3-4.7] years; 108 [47.8%] male) and 229 children with cord blood PYY and GLP-1 (median [IQR] age at follow-up, 4.5 [4.3-4.8] years; 98 [42.8%] male). PYY levels were positively associated with the adiposity peak (β = 0.14; 95% CI, 0.01-0.27). PYY and PP levels were associated with an higher risk of rapid growth in the first 2 years of life (odds ratio [OR], 1.71; 95% CI, 1.03-2.84; OR, 1.65; 95% CI, 1.21-2.27, respectively). Leptin levels showed an inverse association with rapid growth (OR, 0.43; 95% CI, 0.27-0.66). PYY and PP levels were associated with a higher body mass index z score at 4 to 6 years of age (β = 0.16; 95% CI, 0.04-0.30; β = 0.17; 95% CI, 0.004-0.34, respectively).

Conclusions and Relevance In this cohort study of 325 children, cord blood appetite hormone levels were associated with early-life growth and adiposity, suggesting that appetite hormones may influence childhood growth and body composition trajectory from birth onward.