Early Life Adversity with Height Stunting Is Associated with Cardiometabolic Risk in Adolescents Independent of Body Mass Index

Brie M. Reid, Michelle M. Harbin, Jessica L. Arend, Aaron S Kelly, Donald R Dengel, Megan R Gunnar

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective: To evaluate cardiovascular and metabolic function in youths adopted internationally from orphanages/institutions (postinstitutionalized) who were height-stunted at adoption. Study design: A total of 30 postinstitutionalized youths (age, 9-18 years; body mass index [BMI] percentile, 7.2-90.4) who were height-stunted at adoption were compared with age- and BMI percentile-matched youths (n = 90). Measurements included total body fat and visceral adipose tissue (dual radiograph absorptiometry), arterial stiffness (augmentation index and pulse wave velocity), cardiac autonomic function (heart rate variability), blood pressure, and fasting lipid, glucose, and insulin levels. Linear regression analyses were computed controlling for parent education, age, trunk tissue fat, height-for-age, sex, and race. Results: Compared with controls of the same age, sex, and BMI, the postinstitutionalized children had higher systolic blood pressure (P =.018), augmentation index (P =.033), total cholesterol (P =.047), low-density lipoprotein cholesterol (P =.03), triglycerides (P =.048), insulin (P =.005), and HOMA-IR (P =.01) values. The postinstitutionalized children had a lower low-frequency to high-frequency ratio (P =.008), indicating lower sympathetic tone, as well as a lower total lean mass (P =.016), a lower gynoid lean mass (P =.039), and a higher proportion of trunk tissue fat (P =.017). The postinstitutionalized and control children did not differ in any other body composition measures. Conclusions: Early life stress, as represented by height-stunted growth in institutional care, may be associated with early pathways to cardiovascular and metabolic risk in youths even after moving into well-resourced homes early in life and in the absence of increased adiposity. These findings suggest that postinstitutionalized youths with a history of height stunting may need to be closely monitored for emergent cardiometabolic risk factors.

Original languageEnglish (US)
Pages (from-to)143-149
Number of pages7
JournalJournal of Pediatrics
Volume202
DOIs
StatePublished - Nov 1 2018

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Growth Disorders
Body Mass Index
Orphanages
Fats
Insulin
Body Weights and Measures
Blood Pressure
Pulse Wave Analysis
Vascular Stiffness
Intra-Abdominal Fat
Adiposity
Body Composition
Psychological Stress
LDL Cholesterol
Adipose Tissue
Linear Models
Fasting
Triglycerides
Heart Rate
Cholesterol

Keywords

  • adolescence
  • arterial stiffness
  • body composition
  • early adversity
  • heart rate variability
  • height stunting

PubMed: MeSH publication types

  • Comparative Study
  • Journal Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

Cite this

Early Life Adversity with Height Stunting Is Associated with Cardiometabolic Risk in Adolescents Independent of Body Mass Index. / Reid, Brie M.; Harbin, Michelle M.; Arend, Jessica L.; Kelly, Aaron S; Dengel, Donald R; Gunnar, Megan R.

In: Journal of Pediatrics, Vol. 202, 01.11.2018, p. 143-149.

Research output: Contribution to journalArticle

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abstract = "Objective: To evaluate cardiovascular and metabolic function in youths adopted internationally from orphanages/institutions (postinstitutionalized) who were height-stunted at adoption. Study design: A total of 30 postinstitutionalized youths (age, 9-18 years; body mass index [BMI] percentile, 7.2-90.4) who were height-stunted at adoption were compared with age- and BMI percentile-matched youths (n = 90). Measurements included total body fat and visceral adipose tissue (dual radiograph absorptiometry), arterial stiffness (augmentation index and pulse wave velocity), cardiac autonomic function (heart rate variability), blood pressure, and fasting lipid, glucose, and insulin levels. Linear regression analyses were computed controlling for parent education, age, trunk tissue fat, height-for-age, sex, and race. Results: Compared with controls of the same age, sex, and BMI, the postinstitutionalized children had higher systolic blood pressure (P =.018), augmentation index (P =.033), total cholesterol (P =.047), low-density lipoprotein cholesterol (P =.03), triglycerides (P =.048), insulin (P =.005), and HOMA-IR (P =.01) values. The postinstitutionalized children had a lower low-frequency to high-frequency ratio (P =.008), indicating lower sympathetic tone, as well as a lower total lean mass (P =.016), a lower gynoid lean mass (P =.039), and a higher proportion of trunk tissue fat (P =.017). The postinstitutionalized and control children did not differ in any other body composition measures. Conclusions: Early life stress, as represented by height-stunted growth in institutional care, may be associated with early pathways to cardiovascular and metabolic risk in youths even after moving into well-resourced homes early in life and in the absence of increased adiposity. These findings suggest that postinstitutionalized youths with a history of height stunting may need to be closely monitored for emergent cardiometabolic risk factors.",
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AU - Harbin, Michelle M.

AU - Arend, Jessica L.

AU - Kelly, Aaron S

AU - Dengel, Donald R

AU - Gunnar, Megan R

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N2 - Objective: To evaluate cardiovascular and metabolic function in youths adopted internationally from orphanages/institutions (postinstitutionalized) who were height-stunted at adoption. Study design: A total of 30 postinstitutionalized youths (age, 9-18 years; body mass index [BMI] percentile, 7.2-90.4) who were height-stunted at adoption were compared with age- and BMI percentile-matched youths (n = 90). Measurements included total body fat and visceral adipose tissue (dual radiograph absorptiometry), arterial stiffness (augmentation index and pulse wave velocity), cardiac autonomic function (heart rate variability), blood pressure, and fasting lipid, glucose, and insulin levels. Linear regression analyses were computed controlling for parent education, age, trunk tissue fat, height-for-age, sex, and race. Results: Compared with controls of the same age, sex, and BMI, the postinstitutionalized children had higher systolic blood pressure (P =.018), augmentation index (P =.033), total cholesterol (P =.047), low-density lipoprotein cholesterol (P =.03), triglycerides (P =.048), insulin (P =.005), and HOMA-IR (P =.01) values. The postinstitutionalized children had a lower low-frequency to high-frequency ratio (P =.008), indicating lower sympathetic tone, as well as a lower total lean mass (P =.016), a lower gynoid lean mass (P =.039), and a higher proportion of trunk tissue fat (P =.017). The postinstitutionalized and control children did not differ in any other body composition measures. Conclusions: Early life stress, as represented by height-stunted growth in institutional care, may be associated with early pathways to cardiovascular and metabolic risk in youths even after moving into well-resourced homes early in life and in the absence of increased adiposity. These findings suggest that postinstitutionalized youths with a history of height stunting may need to be closely monitored for emergent cardiometabolic risk factors.

AB - Objective: To evaluate cardiovascular and metabolic function in youths adopted internationally from orphanages/institutions (postinstitutionalized) who were height-stunted at adoption. Study design: A total of 30 postinstitutionalized youths (age, 9-18 years; body mass index [BMI] percentile, 7.2-90.4) who were height-stunted at adoption were compared with age- and BMI percentile-matched youths (n = 90). Measurements included total body fat and visceral adipose tissue (dual radiograph absorptiometry), arterial stiffness (augmentation index and pulse wave velocity), cardiac autonomic function (heart rate variability), blood pressure, and fasting lipid, glucose, and insulin levels. Linear regression analyses were computed controlling for parent education, age, trunk tissue fat, height-for-age, sex, and race. Results: Compared with controls of the same age, sex, and BMI, the postinstitutionalized children had higher systolic blood pressure (P =.018), augmentation index (P =.033), total cholesterol (P =.047), low-density lipoprotein cholesterol (P =.03), triglycerides (P =.048), insulin (P =.005), and HOMA-IR (P =.01) values. The postinstitutionalized children had a lower low-frequency to high-frequency ratio (P =.008), indicating lower sympathetic tone, as well as a lower total lean mass (P =.016), a lower gynoid lean mass (P =.039), and a higher proportion of trunk tissue fat (P =.017). The postinstitutionalized and control children did not differ in any other body composition measures. Conclusions: Early life stress, as represented by height-stunted growth in institutional care, may be associated with early pathways to cardiovascular and metabolic risk in youths even after moving into well-resourced homes early in life and in the absence of increased adiposity. These findings suggest that postinstitutionalized youths with a history of height stunting may need to be closely monitored for emergent cardiometabolic risk factors.

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KW - arterial stiffness

KW - body composition

KW - early adversity

KW - heart rate variability

KW - height stunting

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