Early life factors and later metabolic syndrome in European children and adolescents.

Background and aims: Early life factors have been suggested to be associated with later cardiometabolic risk in children, adolescents and adults. Our study aimed to investigate the associations between early life factors and metabolic syndrome (MetS) in children and adolescents.

Methods and results: Our analysis sample comprised of 8852 children aged 2-9 years at baseline that participated in up to three examination waves of the pan-European IDEFICS/I.Family cohort (baseline: 2007/08, 1st follow-up 2009/10, 2nd follow-up 2013/14). Mixed-effects models were used to estimate the associations between early life factors and MetS score and z-scores of waist circumference (WC), systolic (SBP) and diastolic blood pressure (DBP), Homeostasis Model Assessment for Insulin Resistance, high density lipoprotein cholesterol (HDL) and triglycerides. Being born large for gestational age (LGA) showed a positive association with MetS score (β = 0.67; 99%CI 0.44, 0.90) and with WC z-score (β = 0.51; 99%CI 0.39, 0.63) and was weakly inversely associated with HDL z-score. Being born small for gestational age (SGA) was associated with lower WC z-score (ß = -0.26; 99%CI -0.37, -0.16), with a lower MetS score (ß = -0.13; 99%CI -0.33, 0.08) and slightly higher z-scores of SBP and DBP. Weight gain during pregnancy was positively associated with MetS score and WC z-score while premature birth was positively associated with SBP.

Conclusions: Children born LGA, SGA or preterm may warrant closer monitoring to prevent MetS later on.