Very preterm birth frequently results in extra-uterine growth restriction, often associated with various morbidities such as bronchopulmonary dysplasia, apnea of prematurity, sepsis, and episodes of feeding intolerance. This early struggle often casts a long shadow, impacting height and lean body mass into adulthood. The well-known link between prematurity and chronic diseases in later life, including cardio-pulmonary disorders, hypertension, type 2 diabetes, osteopenia, and osteoporosis, raises questions about the role of birth weight and body composition in shaping these long-term sequelae. Jussinniemi et al.1 contribute significantly to this discourse with a meticulous study examining 137 preterm very low birth weight (VLBW < 1500 g) adults and 158 term-born controls from Finland and Norway. This longitudinal study spans from young adult life to mid-adulthood, offering valuable insights into the body composition changes of VLBW survivors.
Understanding body composition is paramount for clinical assessment, and the study employed advanced methods such as Dual-Energy X-Ray Absorptiometry (DXA) and Bioelectrical Impedance (BIA). DXA, utilizing X-rays, unveils details on bone mineral content and regional adiposity. BIA estimates total body water and fat-free mass by measuring the body’s resistance to a weak electrical current. Initial assessments during young adulthood using DXA, revealed lower lean body mass and lower bone mineral density among VLBW individuals, providing a foundational understanding of their body composition trajectory. They were then followed up in mid-adulthood by BIA at a mean age of 36 years. In this subsequent analysis, VLBW women were found to be 4.1 cm shorter, and men 6.1 cm shorter, with smaller head circumference compared to controls. Notably, fat percentage, fat mass, and BMI were not significantly different from controls. However, lower lean body mass in preterm VLBW adults, primarily attributed to their shorter height, was a noteworthy finding. Both groups, regardless of birth weight, exhibited gains in fat and lean body mass over time. The observed lower lean body mass among VLBW survivors suggests potential adverse impacts on insulin sensitivity and muscular fitness with further aging, increasing the risk of cardiopulmonary disease. The study’s robust methodology, including dual assessment methods and rigorous statistical analysis, reinforces the reliability of these findings.
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