Longitudinal Trajectory and Early Life Determinant of Childhood Adipokines: Findings From a Racially Diverse Birth Cohort

Abstract

Context: Leptin and adiponectin play important roles in systemic metabolic homeostasis, beginning in utero. Limited data exist on the levels and trajectories of these 2 hormones at birth and in childhood and their biological and social determinants.

Objective: We examined the longitudinal trajectories of leptin and adiponectin from birth to early childhood, along with influential prenatal and infancy factors, and whether the trajectories and risk factors differ by preterm birth status.

Methods: We included mother-infant pairs in the Boston Birth Cohort, a predominantly Black, indigenous, and people of color (BIPOC) study population. We measured infant plasma leptin and adiponectin levels at birth and in early childhood. We examined longitudinal trajectories and the associated prenatal maternal and infancy factors. We analyzed 716 infants (158 preterm) who had leptin and adiponectin measured at birth and in early childhood (mean corrected age 2.18 years [interquartile range, 0.4-10.4]).

Results: Cord leptin was higher in term infants (40 230 vs 20 481 in preterm, P < 0.0001) but childhood leptin did not differ by prematurity (4123 in term vs 4181 in preterm, P = 0.92). Adiponectin was higher in term infants at birth (18 416 vs 11 223, P < 0.0001) and in childhood (12 108 vs 10532, P = 0.04). In stepwise regression, Black race was associated with higher childhood leptin and lower childhood adiponectin. Female sex was associated with higher childhood leptin levels and lower childhood adiponectin levels in multivariable regression models.

Conclusion: Our results highlight preterm status, race, and biological sex as predictors of adipokine trajectory throughout childhood. These findings raise the possibility that early life programming of adipokines may contribute to higher metabolic risk in life, especially among Black children born preterm.

Keywords: adipokines; developmental programming; preterm.

Figure 1.

Panel A, Plasma leptin levels in preterm infants at birth were lower as compared with term infants. Panel B, Without considering gestation, infants born SGA and LGA had significantly lower and higher cord leptin levels, respectively, than AGA infants (reference) at birth, but the difference ceased to exist postnatally. Panel C: When considering both gestation and fetal growth simultaneously, LGA infants continued to have significantly higher leptin at birth while SGA infants had significantly lower birth leptin for both term and preterm infants.

Figure 2.

Panel A, Children born preterm had lower levels of cord adiponectin and similar postnatal leptin levels. Panel B, Without considering gestation, infants born SGA had significantly lower cord adiponectin levels (with no difference with infants born LGA) than AGA infants (reference) at birth, but the difference ceased to exist for postnatal adiponectin. Panel C, When considering both gestation and fetal growth simultaneously, preterm infants continued to have significantly lower adiponectin at birth while but postnatal adiponectin did not differ across these groups.