Presented at the Neonatal Society 2009 Spring Meeting.

Doolan A¹, Thomas EL¹, Uthaya S¹, Fitzpatrick J², Durighel G², McCarthy J², Bell J², Modi N¹

¹ Section of Neonatal Medicine, Imperial College London, Chelsea and Westminster campus, London SW10 9NH, UK
² Metabolic and Molecular Imaging Group, MRC Clinical Sciences Centre, Imperial College, London, UK

Introduction: Lipid accumulation in the liver is associated with insulin resistance and type 2 diabetes. We have previously shown that by the time they reach term, preterm babies have increased lipid deposition in the liver (1). An increased prevalence of insulin resistance has been described in children and young adults born preterm but it is not yet known if this group is also at risk of hepatic lipid accumulation (2).

Aim: We are studying body size, composition and metabolism in young adults born below 33 weeks gestation and healthy term-born controls. Here we present the results of preliminary analyses testing the hypothesis that anthropometric measurements and intrahepatocellular lipid (IHCL) differ between these groups.

Methods: Healthy subjects aged 19-27 years born below 33 weeks gestation (cases) or at term (controls) were recruited via advertisements and hospital birth registers. We used ¹H magnetic resonance spectroscopy on a 1.5T Phillips Achiva scanner to acquire hepatic spectra following an 8 hour fast. These were analysed with hepatic water as an internal standard. Results of the IHCL CH2 : water ratio are presented. Data were analysed in SPSS 16.0 using both parametric and non parametric tests. The study was approved by the local research ethics committee (REC No 07/H011/118).

Results: To date 44 subjects have been recruited (28 controls; 14 male, 14 female; 16 cases 10 male, 6 female). There were no significant differences between the groups in height, weight, body mass index (BMI), waist and hip circumferences and waist to hip ratio (WHR), see Table 1. Median (range) IHCL was significantly higher in preterm adults than in adults born at term (0.76 (0.21, 11.19) versus 0.04 (0, 1.75); p<0.0001; Mann Whitney U test, two tailed).

Discussion: The demonstration of higher IHCL in ex-preterm adults relative to their term-born counterparts is a novel finding. The preliminary results add to the accumulating evidence indicating that this group is at risk of poor metabolic health and warrants closer follow-up beyond childhood and into adult life.

References
1. Thomas EL, Uthaya S, et al Arch Dis Child Fetal Neonatal Ed 2008; 93: F382-F383 
2. Johansson S, Iliadou A, et al Circulation 2005; 112: 3430-6