Yuya Nakano

High-Molecular-Weight Adiponectin and Leptin Levels in Cord Blood Are Associated with Anthropometric Measurements at Birth

Aims: High-molecular-weight adiponectin (HMW-ad) is an active form of adiponectin. No information is available with respect to HMW-ad in neonates. The aims of this study were to examine whether HMW-ad is present in cord blood, to define the association between the concentrations of cord blood HMW-ad and leptin, and their correlation with anthropometric measurements of term neonates at birth. Methods: Venous cord blood samples were obtained from 135 term healthy neonates (birth weight 2,261–4,164 g) born at Showa University Hospital. Total adiponectin (T-ad), HMW-ad and leptin levels were measured by ELISA. Results: HMW-ad levels were 14.9 ± 5.8 µg/ml and the ratio of HMW-ad to T-ad was 0.49 ± 0.15. In a multiple regression analysis, cord blood HMW-ad levels were a significant predictor of birth weight and birth length, and leptin level was a significant predictor of birth weight and birth weight to body length ratio. There was a significant relationship between concentrations of HMW-ad and leptin controlling for sex, gestational age and birth weight. Conclusion: These results show that HMW-ad exists as a half of T-ad in the cord blood. Leptin and HMW-ad may regulate synergistically fetal growth.

Predictors of Low Milk Volume among Mothers Who Delivered Preterm

Background: Factors associated with successful provision of mother’s own milk (MOM) for premature infants in a Japanese neonatal intensive care unit (NICU) context are not well known. Objective: We determined the independent risk factors for low milk volume at day 4 postpartum and formula feeding at the time of NICU discharge. Methods: We reviewed the medical records of mothers who delivered at < 32 weeks’ gestation. We determined maternal, premature infant, and milk expression variables predictive of (1) day 4 postpartum milk volume being less than the cohort median and (2) formula feeding at the time of NICU discharge, reported as adjusted odds ratios (95% confidence interval). Results: Among 85 dyads, median (quartile range) milk volume on day 4 postpartum was 153 (34-255) mL. The rate of formula feeding at discharge was 42%. Mothers delivering by cesarean (vs vaginal) delivery had 4.3-fold (1.5-12.4) greater odds of day 4 milk volume < median (P < .01). Pregnancy-induced hypertension, delayed milk expression initiation, and low pumping frequency were strongly associated with cesarean delivery. Subsequently, mothers with day 4 milk volume < median (vs ≥ median) had 7.1-fold (2.6-19.5) greater odds of formula feeding at discharge (P < .01). Conclusion: Cesarean delivery is associated with lower milk volume on day 4 but may represent a composite of underlying risk factors for low milk volume in the early postpartum period. Further, low milk volume on day 4 is a strong correlate of lack of exclusive breast milk feeding at NICU discharge.

Accumulation of subcutaneous fat, but not visceral fat, is a predictor of adiponectin levels in preterm infants at term-equivalent age

BACKGROUND Preterm infants have altered fat tissue development, including a higher percentage of fat mass and increased volume of visceral fat. They also have altered adiponectin levels, including a lower ratio of high-molecular-weight adiponectin (HMW-Ad) to total adiponectin (T-Ad) at term-equivalent age, compared with term infants. AIMS The objective of this study was to investigate the association between adiponectin levels and fat tissue accumulation or distribution in preterm infants at term-equivalent age. STUDY DESIGN Cross-sectional clinical study. SUBJECTS Study subjects were 53 preterm infants born at ≤34weeks gestation with a mean birth weight of 1592g. OUTCOME MEASURES Serum levels of T-Ad and HMW-Ad were measured and a computed tomography (CT) scan was performed at the level of the umbilicus at term-equivalent age to analyze how fat tissue accumulation or distribution was correlated with adiponectin levels. RESULTS T-Ad (r=0.315, p=0.022) and HMW-Ad levels (r=0.338, p=0.013) were positively associated with subcutaneous fat area evaluated by performing CT scan at term-equivalent age, but were not associated with visceral fat area in simple regression analyses. In addition, T-Ad (β=0.487, p=0.003) and HMW-Ad levels (β=0.602, p<0.001) were positively associated with subcutaneous fat tissue area, but they were not associated with visceral fat area also in multiple regression analyses. CONCLUSION Subcutaneous fat accumulation contributes to increased levels of T-Ad and HMW-Ad, while visceral fat accumulation does not influence adiponectin levels in preterm infants at term-equivalent age.

Longitudinal Changes in High Molecular Weight Serum Adiponectin Levels in Healthy Infants

To determine the factors associated with high molecular weight adiponectin (HMW-ad) levels during the first year of life, the longitudinal changes in serum HMW-ad were investigated from birth to 12 mo of age. The total adiponectin levels, HMW-ad, and leptin were measured longitudinally from birth to 12 mo of age in 56 healthy infants (≥35 wk of gestation). Serum HMW-ad levels were positively correlated with total adiponectin levels (R2 = 0.93, p < 0.0001). Serum HMW-ad levels at birth, six, and 12 mo were 13.7 ± 0.9 (mean ± SE), 13.3 ± 0.8, and 7.7 ± 0.5 μg/mL, respectively. The levels at 12 mo were significantly lower than those at birth and 6 mo, respectively. In a multiple regression analysis, the HMW-ad levels at 12 mo were found to be related only to cord blood HMW-ad levels (β = 0.680, p < 0.001) and not to any other factors. These results imply that postnatal production of HMW-ad at least during infancy may be regulated before birth. Further study is necessary to determine whether cord blood HMW-ad has an effect and whether it is involved in the development of metabolic syndrome.

Cord serum adiponectin is positively related to postnatal body mass index gain.

Background:  The roles of adiponectin and leptin in the early stages of life are poorly understood. We previously studied longitudinal changes in these adipocytokines from birth to 12 months of age. The aim of this investigation was to evaluate the correlation between cord serum adipocytokine levels and postnatal growth by 3 years of age.

Association between serum adipocytokine and cholesterol levels in cord blood.

Background:  Serum leptin and adiponectin levels are strongly associated with lipid metabolism in adults. These adipocytokines play a role in intrauterine and postnatal growth but the association between cord blood levels of these adipocytokines and cholesterol at birth remains unclear.

Fatal case of mitochondrial DNA depletion with severe asphyxia in a newborn

Yuya Nakano, Kei Murayama, Tomkoko Tsuruoka, Madoka Aizawa, Hironori Nagasaka, Hiroshi Horie, Akira Ohtake and Kayoko Saitou Department of Pediatrics, Showa University School of Medicine, Department of Genetics, Tokyo Women’s Medical University, Tokyo, Departments of Neonatology, Metabolism, and Pathology, Chiba Children’s Hospital, Chiba, and Department of Pediatrics, Saitama Medical University, Saitama, Japan

Longitudinal changes in adiponectin multimer levels in preterm infants

BACKGROUND Preterm infants have altered adiponectin levels at term-equivalent age and have a higher risk of developing components of the metabolic syndrome in later life than term infants. AIMS To investigate the longitudinal changes in adiponectin levels in preterm infants and to compare the levels between term and preterm infants. STUDY DESIGN A cohort study. SUBJECTS The study subjects were 43 term infants and 42 preterm infants born at ≤ 34-week gestation. OUTCOME MEASURES Serum levels of total adiponectin (T-Ad) and high-molecular-weight adiponectin (HMW-Ad) were measured in 42 preterm infants at term-, 6 month-, and 12 month-equivalent ages. Moreover, the levels in 43 term infants investigated previously were reviewed. RESULTS In preterm infants, T-Ad and HMW-Ad levels at the 12 month-equivalent age were lower than at the term- and 6 month-equivalent ages (all values p<0.001), which was consistent with previous results in term infants. The difference in ratios of HMW-Ad to T-Ad between term and preterm infants continued at the 6 month-equivalent age but disappeared at the 12 month-equivalent age. Multiple regression analyses revealed that HMW-Ad levels at term-equivalent age were only a significant determinant of the changes in HMW-Ad between the term- and 12 month-equivalent ages in preterm infants (p<0.001). CONCLUSIONS The HMW-Ad levels decline till the 12 month-equivalent age in both term and preterm infants. The changes in HMW-Ad level during infancy might be determined at least to a certain degree up to term-equivalent age in preterm infants.

A neonate with an anomalous bone attached to the cervical spine

BACKGROUND CONTEXT A digit/rib-like ectopic bone is a rare congenital anomaly that is most commonly seen in the thorax or pelvis. There is a single report of an adult possessing a phalanx-like bone in the cervical region; however, whether the abnormal bone was congenital or acquired remains elusive. PURPOSE To elucidate that a phalanx-like bone in the cervical region represents a congenital anomaly. STUDY DESIGN Case report. METHODS Report of the imaging findings in a neonate with a palpable bone projection in the posterior neck. RESULTS Plain radiographs demonstrated an ectopic bone posterior to the spinous process of the C5 vertebra. Three-dimensional computed tomography demonstrated that the anomalous bone was attached to the left lamina of the C5 vertebra and that there was abnormal segmentation of the left side of the cervical spine. CONCLUSIONS The anomalous bone in the neck is a congenital malformation that is accompanied by the maldevelopment of the cervical spine.

Body length and occipitofrontal circumference may be good indicators of neurodevelopment in very low birthweight infants - secondary publication

The aim of this study was to predict the neurological prognosis of very low birthweight (VLBW) infants. We examined the relationship between nutritional status, brain volume measured by magnetic resonance imaging (MRI) and anthropometric measurements of VLBW infants at term‐equivalent age (TEA).