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Birth Weight and Creatinine Clearance in Young Adult Twins: Influence of Genetic, Prenatal, and Maternal Factors

Marij Gielen^*, Sara-Joan Pinto-Sietsma, Maurice P. Zeegers^,, Ruth J. Loos^||,**, Robert Fagard^¶, Peter W. de Leeuw, Gaston Beunen^||, Catherine Derom^# and Robert Vlietinck^*,#

Departments of ^* Population Genetics, Genomics and Bioinformatics, and Epidemiology, Maastricht University, and Department of Internal Medicine, Division of Vascular Medicine, University Hospital Maastricht, Maastricht, the Netherlands; Comprehensive Cancer Institute Limburg and Department of General Practice, ^|| Department of Sport and Movement Science, Faculty of Kinesiology and Rehabilitation Sciences, ^¶ Hypertension and Cardiovascular Rehabilitation Unit, and ^# Center for Human Genetics, Faculty of Medicine, Catholic University of Leuven, Leuven, Belgium; and ^** Human Genome Lab, Pennington Biomedical Research Center, Baton Rouge, Louisiana

Address correspondence to: Dr. Marij Gielen, Department of Population Genetics, Genomics and Bioinformatics, Maastricht University, Universiteitssingel 50, Box 616, 6200 MD Maastricht, The Netherlands. Phone: +31-43-3882982 (secretary 3881995); Fax: +31-43-3884573; E-mail: marij.gielen{at}gen.unimaas.nl

Received for publication March 18, 2004. Accepted for publication April 24, 2005.

Previous studies have shown that low birth weight (LBW) is a risk factor for renal impairment in adult life. The effects of LBW and renal function were studied by using twins, which allows distinguishing among fetoplacental, maternal, and genetic influences. Perinatal data were obtained at birth, and absolute creatinine clearance (not corrected for body surface area) was measured at a mean age of 25.6 yr in 653 individuals. Twins were considered both as individuals and as members of twin pairs. Statistical analyses were performed with and without adjusting for gestational age, zygosity, gender, age, body mass index, glucose level, BP, and smoking status. Creatinine clearance was 4 ml/min lower in twins with LBW (<2500 g) than in twins with a high birth weight (P < 0.04, adjusted). Intrapair birth weight difference correlated positively with the intrapair difference in creatinine clearance equally in monozygotic and dizygotic twins (r = 0.35, P < 0.0001; r = 0.43, P < 0.0001, respectively). This suggests that fetoplacental factors are related to renal function and that genetic factors are less important. There was no significant difference in creatinine clearance between twins who both had LBW as compared with twins who both had a high birth weight. This may suggest that maternal factors, which influence the relation between LBW and renal function, are less important. LBW is related to a lower creatinine clearance at adult age. This relationship is probably due to fetoplacental factors. Surprising, genetic and maternal factors seem less important.

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Copyright © 2008 by the American Society of Nephrology. Online ISSN: 1533-3450 Print ISSN: 1046-6673