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Sibling controls were used to account for the potential influence of shared genetic and\/or lifestyle factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cohort study featured 77 adults born at VLBW and 70 term\u2010born siblings. Dual\u2010energy X\u2010ray absorptiometry assessment took place at a mean age of 29\u2009years. Fat mass (FM) distribution was calculated by dividing appendicular by truncal FM. Appendicular skeletal mass (ASM) measurements were used to calculate two indices: Skeletal mass index (SMI, ASM divided by height squared) and ASM\/BMI (ASM divided by body mass index). Data were analysed by linear mixed models. An exploratory analysis subdivided the VLBW group by size at gestational age [small or appropriate for gestational age (SGA, defined as a birthweight &lt;\u20092 SD, or AGA)].<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants born at VLBW were lighter (\u22124.7\u2009kg, 95% CI \u22128.2, \u22121.2) and shorter (\u22124.3\u2009cm, 95% CI \u22126.2, \u22122.4) than sibling peers. After controlling for sex, age, and maternal factors, they had lower limb\/trunk fat ratios (\u22120.06, 95% CI \u22120.11, \u22120.003), LBM (\u22122.02\u2009kg, 95% CI \u22123.92, \u22120.12), ASM (\u22121.22\u2009kg, 95% CI \u22122.14, \u22120.30) and ASM\/BMI (\u22120.05, 95% CI \u22120.10, \u22120.004). FM and SMI did not differ between groups. In the subgroup analysis, findings were limited to those born VLBW + SGA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Individuals born at VLBW had, on average, lower limb\/trunk fat ratios and lower relative ASM compared with term\u2010born siblings. A more centralised fat distribution, as well as lower appendicular muscle mass, could potentially mediate the association between VLBW birth and cardiometabolic risk.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ppe.13147","type":"journal-article","created":{"date-parts":[[2025,1,8]],"date-time":"2025-01-08T09:33:00Z","timestamp":1736328780000},"page":"177-183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Body Composition in Adults Born at Very Low Birthweight\u2014A Sibling Study"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1354-4026","authenticated-orcid":false,"given":"Samuel","family":"Sandboge","sequence":"first","affiliation":[{"name":"Population Health Unit Finnish Institute for Health and Welfare  Helsinki Finland"},{"name":"Psychology\/Welfare, Faculty of Social Sciences University of Tampere  Tampere 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