Early development of adiposity and insulin resistance after catch-up weight gain in small-for-gestational-age children.
OBJECTIVE
Low birth weight followed by rapid postnatal weight gain is associated with long-term risks for central obesity and insulin resistance. However, the timing of these changes is unclear.


METHODS
This was a longitudinal cohort study in low birth weight (SGA; birth weight < -2 sd; n = 29) and normal birth weight (AGA; n = 22) children from Barcelona.


METHODS
Body composition, by dual-energy x-ray absorptiometry scan, and insulin sensitivity, assessed longitudinally at ages 2, 3, and 4 yr, were measured.


RESULTS
Mean height, weight, and body mass index at ages 2, 3, and 4 yr were not different between SGA and AGA children. At age 2 yr, SGA children had similar body composition but were more insulin sensitive than AGA children and had lower serum IGF-I levels and lower neutrophil counts. Between ages 2 and 4 yr, despite similar gains in weight and body mass index, SGA children gained more abdominal fat and body adiposity and less lean mass than AGA children; by age 4 yr, SGA children had greater adiposity, insulin resistance, and higher neutrophil counts than AGA children (P = 0.01-0.0004). In SGA children, total and abdominal fat mass at 4 yr was more closely related to rate of weight gain between 0 and 2 yr (P = 0.002-0.0003) than between 2 and 4 yr (P = 0.04-0.1).


CONCLUSIONS
Consequent to catch-up weight gain between birth and 2 yr, SGA children showed a dramatic transition toward central adiposity and insulin resistance between ages 2 and 4 yr. Understanding the mechanisms underlying this predisposition to adverse future health could lead to specific preventive interventions during early childhood.
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950 Esplugues, Barcelona, Spain. libanez@hsjdbcn.org
Lourdes
L
Ibáñez
Ken
K
Ong
David B
DB
Dunger
Francis
F
de Zegher
D050154:Adiposity; D001823:Body Composition; D015992:Body Mass Index; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D007333:Insulin Resistance; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007958:Leukocyte Count; D008137:Longitudinal Studies; D008297:Male; D015430:Weight Gain
D007334:Insulin-Like Growth Factor I