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.
Ibáñez
Lourdes
L
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, 08950 Esplugues, Barcelona, Spain. libanez@hsjdbcn.org
Ong
Ken
K
Dunger
David B
DB
de Zegher
Francis
F
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