Visceral adiposity without overweight in children born small for gestational age.
BACKGROUND
Children born small for gestational age (SGA) tend to develop catch-up growth in infancy and become overweight by the age of 6 yr. Weight control is advocated as a preventive measure, but it is unknown whether such control suffices to prevent visceral fat excess and hypoadiponectinemia.


METHODS
The study was performed at a university hospital.


METHODS
A total of 64 children (32 matched pairs) aged 6 yr, of whom 32 were born appropriate for gestational age and 32 were born SGA, and had subsequently developed spontaneous catch-up growth were included in the study; matching was performed for gender, height, weight, and, thus, body mass index.


RESULTS
Fasting insulin, IGF-I, high molecular weight adiponectin, leptin, visfatin, and lean and fat mass were calculated by absorptiometry, and abdominally sc and visceral fat by magnetic resonance imaging.


RESULTS
After strict matching, SGA children had a total lean mass, total fat mass, leptinemia, and visfatinemia comparable to those in the appropriate for gestational age children, but they still had higher fasting insulin and IGF-I levels (P < 0.01), much lower high molecular weight adiponectin levels (P < 0.0001), and a striking shift from abdominally sc to visceral fat (P < 0.0001). Fasting insulin (r = 0.52; P < 0.00001) was a major determinant of visceral fat in boys and girls, explaining 28% of its variance.


CONCLUSIONS
SGA children tend to be viscerally adipose and hypo-adiponectinemic, even if they are not overweight. Therefore, measures beyond weight control seem to be needed to allow most SGA children to normalize their body composition and endocrine-metabolic homeostasis.
Ibáñez
Lourdes
L
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues, Barcelona, Spain. libanez@hsjdbcn.org
Lopez-Bermejo
Abel
A
Suárez
Larisa
L
Marcos
Maria Victoria
MV
Díaz
Marta
M
de Zegher
Francis
F
D052242:Adiponectin / Q000097:blood; D050154:Adiposity / Q000502:physiology; D000367:Age Factors; D001724:Birth Weight / Q000502:physiology; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002657:Child Development / Q000502:physiology; D002675:Child, Preschool; D016207:Cytokines / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood / Q000502:physiology*; D007328:Insulin / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D050152:Intra-Abdominal Fat / Q000033:anatomy & histology*; D008297:Male; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood; D050177:Overweight / Q000473:pathology
C499918:ADIPOQ protein, human; D052242:Adiponectin; D016207:Cytokines; D007328:Insulin; D007334:Insulin-Like Growth Factor I; D054409:Nicotinamide Phosphoribosyltransferase; C085455:nicotinamide phosphoribosyltransferase, human