Catch-up growth in body mass index is associated neither with reduced insulin sensitivity nor with altered lipid profile in children born small for gestational age.
OBJECTIVE
Low birth weight is a risk factor for coronary heart disease. Persons who have coronary events as adults tend to have been small at birth and thin at 2 yr of age, after which they tended to increase their body mass index (BMI). Our aim was to determine whether BMI gain is associated to alterations in insulin sensitivity and/or lipid profile in children born small for gestational age (SGA).


METHODS
Retrospective case-control study.


METHODS
We studied 78 children (mean age 7.8+/-2.5 yr): 26 SGA children with catch-up growth in BMI (CGB-SGA) (BMI= 10th to 75th centile), 26 SGA without catch-up growth (NCGB-SGA) (BMI<10th centile), and 26 appropriate for gestational age (AGA) control children (BMI: 10th to 75th centile). For each CGB-SGA child, we selected an NCGB-SGA and an AGA child of the same gender, age (within 1 yr), and pubertal status. SGA children were also subdivided into 2 groups according to post-natal catch-up growth in height (CGH).


RESULTS
Glucose was significantly lower in NCGBSGA than AGA group (p=0.02). No significant differences in fasting insulin, fasting glucose/insulin ratio, homeostasis model assessment, quantitative insulin-sensitivity check index, and lipid profile were found among the 3 groups. HDL-cholesterol proved significantly reduced in SGA children with post-natal CGH (p=0.02).


CONCLUSIONS
Our findings do not support the hypothesis of early alterations in insulin sensitivity and lipid metabolism in CGB-SGA subjects during childhood provided that BMI remains within the normal range. Finally, the finding of reduced HDL-cholesterol levels in CGH-SGA children suggests detrimental metabolic effects of the height gain.
Torre
P
P
Rina Balducci Center of Pediatric Endocrinology, Department of Public Health and Cell Biology, Tor Vergata University, Rome, Italy.
Ladaki
C
C
Scirè
G
G
Spadoni
G L
GL
Cianfarani
S
S
D000886:Anthropometry; D001786:Blood Glucose / Q000378:metabolism; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age / Q000097:blood / Q000254:growth & development / Q000502:physiology*; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance / Q000502:physiology*; D050356:Lipid Metabolism / Q000502:physiology*; D008297:Male; D012189:Retrospective Studies; D014280:Triglycerides / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D014280:Triglycerides; D002784:Cholesterol