title: Progression of cardio-metabolic risk factors in subjects born small and large for gestational age.
abstract: BACKGROUND
  Subjects born small (SGA) and large (LGA) for gestational age have an increased risk of cardio-metabolic alterations already during prepuberty. Nevertheless, the progression of their cardio-metabolic profile from childhood to adolescence has not been fully explored. Our aim was to assess potential changes in the cardio-metabolic profile from childhood to adolescence in subjects born SGA and LGA compared to those born appropriate (AGA) for gestational age.
  
  
  METHODS
  This longitudinal study included 35 AGA, 24 SGA and 31 LGA subjects evaluated during childhood (mean age (± SD) 8.4 ± 1.4 yr) and then re-assessed during adolescence (mean age 13.3 ± 1.8 yr). BMI, blood pressure, insulin resistance (fasting insulin, HOMA-IR) and lipids were assessed. A cardio-metabolic risk z-score was applied and this consisted in calculating the sum of sex-specific z-scores for BMI, blood pressure, HOMA-IR, triglycerides and triglycerides:high-density lipoprotein cholesterol ratio.
  
  
  RESULTS
  Fasting insulin and HOMA-IR were higher in SGA and LGA than AGA subjects both during childhood (all P<0.01) and adolescence (all P<0.01). Similarly, the clustered cardio-metabolic risk score was higher in SGA and LGA than AGA children (both P<0.05), and these differences among groups increased during adolescence (both P<0.05). Of note, a progression of the clustered cardio-metabolic risk score was observed from childhood to adolescence within SGA and within LGA subjects (both P<0.05).
  
  
  CONCLUSIONS
  SGA and LGA subjects showed an adverse cardio-metabolic profile during childhood when compared to AGA peers, with a worsening of this profile during adolescence. These findings indicate an overtime progression of insulin resistance and overall estimated cardiovascular risk from childhood to adolescence in SGA and LGA populations.
authors.affiliation: Department of Paediatrics, University of Chieti, Chieti, Italy; Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Chiavaroli
authors.affiliation: Department of Paediatrics, University of Chieti, Chieti, Italy; Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Maria Loredana
authors.initials: ML
authors.lastname: Marcovecchio
authors.affiliation: Department of Paediatrics, University of Chieti, Chieti, Italy; Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Tommaso
authors.initials: T
authors.lastname: de Giorgis
authors.affiliation: Department of Paediatrics, University of Chieti, Chieti, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Diesse
authors.affiliation: Department of Paediatrics, University of Chieti, Chieti, Italy; Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Chiarelli
authors.affiliation: Department of Paediatrics, University of Chieti, Chieti, Italy; Center of Excellence on Aging, "G. d'Annunzio" University Foundation, University of Chieti, Chieti, Italy.
authors.forename: Angelika
authors.initials: A
authors.lastname: Mohn
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D001724:Birth Weight; D001786:Blood Glucose; D001794:Blood Pressure; D001837:Body Weights and Measures; D002648:Child; D005260:Female; D005865:Gestational Age; D006801:Humans; D007236:Infant, Small for Gestational Age; D007328:Insulin / Q000097:blood; D007558:Italy; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D007328:Insulin; D008055:Lipids