Dynamic Alterations in Linear Growth and Endocrine Parameters in Children with Obesity Compared to Normal-Weight Children from Infancy to Adolescence

Abstract

Background: Obesity can affect growth and development of children but there is uncertainty regarding the dynamics and potential causes. We assessed the growth dynamics of children with obesity from infancy to adolescence and evaluated associated endocrine and metabolic changes. Methods: In the population-based LIFE Child and the obesity-enriched Leipzig Obesity Childhood Cohorts encompassing 7,961 children (35,134 measurements), we compared (parental-height-corrected) height, growth velocities and serum hormone levels between normal-weight and children with obesity aged 0 to 20 years. Findings: Children with obesity were significantly taller than normal-weight children, independently of parental height, reaching a maximum difference of 7·6 cm at age 6-7 years. Already at birth, children with obesity were up to 0·5 cm taller and had slightly increased growth velocities of up to 0·9 cm/y (+1·1 SDS) in early childhood. During puberty, children with obesity showed a catch-down in height, with an almost blunted growth spurt particularly in boys. The reduction in pubertal growth velocity by 30% coincided with a decrease in levels of insulin-like growth factor-1 (IGF-1) (by 17%) and testosterone (by 61%) in boys, as well as with reductions in estradiol (by 44%) in girls with obesity. Interpretation: Children with obesity are taller in early childhood with catch-down growth in puberty. The blunted pubertal growth spurt is paralleled by reduced serum levels of IGF-1 and sex hormones. Funding: German Research Foundation, European Union, European Regional Development Fund, Free State of Saxony, German Federal Ministry of Education and Research, and European Society for Pediatric Endocrinology. Declaration of Interest: The authors have nothing to declare. Ethical Approval: The study was approved by the ethics committee of the University of Leipzig (NCT02550236, NCT02208141, NCT01605123).