Weight Catch-up Growth Research Articles

Co-recovery of physical size and cognitive ability from infancy to adolescence: A twin study.

This study tested phenotypic and biometric associations between physical and cognitive catch-up growth in a community sample of twins (n = 1285, 51.8% female, 89.3% White). Height and weight were measured at up to 17 time points between birth and 15 years, and cognitive ability was assessed at up to 16 time points between 3 months and 15 years. Weight and length at birth were positively associated with cognitive abilities in infancy and adolescence (r's = .16-.51). More rapid weight catch-up growth was associated with slower, steadier cognitive catch-up growth. Shared and nonshared environmental factors accounted for positive associations between physical size at birth and cognitive outcomes. Findings highlight the role of prenatal environmental experiences in physical and cognitive co-development.

Crecimiento y desarrollo puberal en niñas adoptadas de Rusia: seguimiento de 12 años

Introduction: the objectives were to provide longitudinal data on growth and determine the age of thelarche and menarche in girls adopted from Russia. Material and methods: prospective cohort study in 24 girls from Russia adopted in Spain in the 2002-2010 period, who were followed up for 12 years. The history of adverse childhood experiences was collected by reviewing pre-adoption medical records. We recorded standardised measurements of weight, height and head circumference and the age at thelarche and menarche. The mean values were compared with reference standards. Results: Salient history: preterm birth (33.3%), low birth weight (41.7%), prenatal alcohol exposure (45.8%), abuse and neglect (54.2%). Initial evaluation: mean age, 3 years (standard deviation [SD] 1.6) years; weight z-score (z), −1.35; height z, −2.42; head circumference z −1.77. One year after adoption, there was significant catch-up growth in weight (z +0.68), height (z +0.98), and head circumference (z +0.76). Temporal trends in growth: no weight delay from age 7 years; height continued to recover until age 10 (z −0.40) and remained stable until age 15 (z −0.46); the delay was greater compared to weight at every timepoint. The mean age at onset of thelarche was 9.9 years (SD 0.8) with a height of 135.4 cm (z −0.43). The mean age at menarche was 11.9 years (SD 0.7) years, with a height of 147.6 cm (z −0.44). Conclusions: the pattern of growth and development was characterized by severe delay in linear growth and a moderate delay in weight and head circumference at the time of adoption, rapid, significant and prolonged catch-up growth, acceleration of pubertal development with early thelarche and menarche and an incomplete recovery of linear growth.

Growth Status of Full-Term Infants with Different Sizes for Gestational Age During the First Year of Life.

This study aimed to assess the growth of full-term infants with different sizes at birth and examine catch-up and catch-down growth in their first year. This retrospective population-based cohort study was based on the Guangdong Provincial Women and Children Health Information System. 194797 full-term singleton live births were extracted. Measurements for weight and length were taken at birth, 6 months, and 12 months. The size-for-gestational age was categorized as small (SGA, <10th centile), appropriate (AGA, 10th-90th centiles), or large (LGA, >90th centile) based on the international newborn size for gestational age and sex INTERGROWTH-21st standards. Catch-up and catch- down growth were defined as a change in standard deviation in z-score greater than 0.67 in the growth curves. Of the 194797 full-term singletons, the average gestational age was 39.28 ± 1.03 weeks, and the average weight of the newborns was 3205 ± 383 grams. 15632 infants were identified as SGA (8.0%) and 12756 were LGA (6.5%). At 1 year of age, catch-up growth in weight was observed in 63.0% of SGA infants, 29.5% of AGA infants, and 5.4% of LGA infants. Conversely, catch-down growth occurred in 3.3% of SGA infants, 17.8% of AGA infants, and 54.7% of LGA infants. The proportions of catch-up growth in length for SGA, AGA, and LGA infants within the first year were 31.4%, 22.5%, and 17.1%, respectively. Catch-up or catch-down growth predominantly occurred before 6 months of age. However, from 6 to 12 months, there was no significant variation in WAZ among children with different birth sizes. In their first year of life, full-term singleton live births tend towards regression to the mean in their postnatal weight and length. The average delay in the growth of LGA is compensated by an increase in it of the SGA. Early monitoring and intervention are crucial for optimizing growth in infants with different birth sizes.

Postnatal growth and gut microbiota development influenced early childhood growth in preterm infants.

BackgroundPreterm infants are at high risk for growth failure and childhood weight problems due to the disruption of normal intrauterine growth and nutrition. Early nutritional support and microbiome acquisition can play an important role in childhood growth.ObjectiveOur study examined potential postnatal indicators, including gut bacterial compositions, macronutrients, and catch-up growth, of growth pattern from infancy into early childhood.MethodsThis is a retrospective study of preterm infants born < 35 weeks who were followed up in the university complex care clinic from 2012–2018. Weight and length z-scores at birth, 1, 2, 4, 6, 12 and 15 months, and body mass index (BMI) and length z-scores from 2 to 5 years of age were collected. Catch-up growths were calculated by changes in z-scores and divided into early (birth-4 months) and late (4–18 months). Postnatal nutritional data and fecal samples were collected. Fecal microbiome data obtained from 16S RNA V4 sequencing was analyzed against clinical and growth data using a regression model.Results160 infants included in the final analysis had birth weight and gestational age of 1,149 ± 496 grams and 28 ± 3 weeks. Early weight gain positively correlated with length z-scores but not with BMI at 2 years of age. BMI at 2 years of age strongly correlated with BMI at 3, 4, and 5 years of age. Postnatal abundance of Gammaproteobacteria was negatively associated with early growth while Bacteroides and Lactobacillus were positively associated with childhood BMI.ConclusionOur findings suggest that optimal postnatal nutrition promoted early catch-up growth in weight as well as improved linear growth without influence on childhood BMI. Postnatal gut microbial colonization, which is a modifiable factor, was associated with childhood growth in preterm infants.

First Year Metabolic and Hormonal Behavior Define two Different Populations of SGA Newborn for Weight or Height.

ContextSmall-for-gestational-age (SGA) children have a particular metabolic and hormonal pattern at birth that changes rapidly.ObjectiveTo evaluate the linear and weight growth in the first year of life in SGA children.DesignProspective, monocentric cohort study.SettingReal-world data collected from April 2012 to January 2016.PatientsSGA newborns uniformly defined by either growth or length lower than -2 SDs for gestational age.InterventionsAll children were evaluated for 1 year after birth, at 3 days of life, then 3, 6, and 12 months after birth.Main outcome measuresAnthropometric parameters and biochemical variables, such as blood glucose, insulin, leptin, IGF-1, IGF binding protein-3 (IGFBP-3), and homeostasis model assessment - insulin resistance (HOMA-IR) index.ResultsA total of 133 SGA children were enrolled. Length significantly improved 1 month after birth, whereas weight significantly increased only at 3 months after birth. Biochemical variables increased during the first year of life, showing a prediction by IGFBP-3 and HOMA-IR index. Then, the variables were divided considering either weight, length, or both, showing a different incidence. The biochemical variable changes recorded in the first step were maintained considering SGA children for weight or length, whereas they disappeared when weight and length were considered together.ConclusionsOur study shows a specific catchup growth for weight and length in SGA children. Moreover, we highlight that weight and length should be considered as independent parameters in SGA children, defining 2 different metabolic-hormonal populations with different conceivable predictive role in early catchup growth and in later growth and metabolic status.

Associations between prepregnancy body mass index, gestational weight gain and weight catch-up in small-for-gestational-age children.

Inadequate gestational weight gain (GWG) was related with a higher incidence of small‐for‐gestational‐age (SGA) births than appropriate GWG; however, the long‐term association of maternal GWG with weight catch‐up growth in SGA children remains unknown. The objective of this study is to evaluate the associations between prepregnancy body mass index (pBMI), GWG and weight catch‐up patterns in SGA children. Data were from the Collaborative Perinatal Project, an American multicentre prospective cohort study. A total of 56,990 gravidas were recruited at the first prenatal visit, and children were followed up until school age. Maternal pBMI, GWG and physical growth of the offspring at birth, 4 months, 1 year, 4 years and 7 years old were recorded. The latent class analysis was employed to form weight catch‐up growth patterns (appropriate, excessive, slow, regression and no catch‐up patterns) in SGA children. SGA children who developed the ‘appropriate catch‐up growth’ pattern and whose mothers had appropriate pBMI and GWG were chosen as the reference. Associations between GWG for different pBMI and weight catch‐up patterns were analysed by multivariate logistic regression models. A total of 1619 infants (9.45%) were born term SGA. After adjusting for relevant confounders, compared with SGA children whose mothers had appropriate pBMI and GWG, SGA children with maternal prepregnancy underweight (for inadequate GWG, GWG below recommendations, adjusted OR: 2.88, 95% CI: 1.13–7.31; for appropriate/excessive GWG, adjusted OR: 3.07, 95% CI: 1.74–5.42) or with prepregnancy normal weight but inadequate GWG (adjusted OR: 2.14, 95% CI: 1.36–3.38) were at a higher risk of having the ‘no catch‐up growth’ pattern. We suggest that SGA children with maternal prepregnancy underweight or inadequate GWG tend to have a poor weight catch‐up growth at least until school age.

Catch-Up Growth in Children Born Small for Gestational Age Related to Body Composition and Metabolic Risk at Six Years of Age in the UK

Objectives: To determine differences in body composition and glucose metabolism according to childhood growth outcomes in a population-based sample of children born small for gestational age (SGA). Methods: A single-centre study of 259 children born SGA identified through hospital records and contacted when aged 4–7 years. Questionnaire data on pre/perinatal history and growth parameters during childhood was collected from the parents, and in a subgroup of 150 children face-to-face assessments were performed, including anthropometric parameters, lean and fat mass, blood pressure, fasting glucose, and C-peptide. Results: Based on the questionnaires, few children had formal clinic follow-up of growth, but 7% of the cohort showed a height and weight of <–2SDS during childhood, and only 2 children met the criteria for growth hormone therapy. Out of the 150 children assessed at a mean age of 6.1 ± 0.8 years, 122 (81%) showed a catch-up growth in weight. Compared to those without weight catch-up, these children had a higher fat mass index (3.13 ± 1.36 vs. 2.56 ± 0.91 kg/m², p = 0.04), trunk-to-limb fat mass ratio (0.63 ± 0.14 vs. 0.56 ± 0.08, p = 0.002), systolic blood pressure SDS (0.09 ± 0.71 vs. –0.32 ± 0.63, p = 0.008), fasting glucose (4.5 ± 0.5 vs. 4.3 ± 0.5 mmol/L, p = 0.03), and C-peptide (306 ± 116 vs. 256 ± 112 pmol/L, p = 0.08). Among children with weight catch-up growth, those with less height gain had a lower limb lean mass index (4.25 ± 0.48 vs. 4.48 ± 0.56 kg/m², p = 0.02) and fat mass index (1.57 ± 0.59 vs. 1.83 ± 0.77 kg/m², p = 0.04). Conclusions: Within this population-based sample of SGA children, catch-up growth in weight was associated with higher abdominal fat mass, blood pressure and glycemia; furthermore, in these children, less height gain was associated with reduced limb lean and fat mass.

Association of sport participation in preterm and full term born children and body and fat mass indices from age 3 to 14 years

ObjectivesTo assess the association of gestational age groups (VP: <32 weeks, MP: 32–33 weeks, LP: 34–36 weeks and FT: ≥37 weeks of gestation) and club sport participation in childhood on body mass index (BMI), fat free mass index (FFMI) and fat mass index (FMI). DesignLongitudinal, cross sectional. MethodsBMI (age 3, 5, 7, 11 and 14 years; N=10581–14702) and FFMI/FMI (age 7, 11 and 14 years; N=10446–12996) and consistent club sport participation at age 5, 7 and 11 years (ranging from never participating to participating at all three ages) were assessed prospectively. These were compared by gestational age and their associations with BMI and FMI were investigated, while controlling for confounders (socio-economic, maternal obesity, child related, diet). ResultsBMI and FFMI was lower in VP or MP until age 7, but no differences were found in BMI, FFMI or FMI after age 11 with regard to gestational age. Consistent club sport participation from age 5–11 was unrelated to BMI at ages 3–7. However, FT children with club sport participation had lower BMI and FMI at ages 11 and 14; but this association was not found in VP or MP. ConclusionsDuring adolescence body composition of VP and MP become similar to FT born peers. Consistent sport participation reduces BMI and FMI in FT only. In VP or MP children modifying effects of sport on body composition might not be detected due to the catch-up growth in weight, height and fat mass at the same time.

First-year growth of 834 preterm infants in a Chinese population: a single-center study

BackgroundThe aim of this study was to follow the growth and hematological indicators of preterm infants during their first year.MethodsNeonates below 37 gestational weeks had routine follow-ups up through 1 year from January 2012 to December 2015 at West China 2nd University Hospital, Sichuan University. Weight, length and head circumference (HC) were measured monthly during the first 6 months, followed by monitoring every second month until 12 months. The catch-up growth defined as a gain of Z-score > 0.67 according to previous study. All preterm infants were prescribed iron prophylaxis based on national guideline. The hemoglobin concentration was examined at 6 and 12 months.ResultsAltogether, 132 very-low-birth-weight (VLBW), 504 low-birth-weight (LBW) and 198 normal-birth-weight (NBW) infants were followed. The rates of catch-up growth for weight, length and HC 12 months of corrected age (CA) were 22.6, 29.1 and 14.6%, respectively. SGA and VLBW infants showed higher catch-up growth rates. The overall prevalence of anemia was 6.8% at 6 months and 7.8% at 12 months. The Z-scores for weight-for-length, length and HC were lower in the VLBW and SGA preterm infant groups than in the other preterm groups throughout the first year of life. The incidences of stunting, microcephaly and wasting changed from 5, 1.3 and 3.7% to 2, 1.1, 0.9 and 2.4%, respectively, during the first year. However, the incidences of wasting and stunting were higher for the VLBW infants than for the LBW and NBW infants at 12 months (9.3% vs. 1.4%, p < 0.01; 9.3% vs. 1%, p < 0.01,respectively; 4.7% vs. 0.8%, p < 0.01, 4.7% vs. 0%, p < 0.01,respectively). Similar results were observed between SGA and AGA infants (8.7% vs. 1.5%, p < 0.01; 5.8% vs. 0.4%, p < 0.01). Logistic regression revealed SGA and VLBW as risk factors for poor growth (WLZ < -2SD) at 12 months (OR = 5.5, 95% CI: 2.1–14.8, p < 0.01: OR = 4.8, 95% CI: 1.8–12.8, p < 0.01, respectively).ConclusionThe VLBW and SGA preterm infants showed significant catch-up growth during their first year of life. However, SGA and VLBW were risk factors for poor growth during the preterm infants’ first year of life. Prophylactic iron supplementation in preterm infants appears to reduce the prevalence of anemia.

Postnatal length and weight growth velocities according to Fenton reference and their associated perinatal factors in healthy late preterm infants during birth to term-corrected age: an observational study

BackgroundOptimum early postnatal growth is critical for early and later health of preterm infants. Postnatal length and weight growth velocities and their associated perinatal factors in healthy late preterm infants without restriction of neonatal complications and nutritional problems have not been widely studied.MethodsAs part of ongoing longitudinal follow-up study of growth and development of preterm infants in Shandong Qianfoshan Hospital in China, 599 healthy late preterm infants without neonatal complications and nutritional problems were sampled from 795 preterm infants born in January 2014 to April 2017. Perinatal factors, growth parameters, growth velocities(ΔLengthZ and ΔWeightZ: Z-score changes of length and weight) during birth and term-corrected age were documented. Associated variables of growth velocities were analyzed by bivariate and multivariate regression analyses. Adjusted ΔLengthZ and ΔWeightZ were compared between/among subgroups of associated variables using analysis of covariance. Catch-up growth were defined as ΔLengthZ or ΔWeightZ > 0.67.ResultsThe mean ΔLengthZ and ΔWeightZ were 0.28, 0.65, respectively. Catch-up growth of length and weight was ubiquitous(30.7, 46.2%, respectively). Faster length growth velocity was associated with male, larger postmenstrual age(PMA) at birth, younger mother and larger PMA at visit; Faster weight growth velocity was associated with male, unfavorable intrauterine growth status defined by birth weight percentile(Small-for-Gestational-Age(<P10), Appropriate-for-Gestational-Age(P10–90), Large-for-Gestational-Age(>P90)), twin and larger PMA at visit. When adjusted for associated co-variables, weight catch-up growth existed in subgroups of 36 weeks PMA at birth, male, twin and SGA, while AGA almost reached this standard with mean adjusted ΔWeightZ as 0.66. Although none of these subgroups got length catch-up growth standard, infants of 36 weeks PMA at birth had statistically rapider length growth velocity than 34 and 35 weeks PMA at birth subgroups(mean adjusted ΔLengthZs of 34, 35 and 36 weeks subgroups: 0.10, 0.22, 0.38, respectively).ConclusionsPostnatal length and weight growth velocities of healthy late preterm infants from birth to term-corrected age were much superior than that of Fenton reference, especially for weight, with ubiquitous catch-up growth. Different associated factors for length and weight growth signified the necessity of constructing more detailed growth standards by specific stratification for associated factors.

Efficacy of Maternal Choline Supplementation During Pregnancy in Mitigating Adverse Effects of Prenatal Alcohol Exposure on Growth and Cognitive Function: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

We recently demonstrated the acceptability and feasibility of a randomized, double-blind choline supplementation intervention for heavy drinking women during pregnancy. In this study, we report our results relating to the efficacy of this intervention in mitigating adverse effects of prenatal alcohol exposure (PAE) on infant growth and cognitive function. Sixty-nine Cape Coloured (mixed ancestry) heavy drinkers in Cape Town, South Africa, recruited in mid-pregnancy, were randomly assigned to receive a daily oral dose of either 2g of choline or placebo from time of enrollment until delivery. Each dose consisted of an individually wrapped packet of powder that, when mixed with water, produced a sweet tasting grape-flavored drink. The primary outcome, eyeblink conditioning (EBC), was assessed at 6.5months. Somatic growth was measured at birth, 6.5, and 12months, recognition memory and processing speed on the Fagan Test of Infant Intelligence, at 6.5 and 12months. Infants born to choline-treated mothers were more likely to meet criterion for conditioning on EBC than the placebo group. Moreover, within the choline arm, degree of maternal adherence to the supplementation protocol strongly predicted EBC performance. Both groups were small at birth, but choline-treated infants showed considerable catch-up growth in weight and head circumference at 6.5 and 12months. At 12months, the infants in the choline treatment arm had higher novelty preference scores, indicating better visual recognition memory. This exploratory study is the first to provide evidence that a high dose of choline administered early in pregnancy can mitigate adverse effects of heavy PAE on EBC, postnatal growth, and cognition in human infants. These findings are consistent with studies of alcohol-exposed animals that have demonstrated beneficial effects of choline supplementation on classical conditioning, learning, and memory.

Comparison of postnatal catch-up growth according to definitions of small for gestational age infants.

PurposeSmall for gestational age (SGA) is confusingly defined as birth weight (BW) either below 3rd percentile or 10th percentile for infants. This study aimed to compare postnatal catch-up growth between SGA groups according to different definitions.MethodsData of 129 infants born with BW below the 10th percentile and admitted to Korea University Anam Hospital and Ansan Hospital were retrospectively reviewed. Height and weight were measured at 6, 12, and 24 months. Results were compared between group A (BW: <3rd percentile) and group B (BW: 3rd–10th percentile).ResultsGroup A included 66 infants and group B included 63. At age 6 months (n=122), 62.9% of group A and 71.7% (P=0.303) of group B showed catch-up growth in weight. At 6 months (n=69), 55.9% of group A and 80.0% of group B (P<0.05) showed catch-up growth in height. At 12 months (n=106), 58.5% of group A, and 75.5% (P=0.062) of group B showed catch-up growth in weight. At 12 months (n=75), 52.8% of group A and 64.1% of group B (P=0.320) showed catch-up growth in height. Up to age 24 months, 66.7%/80.0% in group A and 63.6%/80.0% in group B showed catch-up growth in weight/height.ConclusionDespite different definitions, there were no significant differences between the two SGA groups in postnatal catch-up growth up to age 24 months, except for height at 6 months. Compared to infants with appropriate catch-up growth, low gestational age and BW were risk factors for failed catch-up growth at 6 months.

Catch–up growth in the first two years of life in Extremely Low Birth Weight (ELBW) infants is associated with lower body fat in young adolescence

AimTo investigate growth patterns and anthropometrics in former extremely low birth weight (ELBW, <1000 g) children and link these outcomes to neurocognition and body composition in childhood.MethodsELBW children were examined at birth (n = 140), at 9 and 24 months (n≥96) and at approximately 11 years within the framework of the PREMATCH (PREMATurity as predictor children’s of Cardiovascular and renal Health) case–control (n = 93–87) study. Regional growth charts were used to convert anthropometrics into Z–scores. Catch–up growth in the first two years of life was qualified as present if ΔZ–score >0.67 SDS. At 11 years, anthropometrics, neurocognitive performance, body composition, grip strength and puberty scores were assessed.ResultsELBW neonates displayed extra–uterine growth restriction with mean Z–scores for height, weight and head circumference of –0.77, –0.93 and –0.46 at birth, –1.61, –1.67 and –0.72 at 9 months, –1.22, –1.61 and –0.84 at 24 months, and –0.42, –0.49 and –1.09 at 11 years. ELBW children performed consistently worse on neurocognitive testing with an average intelligence quotient equivalent at 11 years of 92.5 (SD 13.1). Catch–up growth was not associated with neurocognitive performance. Compared to controls, ELBW cases had lower grip strength (13.6 vs. 15.9 kg) and percentage lean body weight (75.1 vs. 80.5%), but higher body fat (24.6 vs. 19.2%) and advanced puberty scores at 11 years (all P≤0.025). Catch–up growth for weight and height in the first two years of life in cases was associated with a lower percentage body fat compared to cases without catch–up growth (16.8% catch-up growth for weight vs. 25.7%, P<0.001; 20.9% catch-up for height vs. 25.8%, P = 0.049).ConclusionsIn young adolescence, former ELBW children still have difficulties to reach their target height. Compared to normal birth weight controls, ELBW adolescents show lower neurocognitive performance and grip strength and a higher percentage body fat, a potential risk factor for adverse health outcomes in adulthood. Our key finding is that catch–up growth in ELBW children in the first two years of life is associated with a lower percentage body fat and is therefore likely to be beneficial.

Health impact of catch-up growth in low-birth weight infants: systematic review, evidence appraisal, and meta-analysis.

This study aimed to systematically review and appraise evidence on the short-term (e.g. morbidity, mortality) and long-term (obesity and non-communicable diseases, NCDs) health consequences of catch-up growth (vs. no catch-up growth) in individuals with a history of low birth weight (LBW).We searched MEDLINE, EMBASE, Global Health, CINAHL plus, Cochrane Library, ProQuest Dissertations and Thesis and reference lists. Study quality was assessed using the risk of bias assessment tool from the Agency for Health Care Research and Quality, and the evidence base was assessed using the GRADE tool. Eight studies in seven cohorts (two from high-income countries, five from low-middle-income countries) met the inclusion criteria for short-term (mean age: 13.4 months) and/or longer-term (mean age: 11.1 years) health outcomes of catch-up growth, which had occurred by 24 or 59 months. Of five studies on short-term health outcomes, three found positive associations between weight catch-up growth and body mass and/or glucose metabolism; one suggested reduced risk of hospitalisation and mortality with catch-up growth. Three studies on longer-term health outcomes found catch-up growth were associated with higher body mass, BMI or cholesterol. GRADE assessment suggested that evidence quantity and quality were low. Catch-up growth following LBW may have benefits for the individual with LBW in the short term, and may have adverse population health impacts in the long-term, but the evidence is limited. Future cohort studies could address the question of the consequences of catch-up growth following LBW more convincingly, with a view to informing future prevention of obesity and NCDs. © 2016 John Wiley & Sons Ltd.

A twin-sibling study on early growth and hormone levels in adolescents.

This study addresses how growth during sensitive developmental periods and genes may affect hormone levels in late adolescence. We analyzed hormone levels of dehydroepiandrosterone sulfate (DHEAS) and insulin-like growth factor-I (IGF-I), which are hypothesized to be two pathways linking early growth with adult diseases (such as type 2 diabetes and cardiovascular disease) via their effects on enhanced insulin resistance. In a twin-sibling study, we tested whether there is an association between reduced intra-uterine growth and higher DHEAS or IGF-I levels in serum during adolescence, and we examined the contribution of insulin to the link between early growth and higher DHEAS and/or IGF-I levels. Anthropometric and hormone data were collected in 18-year-old twins (184 pairs) and their non-twin siblings (n = 98). Neither birth weight nor current body size predicted serum DHEAS and IGF-I levels. In the subsample of children who showed catch-up growth in weight during infancy, the children of lower birth weight had significantly higher serum DHEAS and IGF-I levels, but these were not related to insulin levels. Variation in serum DHEAS, IGF-I and fasting insulin levels was largely explained by genetic factors (73, 78 and 61 % respectively). Thus, early growth affects hormone levels in adolescence, but only in children with catch-up growth after birth. No evidence was found that early growth enhances insulin resistance via the hormones DHEAS or IGF-I.

SGA children with moderate catch-up growth are showing the impaired insulin secretion at the age of 4.

BackgroundBeing born small for gestational age (SGA) is a risk factor for later development of type 2 diabetes. The development of glucose tolerance disorders in adults involves insulin resistance and impaired insulin secretion.ObjectiveTo evaluate insulin secretion and insulin sensitivity in a 4-yr old cohort of SGA.Methods85 children were prospectively followed from mid-gestation to 4 years of age. Fetal growth velocity (FGV) was measured using ultrasound measurements. Body composition and hormonal profile were measured at birth, 1 and 4 years.Results23 SGA babies had lower birth weight compared to 62 AGA (−1.9±0.3 vs. −0.6±0.8 z-score; p<0.0001) and they were thinner at birth (ponderal index 24.8±1.8 vs. 26.3±3.1 kg/m3; p = 0.01 and fat mass 11±2.6 vs. 12.9±3.1%; p = 0.01). No significant differences in other measured metabolic and hormonal parameters were observed between two groups at birth. SGA infants experienced an early catch-up growth in weight (mean gain of 1.1±0.6 SD) during the first year of life. At 4 years, SGA children remain lighter than AGA, but with weight z-score in the normal range (−0.1±1.3 vs. 0.5±1.3 z-score; p = 0.05). No excess of fat mass was observed (19±4.8 vs. 19.7±4.1%; p = 0.45). 120-min plasma glucose was significantly higher (6.2±1.1 vs. 5.6±0.9 mmol/l; p = 0.006) and insulinogenic index was significantly lower (0.28±0.15 vs. 0.40±2.4; p = 0.02) in the SGA group at 4-yrs of life contrasting with a preserved insulin sensitivity (QUICKI 0.47±0.09 vs. 0.43±0.05; p = 0.06).ConclusionSGA children with compensatory catch-up growth in first year of life show mild disturbances of glucose tolerance associated to a lower insulinogenic index at 4-yrs of age suggesting impairment of β-cell function.

Nonalcoholic Fatty Liver Disease in Prepubertal Children Born Small for Gestational Age: Influence of Rapid Weight Catch-Up Growth

Background/Aims: We studied the association of low birth weight with ultrasound-assessed nonalcoholic fatty liver disease (NAFLD) to test the hypothesis that fetal growth retardation followed by a rapid weight catch-up growth might be an additional factor responsible for liver steatosis via insulin resistance (IR) and/or intra-abdominal fat. Methods: We enrolled 23 children born small for gestational age (SGA) with a rapid catch-up growth within the first 6-12 months, and 24 appropriate for gestational age (AGA) children as controls. All children underwent anthropometric, body composition measurements and evaluation of liver function tests, lipid profile, plasma glucose and insulin levels. Abdominal ultrasonography was performed in order to asses liver steatosis and thickness of subcutaneous and visceral adipose tissue. Results: NAFLD were observed in 8 out of the 23 SGA children (34.8%). IR and visceral fat were significantly increased in children with hepatic steatosis compared to those without. IR index was significantly related to liver steatosis, independently of body mass index standard deviation score and visceral fat. Conclusions: NAFLD should be recognized as an emerging problem in SGA prepubertal children who presented a rapid weight gain in postnatal life, and IR plays the key role. An appropriate diet during pregnancy and in the first year of life might prevent metabolic syndrome and NAFLD in these subjects.

Nutritional Repletion of Children with Severe Acute Malnutrition Does Not Affect VLDL Apolipoprotein B-100 Synthesis Rate ,

VLDL apo B-100 is essential for the secretion of liver fat. It is thought that synthesis of this lipoprotein is impaired in childhood severe acute malnutrition (SAM), especially in the edematous syndromes, and that this contributes to the common occurrence of hepatic steatosis in this condition. However, to our knowledge, it has not been confirmed that VLDL apo B-100 synthesis is slower in edematous compared with nonedematous SAM and that it is impaired in the malnourished compared with the well-nourished state. Therefore, VLDL apo B-100 kinetics were measured in 2 groups of children with SAM (15 edematous and 7 nonedematous), aged 4–20 mo, at 3 stages during treatment. Measurements were done at 4 ± 1 d postadmission, mid- catch-up growth in weight, and at recovery (normal weight-for-length). VLDL apo B-100 synthesis was determined using stable isotope methodology to measure the rate of incorporation of 2H3-leucine into its apoprotein moiety. The fractional and absolute synthesis of VLDL apo B-100 did not differ between the groups or from the initial malnourished stage to the recovery stage. Concentrations of VLDL apo B-100 were greater in the edematous than in the nonedematous group (P < 0.04) and did not differ from the initial stage to recovery. The data indicate that VLDL apo B-100 synthesis is not reduced when children develop either edematous or nonedematous SAM.

Influence of catch-up growth on IGFBP-2 levels and association between IGFBP-2 and cardiovascular risk factors in Korean children born SGA

Small for gestational age (SGA) at birth and postnatal growth pattern may have an impact on insulin resistance and body composition in their later life. Emerging evidence has indicated that insulin-like growth factor binding protein-2 (IGFBP-2) may be related to insulin sensitivity. The aim of this study was to evaluate insulin resistance and IGFBP-2 levels in SGA children, and to identify the effect of catch-up growth on IGFBP-2 concentration. Serum IGFBP-2 levels were measured in 103 Korean SGA children including 49 prepubertal and 54 pubertal subjects. Anthropometric values, fasting serum levels of metabolic parameters and insulin sensitivity indices were determined. Each prepubertal or pubertal group was subgrouped based on height or weight catch-up growth. The subgroups with weight catch-up showed higher values of BMI, body fat mass, percent body fat, and total cholesterol. Particularly in pubertal children, IGFBP-2 concentration was lower in the subgroup with weight catch-up. Catch-up growth in height did not affect insulin resistance and metabolic parameters. IGFBP-2 levels were inversely correlated with BMI, body fat mass, percent body fat, insulin and leptin levels in both prepubertal and pubertal groups. Additionally in the pubertal group, systolic blood pressure, cholesterol levels were related to IGFBP-2. A strong relationship between IGFBP-2, the insulin sensitivity index, and some cardiovascular risk factors was observed in children born SGA, suggesting that IGFBP-2 might be a promising marker for early recognition of insulin resistance, particularly in children with weight catch-up.

Relationship between Catch-up Growth and Changes in Insulin, Leptin, IGF-I, Adiponectin, and Ghrelin in Infants Born Full-term Small for Gestational Age

Purpose: The aim of the study was to investigate postnatal changes in growth and insulin, leptin, IGF-I, adiponectin, and ghrelin, and to examine the relationship of these hormones with catch-up growth in full-term small for gestational age (SGA) infants. Methods: SGA was defined as a birth weight less than the ten percentile. Weight and height were measured at birth, 1 month, 6 months, 1 year, and 2 years of age in 70 SGA infants (40 females and 30 males). The infants were subdivided according to their weight and height catch-up growth (CUG) at 2 years old. CUG is defined as reaching a standard deviation score (SDS) of -2 SDS. Blood samples were serially taken for insulin, leptin, insulin- ˃ like growth factor (IGF)-I, adiponectin, and ghrelin. Results: 1) Dramatic CUG for weight and height occurred during the first year of life; weight and height growth gain decreased thereafter. 2) Non-catch-up growth (NCUG) infants showed more decreased weight and height growth gain than CUG infants between the first and second year of life. 3) Weight CUG was 77.1% and height CUG was 75.8% in the SGA infants. 4) Weight CUG infants showed significantly higher leptin and ghrelin levels than in weight NCUG infants at the age of 1 year (P 0.05). 5) Height CUG infants showed significantly higher ˂ leptin and ghrelin levels than in height NCUG infants at the age of 1 year (P 0.05). ˂ Conclusion: CUG for weight and height occurred during the first year of life and growth velocity decreased thereafter. Significant corresponding changes occurred with regard to serum leptin and ghrelin. (J Korean Soc Pediatr Endocrinol 2011;16:112-118)