Ezzahir Nadia, Alberti Corinne, Deghmoun Samia, Zaccaria Isabelle, Czernichow Paul, Lévy-Marchal Claire, Jaquet Delphine
INSERM U457, Robert Debré Hospital, 75019 Paris, France.
Pediatr Res. 2005 Aug;58(2):243-7. doi: 10.1203/01.PDR.0000169980.35179.89. Epub 2005 Jul 31.
Although necessary for a normal final height in individuals who were born small for gestational age (SGA), catch-up growth is associated with drastic changes in body composition that have been suspected to favor the later development of the long-term metabolic complications by promoting central adiposity; however, the specific contribution of catch-up itself on these later complications remains unclear. Therefore, the aim of the study was to characterize the dynamic changes in adiposity during childhood in individuals who were born SGA and to investigate their consequences on adulthood. The magnitude and the time course of postnatal changes in body mass index (BMI) relative to birth and their consequences on adult adiposity were investigated in 127 adults who were born SGA and had available serial anthropometric data in childhood (0-6 y) and adulthood. Catch-up in BMI, observed in 91% of individuals who were born SGA, was mostly completed within the first or second year of age. Overall, adult BMI was correlated with the magnitude of gain in BMI during childhood. However, this effect was significant only when this gain persisted after the first year of life. Similarly, the influence of the magnitude in gain in BMI on the risk for adult BMI >25 kg/m(2) was significantly influenced by the age at which the gain in BMI occurred. In summary, although the extent of catch-up in BMI affects adiposity in adulthood, this effect is mostly deleterious when occurring after 1 y of age, suggesting that a rapid catch-up process should be more suitable than a delayed one. Whether this observation holds through regarding the metabolic syndrome remains to be elucidated.
尽管对于出生时小于胎龄(SGA)的个体来说,追赶生长是达到正常最终身高所必需的,但追赶生长与身体成分的剧烈变化有关,人们怀疑这种变化通过促进中心性肥胖而有利于后期长期代谢并发症的发展;然而,追赶生长本身对这些后期并发症的具体影响仍不清楚。因此,本研究的目的是描述SGA出生个体儿童期肥胖的动态变化,并研究其对成年期的影响。在127名SGA出生且在儿童期(0 - 6岁)和成年期有可用连续人体测量数据的成年人中,研究了相对于出生时体重指数(BMI)的产后变化幅度和时间进程及其对成年期肥胖的影响。在91%的SGA出生个体中观察到的BMI追赶生长大多在1岁或2岁时完成。总体而言,成年BMI与儿童期BMI增加幅度相关。然而,只有当这种增加在1岁后持续存在时,这种影响才显著。同样,BMI增加幅度对成年BMI>25 kg/m²风险的影响也受到BMI增加发生年龄的显著影响。总之,尽管BMI追赶生长的程度会影响成年期肥胖,但这种影响在1岁后发生时大多是有害的,这表明快速追赶过程可能比延迟追赶过程更合适。关于代谢综合征,这一观察结果是否成立仍有待阐明。