Ibáñez Lourdes, Lopez-Bermejo Abel, Suárez Larisa, Marcos Maria Victoria, Díaz Marta, de Zegher Francis
Endocrinology Unit, Hospital Sant Joan de Déu, University of Barcelona, Passeig de Sant Joan de Déu, 2, Esplugues, Barcelona, Spain.
J Clin Endocrinol Metab. 2008 Jun;93(6):2079-83. doi: 10.1210/jc.2007-2850. Epub 2008 Mar 11.
Children born small for gestational age (SGA) tend to develop catch-up growth in infancy and become overweight by the age of 6 yr. Weight control is advocated as a preventive measure, but it is unknown whether such control suffices to prevent visceral fat excess and hypoadiponectinemia.
The study was performed at a university hospital.
A total of 64 children (32 matched pairs) aged 6 yr, of whom 32 were born appropriate for gestational age and 32 were born SGA, and had subsequently developed spontaneous catch-up growth were included in the study; matching was performed for gender, height, weight, and, thus, body mass index.
Fasting insulin, IGF-I, high molecular weight adiponectin, leptin, visfatin, and lean and fat mass were calculated by absorptiometry, and abdominally sc and visceral fat by magnetic resonance imaging.
After strict matching, SGA children had a total lean mass, total fat mass, leptinemia, and visfatinemia comparable to those in the appropriate for gestational age children, but they still had higher fasting insulin and IGF-I levels (P < 0.01), much lower high molecular weight adiponectin levels (P < 0.0001), and a striking shift from abdominally sc to visceral fat (P < 0.0001). Fasting insulin (r = 0.52; P < 0.00001) was a major determinant of visceral fat in boys and girls, explaining 28% of its variance.
SGA children tend to be viscerally adipose and hypo-adiponectinemic, even if they are not overweight. Therefore, measures beyond weight control seem to be needed to allow most SGA children to normalize their body composition and endocrine-metabolic homeostasis.
小于胎龄儿（SGA）出生后在婴儿期往往会出现追赶生长，并在6岁时超重。提倡进行体重控制作为预防措施，但尚不清楚这种控制是否足以预防内脏脂肪过多和低脂联素血症。
该研究在一家大学医院进行。
共有64名6岁儿童（32对匹配组）纳入研究，其中32名出生时为适于胎龄儿，32名出生时为小于胎龄儿，且随后出现了自发追赶生长；按性别、身高、体重及体重指数进行匹配。
通过吸收测定法计算空腹胰岛素、胰岛素样生长因子-I（IGF-I）、高分子量脂联素、瘦素、内脂素以及瘦体重和脂肪量，通过磁共振成像测量腹部皮下脂肪和内脏脂肪。
经过严格匹配后，小于胎龄儿的总瘦体重、总脂肪量、瘦素血症和内脂素血症与适于胎龄儿相当，但他们的空腹胰岛素和IGF-I水平仍然较高（P<0.01），高分子量脂联素水平低得多（P<0.0001），并且从腹部皮下脂肪向内脏脂肪有显著转变（P<0.0001）。空腹胰岛素（r=0.52；P<0.00001）是男孩和女孩内脏脂肪的主要决定因素，解释了其28%的变异。
小于胎龄儿即使不超重也往往存在内脏脂肪过多和低脂联素血症。因此，似乎需要采取体重控制以外的措施，以使大多数小于胎龄儿的身体成分和内分泌代谢稳态正常化。
