Torre P, Ladaki C, Scirè G, Spadoni G L, Cianfarani S
Rina Balducci Center of Pediatric Endocrinology, Department of Public Health and Cell Biology, Tor Vergata University, Rome, Italy.
J Endocrinol Invest. 2008 Sep;31(9):760-4. doi: 10.1007/BF03349254.
Low birth weight is a risk factor for coronary heart disease. Persons who have coronary events as adults tend to have been small at birth and thin at 2 yr of age, after which they tended to increase their body mass index (BMI). Our aim was to determine whether BMI gain is associated to alterations in insulin sensitivity and/or lipid profile in children born small for gestational age (SGA).
Retrospective case-control study.
We studied 78 children (mean age 7.8+/-2.5 yr): 26 SGA children with catch-up growth in BMI (CGB-SGA) (BMI= 10th to 75th centile), 26 SGA without catch-up growth (NCGB-SGA) (BMI<10th centile), and 26 appropriate for gestational age (AGA) control children (BMI: 10th to 75th centile). For each CGB-SGA child, we selected an NCGB-SGA and an AGA child of the same gender, age (within 1 yr), and pubertal status. SGA children were also subdivided into 2 groups according to post-natal catch-up growth in height (CGH).
Glucose was significantly lower in NCGBSGA than AGA group (p=0.02). No significant differences in fasting insulin, fasting glucose/insulin ratio, homeostasis model assessment, quantitative insulin-sensitivity check index, and lipid profile were found among the 3 groups. HDL-cholesterol proved significantly reduced in SGA children with post-natal CGH (p=0.02).
Our findings do not support the hypothesis of early alterations in insulin sensitivity and lipid metabolism in CGB-SGA subjects during childhood provided that BMI remains within the normal range. Finally, the finding of reduced HDL-cholesterol levels in CGH-SGA children suggests detrimental metabolic effects of the height gain.
低出生体重是冠心病的一个危险因素。成年后发生冠心病事件的人往往出生时体型小，2岁时消瘦，此后他们的体重指数（BMI）往往会增加。我们的目的是确定BMI增加是否与小于胎龄儿（SGA）出生的儿童胰岛素敏感性和/或血脂谱的改变有关。
回顾性病例对照研究。
我们研究了78名儿童（平均年龄7.8±2.5岁）：26名BMI有追赶生长的SGA儿童（CGB-SGA）（BMI=第10至75百分位数），26名无追赶生长的SGA儿童（NCGB-SGA）（BMI<第10百分位数），以及26名适于胎龄（AGA）对照儿童（BMI：第10至75百分位数）。对于每一名CGB-SGA儿童，我们选择一名性别、年龄（1岁以内）和青春期状态相同的NCGB-SGA儿童和一名AGA儿童。SGA儿童也根据出生后身高的追赶生长（CGH）分为两组。
NCGB-SGA组的葡萄糖水平显著低于AGA组（p=0.02）。三组之间在空腹胰岛素、空腹血糖/胰岛素比值、稳态模型评估、定量胰岛素敏感性检查指数和血脂谱方面未发现显著差异。出生后有CGH的SGA儿童的高密度脂蛋白胆固醇显著降低（p=0.02）。
我们的研究结果不支持BMI保持在正常范围内的CGB-SGA受试者在儿童期胰岛素敏感性和脂质代谢早期改变的假设。最后，CGH-SGA儿童高密度脂蛋白胆固醇水平降低的发现表明身高增加具有有害的代谢影响。
