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产前生长受限和产后追赶生长的顺序:心脏正常,但婴儿晚期内膜中层增厚且腹膜前脂肪增多。

The sequence of prenatal growth restraint and postnatal catch-up growth: normal heart but thicker intima-media and more pre-peritoneal fat in late infancy.

作者信息

Sebastiani G, García-Beltran C, Pie S, Guerra A, López-Bermejo A, de Toledo J S, de Zegher F, Rosés F, Ibáñez L

机构信息

Endocrinology Unit, Pediatric Research Institute Sant Joan de Déu, University of Barcelona, Esplugues, Spain.

Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Health Institute Carlos III, Madrid, Spain.

出版信息

Pediatr Obes. 2019 Mar;14(3):e12476. doi: 10.1111/ijpo.12476. Epub 2018 Oct 25.

Abstract

BACKGROUND

The sequence of prenatal growth restraint and postnatal catch-up growth leads to a thicker intima-media and more pre-peritoneal fat by age 3-6 years.

OBJECTIVES

To study whether carotid intima-media thickness (cIMT) and pre-peritoneal fat differ already between catch-up small-for-gestational-age (SGA) infants and appropriate-for-gestational-age (AGA) controls in late infancy (ages 1 and 2 years) and whether such differences - if any - are accompanied by differences in cardiac morphology and function.

METHODS

Longitudinal assessments included body height and weight; fasting glucose, insulin, Insulin-like growth factor (IGF-I), high-molecular-weight adiponectin; body composition (by absorptiometry); cIMT, aortic IMT, pre-peritoneal fat partitioning (by ultrasound); cardiac morphometry and function (by echocardiography) in AGA and SGA infants at birth, at age 1 year (N = 87), and again at age 2 years (N = 68).

RESULTS

Catch-up SGA infants had already a thicker cIMT than AGA controls at ages 1 and 2 years, and more pre-peritoneal fat by age 2 years (all p values between <0.01 and <0.0001); all cardiac and endocrine-metabolic results were similar in AGA and SGA infants at ages 1 and 2 years.

CONCLUSIONS

From late infancy onwards, catch-up SGA infants have a thicker cIMT and more pre-peritoneal fat than AGA controls, but their cardiac morphology and function remain reassuringly similar.

摘要

背景

产前生长受限及产后追赶生长的过程会导致3至6岁时内膜中层增厚及腹膜前脂肪增多。

目的

研究在婴儿晚期(1岁和2岁),追赶生长的小于胎龄儿(SGA)与适于胎龄儿(AGA)对照之间颈动脉内膜中层厚度(cIMT)和腹膜前脂肪是否已经存在差异,以及此类差异(若存在)是否伴有心脏形态和功能的差异。

方法

纵向评估包括身高和体重;空腹血糖、胰岛素、胰岛素样生长因子(IGF-I)、高分子量脂联素;身体成分(通过吸收测定法);cIMT、主动脉IMT、腹膜前脂肪分布(通过超声);对AGA和SGA婴儿在出生时、1岁时(N = 87)以及2岁时(N = 68)进行心脏形态测量和功能(通过超声心动图)评估。

结果

追赶生长的SGA婴儿在1岁和2岁时cIMT就已经比AGA对照更厚,到2岁时腹膜前脂肪更多(所有p值在<0.01至<0.0001之间);1岁和2岁时AGA和SGA婴儿的所有心脏及内分泌代谢结果相似。

结论

从婴儿晚期起,追赶生长的SGA婴儿比AGA对照的cIMT更厚且腹膜前脂肪更多,但他们的心脏形态和功能仍令人放心地相似。

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