Objective. To investigate the relationship between weight catch-up growth and insulin sensitivity in small for gestational age (SGA) infants. Methods. Forty-four singleton SGA subjects met the inclusion criteria and finished-3-month followup. Body weight, length, fasting glucose, and fasting insulin (FI) levels were measured at 3 days and 3 months. Insulin sensitivity was evaluated by FI and homeostasis model assessment (HOMA). Results. According to the change of weight Z-score, forty-four subjects were divided into two groups: noncatch-up growth (NCUG) and catch-up growth (CUG). By 3 months of age, the body weight, body length and BMI of NCUG group were significantly lower than those of CUG group. The FI and HOMA were significantly higher in NCUG group. The change of weight Z-score during 3 months was inversely related to the HOMA at 3 months. Conclusion. Our data exemplified that no weight catch-up growth during the first 3 months was associated with impaired insulin sensitivity in SGA infants. 1. Introduction The term “small for gestational age” (SGA) is sometimes used synonymously with low birth weight, but actually it refers to a low birth weight with respect to gestational age read on references curves and not a low birth weight per se. During the past decades, dozens of epidemiological studies associated with low birth weight infants confirmed programming hypotheses first proposed by Barker et al. in 1989 [1]. During critical windows of intrauterine development, some deleterious stimuli, such as undernutrition or alterations in placental function, may induce permanent changes in cell/tissue structure and/or function. It indicates that factors distinct from gene inheritance can be modulated by unique events during the life of an individual and lead to permanent changes. Subsequently, it has been suggested that such “programming” events are not restricted to fetal life but may occur during several critical windows during development [2], such as the early postnatal period. Catch-up growth is the acceleration in growth of 85%–90% SGA infants soon after birth [3]. Maximum catch-up growth usually occurs in the first 6 months of life but may continue up to 2 years [4]. In more than 80% of infants born SGA, catch-up growth occurs during the first 6 months of life. For this reason, growth monitoring during the early postnatal period provides useful information, and different growth patterns may be identified in infants as young as 3 months of age. Rapid weight gain, or “catch-up”, was associated with a lower risk for hospital admission and lower
References
[1]
D. J. P. Barker, P. D. Winter, C. Osmond, B. Margetts, and S. J. Simmonds, “Weight in infancy and death from ischaemic heart disease,” Lancet, vol. 2, no. 8663, pp. 577–580, 1989.
[2]
L. Tappy, “Adiposity in children born small for gestational age,” International Journal of Obesity, vol. 30, supplement 4, pp. S36–S40, 2006.
[3]
K. Albertsson-Wikland, M. Boguszewski, and J. Karlberg, “Children born small-for-gestational age: postnatal growth and hormonal status,” Hormone Research, vol. 49, supplement 2, pp. 7–13, 1998.
[4]
J. P. E. Karlberg, K. Albertsson-Wikland, E. Y. W. Kwan, B. C. C. Lam, and L. C. K. Low, “The timing of early postnatal catch-up growth in normal, full-term infants born short for gestational age,” Hormone Research, vol. 48, supplement 1, pp. 17–24, 1997.
[5]
K. K. L. Ong, M. L. Ahmed, P. M. Emmett, M. A. Preece, and D. B. Dunger, “Association between postnatal catch-up growth and obesity in childhood: prospective cohort study,” British Medical Journal, vol. 320, no. 7240, pp. 967–971, 2000.
[6]
S. K. Bhargava, H. S. Sachdev, C. H. D. Fall et al., “Relation of serial changes in childhood body-mass index to impaired glucose tolerance in young adulthood,” New England Journal of Medicine, vol. 350, no. 9, pp. 865–875, 2004.
[7]
T. Forsén, J. G. Eriksson, J. Tuomilehto, C. Osmond, and D. J. P. Barker, “Growth in utero and during childhood among women who develop coronary heart disease: longitudinal study,” British Medical Journal, vol. 319, no. 7222, pp. 1403–1407, 1999.
[8]
D. R. Matthews, J. P. Hosker, A. S. Rudenski, B. A. Naylor, D. R. Treacher, and R. C. Turner, “Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man,” Diabetologia, vol. 28, no. 7, pp. 412–419, 1985.
[9]
H. C. Miller and K. Hassanein, “Diagnosis of impaired fetal growth in newborn infants,” Pediatrics, vol. 48, no. 4, pp. 511–522, 1971.
[10]
A. Pietrobelli, M. S. Faith, D. B. Allison, D. Gallagher, G. Chiumello, and S. B. Heymsfield, “Body mass index as a measure of adiposity among children and adolescents: a validation study,” Journal of Pediatrics, vol. 132, no. 2, pp. 204–210, 1998.
[11]
A. Singhal, M. Fewtrell, T. J. Cole, and A. Lucas, “Low nutrient intake and early growth for later insulin resistance in adolescents born preterm,” Lancet, vol. 361, no. 9363, pp. 1089–1097, 2003.
[12]
U. Ekelund, K. Ong, Y. Linné et al., “Upward weight percentile crossing in infancy and early childhood independently predicts fat mass in young adults: the Stockholm Weight Development Study (SWEDES),” American Journal of Clinical Nutrition, vol. 83, no. 2, pp. 324–330, 2006.
[13]
U. Ekelund, K. K. Ong, Y. Linné et al., “Association of weight gain in infancy and early childhood with metabolic risk in young adults,” Journal of Clinical Endocrinology and Metabolism, vol. 92, no. 1, pp. 98–103, 2007.
[14]
C. N. Hales and S. E. Ozanne, “The dangerous road of catch-up growth,” Journal of Physiology, vol. 547, no. 1, pp. 5–10, 2003.
[15]
N. Soto, R. A. Bazaes, V. Pe?a et al., “Insulin sensitivity and secretion are related to catch-up growth in small-for-gestational-age infants at age 1 year: results from a prospective cohort,” Journal of Clinical Endocrinology and Metabolism, vol. 88, no. 8, pp. 3645–3650, 2003.
[16]
D. J. P. Barker, C. Osmond, T. J. Forsén, E. Kajantie, and J. G. Eriksson, “Trajectories of growth among children who have coronary events as adults,” New England Journal of Medicine, vol. 353, no. 17, pp. 1802–1809, 2005.
[17]
J. G. Eriksson, T. Forsén, J. Tuomilehto, C. Osmond, and D. J. P. Barker, “Early growth and coronary heart disease in later life: longitudinal study,” British Medical Journal, vol. 322, no. 7292, pp. 949–953, 2001.
[18]
L. Ibá?ez, K. Ong, D. B. Dunger, and F. De Zegher, “Early development of adiposity and insulin resistance after catch-up weight gain in small-for-gestational-age children,” Journal of Clinical Endocrinology and Metabolism, vol. 91, no. 6, pp. 2153–2158, 2006.